Double whammy for grieving spouses with sleep problems

November 08, 2018

CHICAGO --- Sleep disturbances have a strong negative impact on the immune system of people who have recently lost a spouse, reports a new study from Northwestern Medicine and Rice University.

The overactivated immune system of the bereaved triggered by sleep disturbances -- and resulting chronic inflammation -- may make them more susceptible to heart disease or cancer, the study authors said. Grieving spouses have a higher risk of developing heart disease or dying within a year of their loved one's death.

The study, Project Heart, compared recent widows or widowers with sleep disturbances such as insomnia to married or single individuals with sleep disturbances. The association between sleep disturbances and inflammation was two to three times higher in the grieving spouses.

"We think these individuals are more vulnerable to the negative effects of poor sleep," said corresponding author Diana Chirinos, research assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine. "They have been hit twice. The death of a spouse is an acutely stressful event, and they have to adapt to living without the support of the spouse. Add sleep disturbance to their already stressful situation, and you double the stressor. As a result, their immune system is more overactivated."

Chirinos conducted the study, published recently in Psychosomatic Medicine, when she was a researcher at Rice. It adds to previously published research showing individuals who have lost a spouse within the past three months have higher levels of pro-inflammatory cytokines (immune markers that indicate inflammation in the bloodstream) and lower heart rate variability. Both increase an individual's risk for cardiac events, including death. Heart rate variability is the variation in time between each heartbeat.

"We already knew bereaved people had higher inflammation and a higher risk for heart disease and dying within a year of the spouse's death," said Chirinos. "But what was causing it? Was it the grief or sadness itself, loneliness or sleep?

"Now we know it's not the grief itself; it is the sleep disturbance that arises from that grief."

The main sleep disturbance driving the overactivated immune system was poor sleep efficiency, which can include insomnia, early waking or difficulty falling asleep. The study controlled for other factors such as depression, obesity and comorbid medical conditions.

The overactive immune system was measured by the level of pro-inflammatory cytokines. These cells help fight disease in the short term, but long term are associated with risk of developing heart disease and cancer.

The study looked at 101 individuals, average age 67. Half were identified through obituaries after they lost a spouse. The other half were the same age but were married or single.

One caveat of the study is that researchers used a measure of self-reported sleep, Chirinos said. "We don't know if an objective measure of sleep would have the same results," she said.

The results show the importance of getting treatment for sleep problems for the bereaved.

"Sleep problems may be most detrimental to health after losing a spouse," Chirinos said. "If someone is experiencing sleep problems shortly after the loss of a spouse, it's important for them to seek treatment."

Cognitive behavioral therapy is offered in all sleep clinics and is highly effective, added Chirinos.

Physicians need to ask patients about their sleep following the death of a spouse, Chirinos said. "It's important to catch this problem early."
-end-
Other authors are Dr. Jason Ong, from Northwestern, senior author Chris Fagundes and Luz Garcini at Rice, and Daisy Alvarado at The University of Texas at El Paso.

The study was supported by grant 1R01HL127260-01from National Heart, Lung and Blood Institute of the National Institutes of Health.

More News at Northwestern Now
Find experts on our Faculty Experts Hub
Follow @NUSources for expert perspectives
http://news.feinberg.northwestern.edu/tag/press-release/

Northwestern University

Related Immune System Articles from Brightsurf:

How the immune system remembers viruses
For a person to acquire immunity to a disease, T cells must develop into memory cells after contact with the pathogen.

How does the immune system develop in the first days of life?
Researchers highlight the anti-inflammatory response taking place after birth and designed to shield the newborn from infection.

Memory training for the immune system
The immune system will memorize the pathogen after an infection and can therefore react promptly after reinfection with the same pathogen.

Immune system may have another job -- combatting depression
An inflammatory autoimmune response within the central nervous system similar to one linked to neurodegenerative diseases such as multiple sclerosis (MS) has also been found in the spinal fluid of healthy people, according to a new Yale-led study comparing immune system cells in the spinal fluid of MS patients and healthy subjects.

COVID-19: Immune system derails
Contrary to what has been generally assumed so far, a severe course of COVID-19 does not solely result in a strong immune reaction - rather, the immune response is caught in a continuous loop of activation and inhibition.

Immune cell steroids help tumours suppress the immune system, offering new drug targets
Tumours found to evade the immune system by telling immune cells to produce immunosuppressive steroids.

Immune system -- Knocked off balance
Instead of protecting us, the immune system can sometimes go awry, as in the case of autoimmune diseases and allergies.

Too much salt weakens the immune system
A high-salt diet is not only bad for one's blood pressure, but also for the immune system.

Parkinson's and the immune system
Mutations in the Parkin gene are a common cause of hereditary forms of Parkinson's disease.

How an immune system regulator shifts the balance of immune cells
Researchers have provided new insight on the role of cyclic AMP (cAMP) in regulating the immune response.

Read More: Immune System News and Immune System Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.