1044 Immune Dysregulation in Sleep Deprivation: A Literature Review on Inflammatory Activation, Infection Risk, and Public Health Implications

Abstract Introduction Sleep is essential for metabolic, cognitive, and immunological homeostasis. Strong evidence has emerged over the past decade which quantifies the impact of chronic sleep deprivation and poor sleep quality on healthy immune functioning. In contrast, how sleep deprivation may increase susceptibility to infection is less well-known. Herein, we review literature about how acute and chronic sleep deprivation affects immune cells, inflames bodies, and makes humans susceptible to viral and bacterial infections. Methods We searched PubMed, Scopus, and Google Scholar using keywords sleep deprivation, immune function, cytokines, and infection risk across 2013-2025. We prioritized controlled laboratory studies, epidemiological population studies, and mechanistic reviews corroborating the findings of epidemiological studies. Studies were excluded if they focused on cognitive performance, psychiatric disorders, or circadian disruption, without immune endpoints. Results Multiple studies have demonstrated that sleep deprivation elevates the pro-inflammatory cytokines IL-6, TNF-α, and CRP, indicating systemic inflammation in the body. Studies restricting sleep in the laboratory reduced NK cell cytotoxicity with sleep deprivation. This reduction happened as early as 24 hours of sleep loss. In large epidemiologic studies, adults reporting less than 6 hours sleep per night were 3 to 4 times more likely to develop viral upper respiratory infection after exposure to a virus than controls with well-sleeping habits. Another study found impaired adaptive immunity among other effects, including decreased antibody response to vaccination, decreased T-cell activation, and decreased immunologic memory. Insufficient chronic sleep has also been correlated with susceptibility to infection by influenza, poor recovery from infection, and hospitalization. Additionally, in several studies, structural risk factors such as shift work, low socioeconomic status, and environmental noise exposure contributed to population-level sleep deprivation and risk of infection. Conclusion There is substantial evidence that sleep deprivation may compromise immunity through pro-inflammatory responses, impaired antiviral immunity and attenuated responses to vaccines, each of which appears biologically plausible. Findings support public-health efforts to reduce sleep inequity, champion sleep hygiene, promote preventive sleep education, and motivate research into the long-term impacts of poor sleep among the most risk-averse people and whether sleep interventions may provide heightened immune resilience. Support (if any) None