Sono e imunidade: uma conexão vital para a saúde humana
Sleep and immunity: a vital connection for human health
Bruno Emanuel Carvalho Oliveira
Resumo
A revisão literária apresentada aborda a relação entre sono, imunidade e doenças alérgicas, enfatizando os impactos da privação de sono em diferentes faixas etárias e suas implicações clínicas. A pesquisa incluiu artigos originais, revisões narrativas e sistemáticas, e metanálises publicadas entre 2005 e 2024, encontrados em bases como PubMed, SciELO, Bireme e Google Scholar. Os critérios de inclusão englobaram estudos sobre os efeitos do sono no sistema imunológico e nas doenças alérgicas. Essa revisão foi feita dada a atualidade e importância do tema. Os resultados indicam que a privação crônica de sono afeta negativamente a imunidade, aumentando marcadores pró-inflamatórios, como proteína C-reativa e interleucina-6, e prejudicando a resposta imunológica. Estudos destacam que ciclos circadianos regulam funções imunológicas, sendo que a imunidade inata predomina durante o dia, enquanto a adaptativa é mais ativa à noite. Dormir menos de sete horas por noite tem sido associado a uma série de problemas de saúde, como doenças cardiovasculares, respiratórias, cognitivas, gastrointestinais, imunológicas, dermatológicas, musculoesqueléticas, obesidade, doenças renais, distúrbios reprodutivos e aumento do estresse. A dermatite atópica, rinite alérgica e asma afetam a qualidade do sono, com interrupções relacionadas à gravidade das doenças. Conclui-se que o sono desempenha um papel essencial na regulação imunológica, evidenciando a necessidade de intervenções clínicas que valorizem a qualidade do sono e o alinhamento dos ritmos circadianos, com o objetivo de promover uma saúde imunológica equilibrada e minimizar o risco de doenças crônicas.
Palavras-chave
Abstract
This literature review examines the relationship between sleep, immunity, and allergic diseases, emphasizing the impacts of sleep deprivation across different age groups and its clinical implications. The search included original articles, narrative and systematic reviews, and meta-analyses published between 2005 and 2024, retrieved from databases such as PubMed, SciELO, Bireme, and Google Scholar. Inclusion criteria comprised studies addressing the effects of sleep on the immune system and allergic diseases. This review was conducted in light of the timeliness and relevance of the topic. The findings indicate that chronic sleep deprivation negatively affects immunity by increasing pro-inflammatory markers, such as C-reactive protein and interleukin-6, and impairing immune responses. Studies highlight that circadian cycles regulate immune functions, with innate immunity predominating during daytime and adaptive immunity being more active at night. Sleeping fewer than 7 hours per night has been associated with a range of health problems, including cardiovascular, respiratory, cognitive, gastrointestinal, immunological, dermatological, and musculoskeletal disorders, as well as obesity, kidney disease, reproductive disorders, and increased stress. Atopic dermatitis, allergic rhinitis, and asthma affect sleep quality, with sleep disruption correlating with disease severity. In conclusion, sleep plays a crucial role in immune regulation, underscoring the need for clinical interventions that prioritize sleep quality and circadian rhythm alignment to promote balanced immune health and reduce the risk of chronic diseases.
Keywords
Referências
1. Itani O, Jike M, Watanabe N, Kaneita Y. Short sleep duration and health outcomes: a systematic review, meta-analysis, and metaregression. Sleep Med. 2017;32:246-56.
2. Besedovsky L, Lange T, Haack M. The sleep-immune crosstalk in health and disease. Physiol Rev. 2019;99(3):1325-80.
3. Dickens C. Barnaby Rudge. London: Chapman and Hall; 1841.
4. Schoenborn CA, Adams PE. Health behaviors of adults: United States, 2005-2007. Vital Health Stat 10. 2010 Mar;(245):1-132.
5. Kolla BP, He JP, Mansukhani MP, Frye MA, Merikangas K. Excessive sleepiness and associated symptoms in the U.S. adult population: prevalence, correlates, and comorbidity. Sleep Health. 2020 Feb;6(1):79-87. doi: 10.1016/j.sleh.2019.09.004. Referências
6. Ng TP, Tan WC. Prevalence and determinants of excessive daytime sleepiness in an Asian multi-ethnic population. Sleep Med. 2005;6:523-9.
7. Luyster FS, Strollo PJ Jr, Zee PC, Walsh JK; Boards of Directors of the American Academy of Sleep Medicine and the Sleep Research Society. Sleep: a health imperative. Sleep. 2012 Jun 1;35(6):727-34. doi: 10.5665/sleep.1846.
8. Lan QY, Chan KC, Yu KN, Chan NY, Wing YK, Li AM, et al. Sleep duration in preschool children and impact of screen time. Sleep Med. 2020;76:48-54.
9. Palma BD, Tiba PA, Machado RB, Tufik S, Suchecki D. Immune outcomes of sleep disorders: the hypothalamic-pituitary-adrenal axis as a modulatory factor. Rev Bras Psiquiatr. 2007;29(Suppl 1):S33-8.
10. Irwin MR. Why Sleep Is Important for Health: A Psychoneuroimmunology Perspective. Annual Review of Psychology. 2015;66(1):143‑72.
11. Grandner MA, Drummond SPA. Who are the long sleepers? Towards an understanding of the mortality relationship. Sleep Medicine Reviews. 2007 Oct;11(5):341-60.
12. Walker MP. The role of sleep in cognition and emotion. Ann N Y Acad Sci. 2009 Mar;1156:168-97. doi: 10.1111/j.1749- 6632.2009.04416.x.
13. Garbarino S, Lanteri P, Bragazzi NL, Magnavita N, Scoditti E. Role of sleep deprivation in immune-related disease risk and outcomes. Commun Biol. 2021 Nov 18;4(1):1304. doi: 10.1038/s42003-021- 02825-4.
14. Liew SC, Aung T. Sleep deprivation and its association with diseases – a review. Sleep Med. 2021;77:192-204. doi 10.1016/j. sleep.2020.07.048.
15. Kocevska D, Lysen TS, Dotinga A, Koopman-Verhoeff ME, Luijk MP, Antypa N, et al. Sleep characteristics across the lifespan in 1.1 million people from the Netherlands, United Kingdom and United States: a systematic review and meta-analysis. Nat Hum Behav. 2021;5(1):113-22. doi 10.1038/s41562-020-00965-x.
16. Farhud D, Aryan Z. Circadian rhythm, lifestyle and health: a narrative review. Iran J Public Health. 2018;47(8):1068-76.
17. Dumaine JE, Ashley NT. Acute sleep fragmentation induces tissuespecific changes in cytokine gene expression and increases serum corticosterone concentration. Am J Physiol Regul Integr Comp Physiol. 2015;308(12):R1062-9.
18. Singh KK, Ghosh S, Bhola A, Verma P, Amist AD, Sharma H, et al. Sleep and immune system crosstalk: implications for inflammatory homeostasis and disease pathogenesis. Ann Neurosci. 2024;31:1‑11.
19. Baranwal N, Yu PK, Siegel NS. Sleep physiology, pathophysiology, and sleep hygiene. Prog Cardiovasc Dis. 2023;77:59-69.
20. Paganelli R, Petrarca C, Di Gioacchino M. Biological clocks: their relevance to immune-allergic diseases. Clin Mol Allergy. 2018;16(1):1.
21. Nakao A. Circadian regulation of the biology of allergic disease: clock disruption can promote allergy. Front Immunol. 2020;11:1237.
22. Xi Y, Deng YQ, Chen SM, Kong YG, Xu Y, Li F, et al. Allergy-related outcomes and sleep-related disorders in adults: a cross-sectional study based on NHANES 2005-2006. Allergy Asthma Clin Immunol. 2022;18(1):27.
23. Fishbein AB, Mueller K, Kruse L, Boor P, Sheldon S, Zee P, et al. Sleep disturbance in children with moderate/severe atopic dermatitis: a case-control study. J Am Acad Dermatol. 2018;78(2):336-41.
24. Ramirez FD, Chen S, Langan SM, Prather AA, McCulloch CE, Kidd SA, et al. Association of atopic dermatitis with sleep quality in children. JAMA Pediatr. 2019;173(5):e190025.
25. Camfferman D, Kennedy JD, Gold M, Simpson C, Lushington K. Sleep and neurocognitive functioning in children with eczema. Int J Psychophysiol. 2013;89(2):265-72.
26. Reuveni H, Chapnick G, Tal A, Tarasiuk A. Sleep fragmentation in children with atopic dermatitis. Arch Pediatr Adolesc Med. 1999;153(3):249-53.
27. Lavie P, Gertner R, Zomer J, Podoshin L. Breathing disorders in sleep associated with “microarousals” in patients with allergic rhinitis. Acta Otolaryngol. 1981;92(5-6):529-33.
28. McNicholas WT, Tarlo S, Cole P, Zamel N, Rutherford R, Griffin D, et al. Obstructive apneas during sleep in patients with seasonal allergic rhinitis. Am Rev Respir Dis. 1982;126(4):625-8.
29. Young T, Finn L, Kim H. Nasal obstruction as a risk factor for sleepdisordered breathing. J Allergy Clin Immunol. 1997;99(2):757-62.
30. Liu J, Zhang X, Zhao Y, Wang Y. The association between allergic rhinitis and sleep: a systematic review and meta-analysis of observational studies. PLoS One. 2020;15(2):e0228533.
31. Xiang B, Hu M, Yu H, Zhang Y, Wang Q, Xue F. Highlighting the importance of healthy sleep patterns in the risk of adult asthma under the combined effects of genetic susceptibility: a large-scale prospective cohort study of 455,405 participants. BMJ Open Respir Res. 2023;10(1):e001535.
32. Ciftci TU, Ciftci B, Guven SF, Kokturk O, Turktas H. Effect of nasal continuous positive airway pressure in uncontrolled nocturnal asthmatic patients with obstructive sleep apnea syndrome. Respir Med. 2005;99(5):529-34.
33. Cukic V, Lovre V, Dragisic D. Sleep disorders in patients with bronchial asthma. Mater Sociomed. 2011;23(4):235-7.
34. Koinis-Mitchell D, Craig T, Esteban CA, Klein RB. Sleep and allergic disease: a summary of the literature and future directions for research. J Allergy Clin Immunol. 2012;130(6):1275-8.
35. Bawany F, Northcott CA, Beck LA, Pigeon WR. Sleep disturbances and atopic dermatitis: relationships, methods for assessment, and therapies. J Allergy Clin Immunol Pract. 2021;9(4):1488-500.
36. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update. Allergy. 2008;63(Suppl 86):8-160.
37. Taylor DR, Bateman ED, Boulet LP, Boushey HA, Busse WW, Casale TB, et al. A new perspective on concepts of asthma severity and control. Eur Respir J. 2008;32(3):545-54.
38. Reddel HK, Taylor DR, Bateman ED, Boulet LP, Boushey HA, Busse WW, et al. An official American Thoracic Society/European Respiratory Society statement: asthma control and exacerbations: standardizing endpoints for clinical asthma trials and clinical practice. Am J Respir Crit Care Med. 2009;180(1):59-99.
39. Menzies-Gow A, Bafadhel M, Busse WW, Casale TB, Kocks JWH, Pavord ID, et al. An expert consensus framework for asthma remission as a treatment goal. J Allergy Clin Immunol. 2020;145(3):757-65.
40. Global Initiative for Asthma. Global strategy for asthma management and prevention [Internet]. 2022. Disponível em: https://ginasthma. org/.
41. Ambrose Y, Lim JJ, Ng JY, Ying Y, Sio YY, Chew FT. Sleep and allergic diseases among young Chinese adults from the Singapore/ Malaysia Cross-Sectional Genetic Epidemiology Study cohort. J Physiol Anthropol. 2024;43(1):1-10.
Submetido em:
28/01/2025
Aceito em:
22/04/2025
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