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Cognitive Behavioral Therapy and Tai Chi Reverse Cellular and Genomic Markers of Inflammation in Late Life Insomnia: A Randomized Controlled Trial

BACKGROUND: Sleep disturbance is associated with activation of systemic and cellular inflammation, as well as pro-inflammatory transcriptional profiles in circulating leukocytes. Whether treatments that target insomnia-related complaints might reverse these markers of inflammation in older adults wi...

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Autores principales: Irwin, Michael R., Olmstead, Richard, Breen, Elizabeth C., Witarama, Tuff, Carrillo, Carmen, Sadeghi, Nina, Arevalo, Jesusa M. G., Ma, Jeffrey, Nicassio, Perry, Bootzin, Richard, Cole, Steve
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524803/
https://www.ncbi.nlm.nih.gov/pubmed/25748580
http://dx.doi.org/10.1016/j.biopsych.2015.01.010
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author Irwin, Michael R.
Olmstead, Richard
Breen, Elizabeth C.
Witarama, Tuff
Carrillo, Carmen
Sadeghi, Nina
Arevalo, Jesusa M. G.
Ma, Jeffrey
Nicassio, Perry
Bootzin, Richard
Cole, Steve
author_facet Irwin, Michael R.
Olmstead, Richard
Breen, Elizabeth C.
Witarama, Tuff
Carrillo, Carmen
Sadeghi, Nina
Arevalo, Jesusa M. G.
Ma, Jeffrey
Nicassio, Perry
Bootzin, Richard
Cole, Steve
author_sort Irwin, Michael R.
collection PubMed
description BACKGROUND: Sleep disturbance is associated with activation of systemic and cellular inflammation, as well as pro-inflammatory transcriptional profiles in circulating leukocytes. Whether treatments that target insomnia-related complaints might reverse these markers of inflammation in older adults with insomnia is not known. METHODS: In this randomized trial, 123 older adults with insomnia were randomly assigned to cognitive behavioral therapy for insomnia (CBT-I), tai chi chih (TCC), or sleep seminar education active control condition (SS) for two hour sessions weekly over 4 months with follow-up at 7- and 16-months. We measured C-reactive protein (CRP) at baseline, month 4 and 16, Toll-like receptor-4 (TLR-4)-activated monocyte production of proinflammatory cytokines at baseline, month 2, 4, 7, and 16, and genome-wide transcriptional profiling at baseline and month 4. RESULTS: As compared to SS active control, CBT-I reduced levels of CRP (month 4, 16, P’s<0.05), monocyte production of proinflammatory cytokines (month 2 only, P<0.05), and pro-inflammatory gene expression (month 4, P<0.01). TCC marginally reduced CRP (month 4, P=0.06), and significantly reduced monocyte production of proinflammatory cytokines (month 2, 4, 7, 16, all P’s<0.05) and proinflammatory gene expression (month 4, P<0.001). In CBT and TCC, TELIS promoter-based bioinformatics analyses indicated reduced activity of nuclear factor (NF)-κB and AP1. CONCLUSIONS: Among older adults with insomnia, CBT-I reduced systemic inflammation, TCC reduced cellular inflammatory responses, and both treatments reduced expression of genes encoding proinflammatory mediators. The findings provide an evidence-based molecular framework to understand the potential salutary effects of insomnia treatment on inflammation, with implications for inflammatory disease risk.
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spelling pubmed-45248032016-11-15 Cognitive Behavioral Therapy and Tai Chi Reverse Cellular and Genomic Markers of Inflammation in Late Life Insomnia: A Randomized Controlled Trial Irwin, Michael R. Olmstead, Richard Breen, Elizabeth C. Witarama, Tuff Carrillo, Carmen Sadeghi, Nina Arevalo, Jesusa M. G. Ma, Jeffrey Nicassio, Perry Bootzin, Richard Cole, Steve Biol Psychiatry Article BACKGROUND: Sleep disturbance is associated with activation of systemic and cellular inflammation, as well as pro-inflammatory transcriptional profiles in circulating leukocytes. Whether treatments that target insomnia-related complaints might reverse these markers of inflammation in older adults with insomnia is not known. METHODS: In this randomized trial, 123 older adults with insomnia were randomly assigned to cognitive behavioral therapy for insomnia (CBT-I), tai chi chih (TCC), or sleep seminar education active control condition (SS) for two hour sessions weekly over 4 months with follow-up at 7- and 16-months. We measured C-reactive protein (CRP) at baseline, month 4 and 16, Toll-like receptor-4 (TLR-4)-activated monocyte production of proinflammatory cytokines at baseline, month 2, 4, 7, and 16, and genome-wide transcriptional profiling at baseline and month 4. RESULTS: As compared to SS active control, CBT-I reduced levels of CRP (month 4, 16, P’s<0.05), monocyte production of proinflammatory cytokines (month 2 only, P<0.05), and pro-inflammatory gene expression (month 4, P<0.01). TCC marginally reduced CRP (month 4, P=0.06), and significantly reduced monocyte production of proinflammatory cytokines (month 2, 4, 7, 16, all P’s<0.05) and proinflammatory gene expression (month 4, P<0.001). In CBT and TCC, TELIS promoter-based bioinformatics analyses indicated reduced activity of nuclear factor (NF)-κB and AP1. CONCLUSIONS: Among older adults with insomnia, CBT-I reduced systemic inflammation, TCC reduced cellular inflammatory responses, and both treatments reduced expression of genes encoding proinflammatory mediators. The findings provide an evidence-based molecular framework to understand the potential salutary effects of insomnia treatment on inflammation, with implications for inflammatory disease risk. 2015-02-04 2015-11-15 /pmc/articles/PMC4524803/ /pubmed/25748580 http://dx.doi.org/10.1016/j.biopsych.2015.01.010 Text en http://creativecommons.org/licenses/by-nc/4.0/ This manuscript version is made available under the CC BY-NC-ND 4.0 license.
spellingShingle Article
Irwin, Michael R.
Olmstead, Richard
Breen, Elizabeth C.
Witarama, Tuff
Carrillo, Carmen
Sadeghi, Nina
Arevalo, Jesusa M. G.
Ma, Jeffrey
Nicassio, Perry
Bootzin, Richard
Cole, Steve
Cognitive Behavioral Therapy and Tai Chi Reverse Cellular and Genomic Markers of Inflammation in Late Life Insomnia: A Randomized Controlled Trial
title Cognitive Behavioral Therapy and Tai Chi Reverse Cellular and Genomic Markers of Inflammation in Late Life Insomnia: A Randomized Controlled Trial
title_full Cognitive Behavioral Therapy and Tai Chi Reverse Cellular and Genomic Markers of Inflammation in Late Life Insomnia: A Randomized Controlled Trial
title_fullStr Cognitive Behavioral Therapy and Tai Chi Reverse Cellular and Genomic Markers of Inflammation in Late Life Insomnia: A Randomized Controlled Trial
title_full_unstemmed Cognitive Behavioral Therapy and Tai Chi Reverse Cellular and Genomic Markers of Inflammation in Late Life Insomnia: A Randomized Controlled Trial
title_short Cognitive Behavioral Therapy and Tai Chi Reverse Cellular and Genomic Markers of Inflammation in Late Life Insomnia: A Randomized Controlled Trial
title_sort cognitive behavioral therapy and tai chi reverse cellular and genomic markers of inflammation in late life insomnia: a randomized controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524803/
https://www.ncbi.nlm.nih.gov/pubmed/25748580
http://dx.doi.org/10.1016/j.biopsych.2015.01.010
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