Annals of Behavioral Medicine

, Volume 51, Issue 1, pp 137–146 | Cite as

Sleep Habits and Susceptibility to Upper Respiratory Illness: the Moderating Role of Subjective Socioeconomic Status

  • Aric A. PratherEmail author
  • Denise Janicki-Deverts
  • Nancy E. Adler
  • Martica Hall
  • Sheldon CohenEmail author
Original Article



Sleep is a predictor of infectious illness that may depend on one’s socioeconomic status (SES).


This study aimed to investigate the moderating effects of objective and subjective SES on sleep-clinical cold risk link and test whether nasal inflammation serves as a plausible biological pathway.


This study combined data (n = 732) from three viral challenge studies. Measures of self-reported sleep and objective and subjective measures of SES were obtained. Participants were quarantined and administrated rhinovirus (RV) or influenza virus and monitored over 5 (RV) or 6 (influenza) days for the development of a cold. Symptom severity, including mucus production and nasal clearance time, and levels of nasal cytokines (interleukin (IL)-6 and IL-1β) were measured prior to administration and each day during the quarantined period.


Subjective SES, but not objective SES, moderated associations between shorter sleep duration and increased likelihood of a clinical cold. Compared to ≥8-hour sleepers, ≤6-hour sleepers with low subjective SES were at increased risk for developing a cold (OR = 2.57, 95% CI 1.10–6.02). There was no association between sleep duration and colds in high subjective SES participants. Among infected individuals who reported low subjective SES, shorter sleep duration was associated with greater mucus production. There was no evidence that markers of nasal inflammation mediated the link between sleep duration and cold susceptibility among those reporting low subjective SES.


Subjective SES may reflect an important social factor for understanding vulnerability to and protection against infectious illness among short sleepers.


Sleep Upper respiratory infection Socioeconomic status Cytokines 



The data used for this article were collected by the Laboratory for the Study of Stress, Immunity, and Disease at Carnegie Mellon University under the directorship of Sheldon Cohen, PhD and were accessed via the Common Cold Project (CCP) website ( CCP data are made publically available through a grant from the National Center for Complementary and Integrative Health (AT006694); the conduct of the studies was supported by grants from the National Institute of Mental Health (MH50429), the National Heart, Lung, and Blood Institute (HL65111; HL65112), and the National Institute for Allergy and Infectious Diseases (AI066367); secondary support was provided by a grant from the National Institutes of Health to the University of Pittsburgh Clinical and Translational Science Institute (UL1 RR024153 and UL1 RT000005), and supplemental support was provided by John D. and Catherine T. MacArthur Foundation Research Network on Socioeconomic Status & Health. Dr. Prather’s participation was supported by a grant from the National Heart, Lung, & Blood Institute (K08HL112961).

Compliance with Ethical Standards

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Dr. Prather is currently a paid consultant for Posit Science. He reports no other potential conflicts of interest. Janicki-Deverts, Adler, Hall, Cohen declare that they have no conflict of interest.


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Copyright information

© The Society of Behavioral Medicine 2016

Authors and Affiliations

  1. 1.Department of PsychiatryUniversity of CaliforniaSan FranciscoUSA
  2. 2.Center for Health and CommunityUniversity of CaliforniaSan FranciscoUSA
  3. 3.Department of PsychiatryUniversity of Pittsburgh Medical CenterPittsburghUSA
  4. 4.Department of PsychologyCarnegie Mellon UniversityPittsburghUSA

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