Sleep, Inflammation & Mental Health in Modern Society: PSYCHONEUROIMMUNE PATHWAYS

It is well documented that psychosocial stressors and sleep have a reciprocal relationship and both are identified determinants of mental health. Research to elucidate the biological mechanisms underlying these associations are essential to reducing socioeconomic disparities in health. Compelling hypotheses have been put forward to explain these relationships, including the hypothalamic-pituitary stress system, a hallmark in the stress response, and inflammation. However, psychoneuroimmune pathways, have been proposed as a more proximal mechanism, with changes seen to cellular, molecular and epigenetic forms of plasticity. The stressors of modern society are postulated to provoke this downward trajectory of effects. Stress poses risk to adaptive sleep routines, and these disruptions to sleep cycles have neuroimmune implications, with downstream associations to psychological distress and psychopathology on a continuum of severity. It is therefore submitted that maladaptive sleep impacts the causal pathway between stress and mental ill-health by modulating neuroimmune processes. The significance of the differences in outcome symptomology and severity is unknown, but this heterogeneity in psychological presentation suggests a gene-environmental interaction.