Links of Common Infections with Sleep in Middle-Aged and Older Adults: Modification by Race in the Baltimore Epidemiologic Catchment Area Study

ObjectivesTo determine associations of common infections with self-reported sleep and explore whether these links differ by race in a diverse cohort. MethodsWe studied 602 participants from the Baltimore Epidemiologic Catchment Area Study (mean age 59.0{+/-}12.8 years; 36.9% male; 35.6% minoritized adults) with data on common infections (IgG antibodies to herpes simplex virus type 1, cytomegalovirus, varicella zoster virus, Epstein-Barr virus, and Toxoplasma gondii) and self-reported symptoms of insomnia (i.e., difficulty falling or staying asleep and early awakening), hypersomnia, and sleep duration. ResultsWe observed differences by race in the association of common infections with sleep disturbances (p-values for interactions<0.05). In fully-adjusted models, among White participants, those who were seropositive for CMV had 51% higher odds of insomnia symptoms (OR=1.51, 95% CI: 0.88, 2.60) and 26% higher odds of early awakening (OR=1.26, 95% CI: 0.67, 2.39). Among minoritized adults, however, CMV seropositivity was associated with 75% lower odds of insomnia symptoms (OR=0.25, 95% CI: 0.09, 0.67) and 73% lower odds of early awakening (OR=0.27, 95% CI: 0.10, 0.74). Seropositivity for a higher number of infections ({beta}=0.24, 95% CI: -0.01, 0.48) or for TOX alone ({beta}=0.64, 95% CI: 0.08, 1.20) was associated with longer sleep among minoritized participants, but shorter sleep among White participants. ConclusionsIn middle-aged and older adults, common infections are differentially associated with sleep disturbances and duration, with infections linked to better sleep profiles and longer sleep among minoritized adults, but poorer sleep among White adults. Research is needed to identify the sources of these differences.