Sleep duration prior to an enterotoxigenic Escherichia coli challenge predicts diarrhea severity during infection

Janna Mantua; Ramiro L Gutierrez; Sandra D Isidean; Ashley N Alcala; Kayla J Testa; Kawsar R Talaat; Tracy Jill Doty; Chad K Porter

doi:10.1016/j.sleep.2022.09.008

Sleep duration prior to an enterotoxigenic Escherichia coli challenge predicts diarrhea severity during infection

Sleep Med. 2022 Dec:100:404-409. doi: 10.1016/j.sleep.2022.09.008. Epub 2022 Sep 16.

Authors

Janna Mantua¹, Ramiro L Gutierrez², Sandra D Isidean³, Ashley N Alcala³, Kayla J Testa³, Kawsar R Talaat⁴, Tracy Jill Doty⁵, Chad K Porter²

Affiliations

¹ Walter Reed Army Institute of Research, Behavioral Biology Branch, Silver Spring, MD, 20910, USA. Electronic address: janna.mantua@gmail.com.
² Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, 20910, USA.
³ Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, 20910, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, 20817, USA.
⁴ Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
⁵ Walter Reed Army Institute of Research, Behavioral Biology Branch, Silver Spring, MD, 20910, USA.

PMID: 36240601
DOI: 10.1016/j.sleep.2022.09.008

Abstract

Background: Acute diarrhea is the most frequent diagnosis among ill travelers. Sleep loss may weaken the body's defense against pathogens and increase susceptibility to infection. The relationship between sleep and infectious diarrhea has not been studied and was assessed utilizing data from a controlled human infection model (CHIM) for enterotoxigenic Escherichia coli (ETEC).

Methods: During a CHIM assessing the efficacy of an immunoprophylactic targeting ETEC against moderate-to-severe diarrhea (MSD) following challenge, we measured sleep via actigraphy over an 8-day inpatient period. We hypothesized better sleep pre-challenge would predict illness symptomatology following challenge.

Results: Among 57 participants (aged 34.4 ± 8.1 years, 64% male), there was no relationship between sleep metrics and incidence of MSD. However, longer total sleep time the night preceding ETEC challenge was associated with lower maximum 24 h diarrhea volume (B = -1.80, p = 0.01) and total diarrhea volume (B = -2.45, p = 0.01).

Conclusions: This novel study showed that shorter sleep duration predicted diarrhea severity over the course of an ETEC infection. Future work should experimentally manipulate sleep to further clarify its impact on diarrhea-related outcomes for ETEC and other important enteric pathogens.

Keywords: A; C; ETEC; Sleep; T; cute diarrhea; ontrolled human infection model; raveler's diarrhea.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Antibodies, Bacterial
Diarrhea / prevention & control
Enterotoxigenic Escherichia coli*
Escherichia coli Infections* / prevention & control
Female
Humans
Male
Sleep

Substances

Antibodies, Bacterial