Sleep and Inflammation Bidirectional Relationship

There is a bidirectional relationship between sleep and inflammation. Inflammatory cytokines follow a circadian rhythm and the most pronounced are the TNF and IL-6. In return, these cytokines, when excreted during the day in situations of illness or irregular sleep, can cause sleepiness and fatigue. Interrupted sleep, either because of physiologic reasons, such as OSAS, or behavioral causes, such as irregular or short sleep, has cardiovascu-lar, metabolic, and most commonly in pediatrics, cognitive consequences. The line that connects between these sleep consequences is inflamma-tion. In this article, the author discussed the known inflammatory agents that cause the morbidity associated with interrupted sleep, both in the local and systemic level, and showed the mechanisms by which they exert their effect. There has been a significant effort in the past few decades to diag-nose and treat sleep-related illnesses, such as OSAS. However, the concept of irregular sleep and short sleep in childhood triggering inflamma-tion and causing equivalent consequences is sig-nificant and needs to drive a push for evaluation of normal sleep by pediatricians and other medical providers.