Sleep duration and systemic inflammation assessed using the systemic inflammation response index: The National Health and Nutrition Examination Survey 2017-2020 and 2021-2023.

Authors

Hao Hu, Shaomin Cheng, Yidong Chen, Rui Xie

Published in

The Journal of international medical research. Volume 54. Issue 11. Pages 3000605261505176. Epub Nov 12, 2026.

Abstract

ObjectiveTo examine the association between usual weekday/workday sleep duration and the systemic inflammation response index among adults reporting at least 7 h of sleep while assessing the influence of questionnaire coding and complex survey design.MethodsThis cross-sectional secondary analysis included 10,971 participants aged ≥18 years from the National Health and Nutrition Examination Survey January 2017 to March 2020 and August 2021 to August 2023 cycles. The systemic inflammation response index was calculated as monocyte count × neutrophil count/lymphocyte count. Unweighted pooled linear models were retained as exploratory analyses after correcting smoking skip-pattern and special-response coding; the fully adjusted sample comprised 9051 participants. Survey-weighted regressions were fitted separately by period using the appropriate examination or phlebotomy weight, strata, and primary sampling units. An existing smooth curve was retained for descriptive purposes, not threshold inference.ResultsIn the corrected pooled fully adjusted model, each additional reported hour was associated with a 0.0371 higher systemic inflammation response index (95% confidence interval: 0.0198-0.0544; p < 0.001). The corresponding period-specific survey-weighted estimates were 0.0246 (95% confidence interval: -0.0108, 0.0601; p = 0.165) before the pandemic and 0.0529 (95% confidence interval: 0.0126-0.0933; p = 0.014) in 2021-2023. Fully adjusted log-Systemic inflammation response index analyses did not reach statistical significance (p < 0.05) in either period. The visual downturn near 11 h was not a formally estimated threshold; only 195 participants reported ≥12 h of sleep.ConclusionsLonger reported sleep within the ≥7 h range was positively associated with the systemic inflammation response index in exploratory pooled analyses; however, period-specific and outcome-scale checks did not provide uniformly significant evidence. These findings are hypothesis-generating and do not establish causality, an optimal sleep duration, or an anti-inflammatory benefit of prolonged sleep duration.

PMID:
43016366
Bibliographic data and abstract were imported from PubMed on 12 Nov 2026.

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