Bidirectional Interaction of Sepsis and Sleep Disorders: The Underlying Mechanisms and Clinical Implications

De-Zhi Guo,1,* Yu Chen,1,* Yan Meng,2 Jin-Jun Bian,3 Yi Wang,3 Jia-Feng Wang3 1School of Basic Medicine, Naval Medical University, Shanghai, People’s Republic of China; 2Department of Intensive Care, Changhai Hospital, Naval Medical University, Shanghai, People’s Republic of China; 3Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yi Wang; Jia-Feng Wang, Email [email protected]; [email protected]: Sepsis is defined as life-threatening organ injury induced by infection, with high incidence and mortality. Sleep disorder is prevalent in septic patients and approximately 50% of patients with sepsis may develop atypical sleep patterns, but many of them may have been underdiagnosed by physicians. Sleep disorders and sepsis exhibit a close bidirectional relationship, with each condition significantly influencing the other. Conversely, sleep deprivation, sleep dysrhythmia and sleep fragmentation have been shown to impact the outcome of sepsis. This review endeavors to offer a comprehensive understanding of the intricate mechanisms that underpin the interplay between sepsis and sleep disorders, in addition to exploring potential clinical intervention strategies that could enhance outcomes for patients suffering from sepsis. Keywords: sepsis, sleep disorders, cytokines, clock genes, sepsis associated encephalopathy