Blood levels of PFAS are linked to sleep disruptions in young adults aged 19 to 24, according to research led by the Keck School of Medicine of the University of Southern California in Los Angeles. Findings from the study, the first to look at the possible link between PFAS and sleep in young adults, were published in Environmental Advances.

Li S, Goodrich JA, Chen JC, et al. Per-and polyfluoroalkyl substances and disrupted sleep: mediating roles of proteins. Environmental Advances. 2024;17:100585.

Lewis W. ‘Forever chemicals’ linked to poor sleep among young adults in first-of-its-kind study [press release]. Keck School of Medicine of USC. October 4, 2024.

“Because the body needs sleep every day, if PFAS might be interfering with your sleep, that may affect you more immediately than other chronic health issues,” said first author Shiwen Li, PhD, in a press release.

Lewis W. ‘Forever chemicals’ linked to poor sleep among young adults in first-of-its-kind study [press release]. Keck School of Medicine of USC. October 4, 2024.

Long-term, poor sleep has been connected to outcomes including neurological and behavioral problems, type 2 diabetes and Alzheimer’s disease.

Forever chemicals

PFAS, which are detectable in the blood of most individuals in the US, enter the body via contact with consumer products or ingestion with food and water. The chemicals persist in the environment for decades as they are water-resistant and do not readily break down.

Li S, Goodrich JA, Chen JC, et al. Per-and polyfluoroalkyl substances and disrupted sleep: mediating roles of proteins. Environmental Advances. 2024;17:100585.

Lewis W. ‘Forever chemicals’ linked to poor sleep among young adults in first-of-its-kind study [press release]. Keck School of Medicine of USC. October 4, 2024.

Research has linked PFAS to cancer, neurological diseases including Alzheimer’s, and deficits in hormone and immune function. However, when it comes to sleep disturbance, the findings had been inconclusive. Studies in China found a link between PFAS and sleep disturbances in pregnant women, infants, and youngsters in early childhood. Prior US studies showed mixed results.

About the study

The researchers collected blood samples from 136 participants and measured blood levels of seven PFAS during 2014-2018 (mean age, 19) and again during 2020-2022 (mean age, 24). Participants self-reported on sleep duration; the researchers measured sleep disturbance and sleep-related impairment during the past week using the eight-item short forms developed from the PROMIS Sleep Disturbance and Sleep-Related Impairment item banks. Of the participants, 76 contributed data at each time point.

Li S, Goodrich JA, Chen JC, et al. Per-and polyfluoroalkyl substances and disrupted sleep: mediating roles of proteins. Environmental Advances. 2024;17:100585.

Lewis W. ‘Forever chemicals’ linked to poor sleep among young adults in first-of-its-kind study [press release]. Keck School of Medicine of USC. October 4, 2024.

Four of the seven PFAS—perfluorodecanoic acid (PFDA), perfluorohexane sulfonate (PFHxS), perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS)—were associated with less sleep or poor quality sleep.

Using toxicology databases, the researchers studied the overlap between genes affected by the four PFAS and genes related to sleep disorders. They also profiled a panel of proteins from participants’ blood samples. Of the more than 600 candidate genes, seven activated by PFAS appeared to influence sleep. This included the HSD11B1 gene that helps produce cortisol, a hormone that regulates sleep, and cathepsin B, which is related to cognitive function and memory.

Li S, Goodrich JA, Chen JC, et al. Per-and polyfluoroalkyl substances and disrupted sleep: mediating roles of proteins. Environmental Advances. 2024;17:100585.

Lewis W. ‘Forever chemicals’ linked to poor sleep among young adults in first-of-its-kind study [press release]. Keck School of Medicine of USC. October 4, 2024.

Health consequences

Various experts (not involved with the current study) have commented on the value of sleep and the importance of understanding its disruptors.

“The significance of sleep and its multifaceted relationship with various substances [is] a growing concern and interest,” said Ryan Sultan, MD, a psychiatrist and assistant professor at Columbia University in New York, in a report from the National Council on Aging.

Marshall S. Substances and sleep: how prescription drugs and stimulants disrupt your sleep. NCO Adviser. June 28, 2024.

“Poor sleep patterns have been linked to cognitive impairments, exacerbating memory issues and potentially accelerating conditions, like Alzheimer’s disease.”

In her research focusing on adolescents, Allison Baker, MD, a psychiatrist at Massachusetts General Hospital and faculty member at Harvard Medical School, has suggested that teenagers with disrupted sleep may exhibit some of the same symptoms as in attention-deficit/hyperactivity disorder.

Zaid Fadul, MD, medical director at online mental health provider Better U, has said there is a "clear connection" between sleep health and mental well-being in teenagers. "It's deeply concerning that such a significant portion of teens are not getting the sleep they need,” which can contribute to feelings of sadness, hopelessness, and disinterest in activities previously enjoyed, as well as impacting academic performance.

Rudy M. 8 in 10 teens aren’t getting enough sleep, says National Sleep Foundation: ‘Deeply concerning.’ Fox News. March 12, 2024.

The Keck School investigators will continue to research PFAS, sleep patterns, and the genes identified in the study.