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Sleep Enhances the Human Antibody Response to Hepatitis A Vaccination

Lange, Tanja MD; Perras, Boris MD; Fehm, Horst L. MD, and; Born, Jan PhD

doi: 10.1097/01.PSY.0000091382.61178.F1

Objective The common belief that sleep supports immune defense has received surprisingly little direct experimental support. The antibody response to vaccination provides a valid tool to assess the influence of sleep on adaptive immune functioning in humans, which is also clinically relevant.

Methods Two groups of healthy humans (N = 19) not previously infected with hepatitis A virus (HAV) were studied. On the night after primary vaccination with inactivated HAV, which took place at 0900 hours, one group had regular sleep. The other group stayed awake, and did not sleep before 2100 hours the following day. HAV antibody titers were measured repeatedly until 28 days after vaccination. Plasma hormone concentrations and white blood cell (WBC) subset counts were determined on the night and day after vaccination.

Results Subjects who had regular sleep after vaccination, displayed a nearly two-fold higher HAV antibody titer after 4 weeks than subjects staying awake on this night (p =.018). Compared with wakefulness, sleep after vaccination distinctly increased release of several immune-stimulating hormones including growth hormone, prolactin, and dopamine (p < .01). Concentrations of thyrotropin, norepinephrine, and epinephrine were lowered by sleep (p < .02), whereas sleep only marginally influenced WBC subset counts.

Conclusions Data suggest that sleep compared with sleep deprivation on the night after vaccination improves the formation of antigen-specific immune defense as reflected by antibody production in humans. Sleep presumably acts by inducing a hormonal environment in secondary lymphoid tissues, enhancing lymphocyte proliferation and differentiation and finally antibody synthesis. Results underscore the importance of sleep for immunocompetence.

From the Department of Neuroendocrinology (T.L., J.B.) and Department of Internal Medicine (B.P.; H.L.F.), University of Lübeck, Lübeck, Germany.

Address reprint requests to: Jan Born, University of Lübeck, Department of Neuroendocrinology, Ratzeburger Allee 160/Hs 23a, 23538 Lübeck, Germany. E-mail:

Received for publication December 10, 2001; revision received October 16, 2002.

Copyright © 2003 by American Psychosomatic Society
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