{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:22:52Z","timestamp":1768954972664,"version":"3.49.0"},"posted":{"date-parts":[[2026,1,16]]},"group-title":"Epidemiology","reference-count":60,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,1,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To determine associations of common infections with self-reported sleep and explore whether these links differ by race in a diverse cohort.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    We studied 602 participants from the Baltimore Epidemiologic Catchment Area Study (mean age 59.0\u00b112.8 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\n                    <jats:italic>Toxoplasma gondii<\/jats:italic>\n                    ) and self-reported symptoms of insomnia (i.e., difficulty falling or staying asleep and early awakening), hypersomnia, and sleep duration.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We observed differences by race in the association of common infections with sleep disturbances (p-values for interactions&lt;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 (\u03b2=0.24, 95% CI: -0.01, 0.48) or for TOX alone (\u03b2=0.64, 95% CI: 0.08, 1.20) was associated with longer sleep among minoritized participants, but shorter sleep among White participants.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In 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.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.01.14.26344029","type":"posted-content","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T01:35:17Z","timestamp":1768613717000},"source":"Crossref","is-referenced-by-count":0,"title":["Links of Common Infections with Sleep in Middle-Aged and Older Adults: Modification by Race in the Baltimore Epidemiologic Catchment Area Study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5144-5685","authenticated-orcid":false,"given":"Yiwei","family":"Yue","sequence":"first","affiliation":[{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3674-8032","authenticated-orcid":false,"given":"Jill A.","family":"Rabinowitz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandra L.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, North Carolina, USA"},{"name":"Intramural Research Program, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiping","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8185-8804","authenticated-orcid":false,"given":"Idiatou","family":"Diallo","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Yolken","sequence":"additional","affiliation":[{"name":"Stanley Laboratory of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William W.","family":"Eaton","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brion S.","family":"Maher","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam P.","family":"Spira","sequence":"additional","affiliation":[{"name":"Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA"},{"name":"Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA"},{"name":"Center on Aging and Health, Johns Hopkins University, Baltimore, MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2026012003450609000_2026.01.14.26344029v1.1","doi-asserted-by":"publisher","DOI":"10.1053\/smrv.2002.0186"},{"key":"2026012003450609000_2026.01.14.26344029v1.2","doi-asserted-by":"publisher","DOI":"10.2147\/nss.S268087"},{"key":"2026012003450609000_2026.01.14.26344029v1.3","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00182-2"},{"key":"2026012003450609000_2026.01.14.26344029v1.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsmc.2017.09.001"},{"key":"2026012003450609000_2026.01.14.26344029v1.5","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/27.7.1255"},{"key":"2026012003450609000_2026.01.14.26344029v1.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2007.00567.x"},{"key":"2026012003450609000_2026.01.14.26344029v1.7","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000002195"},{"key":"2026012003450609000_2026.01.14.26344029v1.8","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268808000551"},{"key":"2026012003450609000_2026.01.14.26344029v1.9","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa005"},{"key":"2026012003450609000_2026.01.14.26344029v1.10","doi-asserted-by":"publisher","DOI":"10.1086\/508173"},{"key":"2026012003450609000_2026.01.14.26344029v1.11","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.23397"},{"key":"2026012003450609000_2026.01.14.26344029v1.12","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-37502-5"},{"key":"2026012003450609000_2026.01.14.26344029v1.13","doi-asserted-by":"publisher","DOI":"10.1086\/340041"},{"key":"2026012003450609000_2026.01.14.26344029v1.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.03.057"},{"key":"2026012003450609000_2026.01.14.26344029v1.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.07.020"},{"key":"2026012003450609000_2026.01.14.26344029v1.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2019.01.026"},{"key":"2026012003450609000_2026.01.14.26344029v1.17","doi-asserted-by":"publisher","DOI":"10.1038\/srep04530"},{"key":"2026012003450609000_2026.01.14.26344029v1.18","doi-asserted-by":"publisher","DOI":"10.1002\/ctm2.108"},{"key":"2026012003450609000_2026.01.14.26344029v1.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2019.12.001"},{"key":"2026012003450609000_2026.01.14.26344029v1.20","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.2499"},{"key":"2026012003450609000_2026.01.14.26344029v1.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2022.02.020"},{"key":"2026012003450609000_2026.01.14.26344029v1.22","doi-asserted-by":"publisher","DOI":"10.2174\/187152412800229107"},{"key":"2026012003450609000_2026.01.14.26344029v1.23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0266214"},{"key":"2026012003450609000_2026.01.14.26344029v1.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadr.2024.100838"},{"key":"2026012003450609000_2026.01.14.26344029v1.25","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291722000113"},{"key":"2026012003450609000_2026.01.14.26344029v1.26","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.0787"},{"key":"2026012003450609000_2026.01.14.26344029v1.27","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4968"},{"key":"2026012003450609000_2026.01.14.26344029v1.28","doi-asserted-by":"publisher","DOI":"10.1007\/S12529-020-09879-4"},{"key":"2026012003450609000_2026.01.14.26344029v1.29","doi-asserted-by":"publisher","DOI":"10.1038\/s42003-021-02825-4"},{"key":"2026012003450609000_2026.01.14.26344029v1.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2012.08.007"},{"key":"2026012003450609000_2026.01.14.26344029v1.31","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-024-01194-y"},{"key":"2026012003450609000_2026.01.14.26344029v1.32","doi-asserted-by":"publisher","DOI":"10.1515\/pteridines-2019-0001"},{"key":"2026012003450609000_2026.01.14.26344029v1.33","doi-asserted-by":"publisher","DOI":"10.1515\/pterid-2017-0010"},{"key":"2026012003450609000_2026.01.14.26344029v1.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.112502"},{"key":"2026012003450609000_2026.01.14.26344029v1.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2015.07.005"},{"key":"2026012003450609000_2026.01.14.26344029v1.36","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4732"},{"key":"2026012003450609000_2026.01.14.26344029v1.37","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.6385"},{"key":"2026012003450609000_2026.01.14.26344029v1.38","doi-asserted-by":"publisher","DOI":"10.18865\/ed.30.3.469"},{"key":"2026012003450609000_2026.01.14.26344029v1.39","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e31816fdf21"},{"key":"2026012003450609000_2026.01.14.26344029v1.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleh.2020.05.004"},{"key":"2026012003450609000_2026.01.14.26344029v1.41","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3508"},{"key":"2026012003450609000_2026.01.14.26344029v1.42","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2020.11.017"},{"key":"2026012003450609000_2026.01.14.26344029v1.43","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2008.078808"},{"key":"2026012003450609000_2026.01.14.26344029v1.44","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gln012"},{"issue":"4","key":"2026012003450609000_2026.01.14.26344029v1.45","first-page":"319","article-title":"The Epidemiologic Catchment Area Program of the National Institute of Mental Health","volume":"96","year":"1981","journal-title":"Public Health Rep Wash DC 1974"},{"key":"2026012003450609000_2026.01.14.26344029v1.46","doi-asserted-by":"publisher","DOI":"10.1159\/000113880"},{"key":"2026012003450609000_2026.01.14.26344029v1.47","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.60.5.466"},{"key":"2026012003450609000_2026.01.14.26344029v1.48","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0000000000000133"},{"key":"2026012003450609000_2026.01.14.26344029v1.49","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1981.01780290015001"},{"key":"2026012003450609000_2026.01.14.26344029v1.50","doi-asserted-by":"publisher","DOI":"10.1111\/apha.12458"},{"key":"2026012003450609000_2026.01.14.26344029v1.51","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2009.10.006"},{"key":"2026012003450609000_2026.01.14.26344029v1.52","doi-asserted-by":"publisher","DOI":"10.1007\/s12552-013-9095-9"},{"key":"2026012003450609000_2026.01.14.26344029v1.53","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2013.02.008"},{"key":"2026012003450609000_2026.01.14.26344029v1.54","doi-asserted-by":"publisher","DOI":"10.1016\/j.freeradbiomed.2020.01.179"},{"key":"2026012003450609000_2026.01.14.26344029v1.55","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2000.tb05408.x"},{"key":"2026012003450609000_2026.01.14.26344029v1.56","doi-asserted-by":"publisher","DOI":"10.4103\/1463-1741.53361"},{"key":"2026012003450609000_2026.01.14.26344029v1.57","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/678164"},{"key":"2026012003450609000_2026.01.14.26344029v1.58","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.9907"},{"key":"2026012003450609000_2026.01.14.26344029v1.59","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.09.249"},{"key":"2026012003450609000_2026.01.14.26344029v1.60","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-13-40"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.64898\/2026.01.14.26344029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T11:45:15Z","timestamp":1768909515000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.64898\/2026.01.14.26344029"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":60,"URL":"https:\/\/doi.org\/10.64898\/2026.01.14.26344029","relation":{},"subject":[],"published":{"date-parts":[[2026,1,16]]},"subtype":"preprint"}}