Long-term/chronic insomnia occurs in patients for over one month; it can affect the functions of the immune system and responses, which may involve cytokines. The aim was to determine alterations of Tumor necrosis factor alpha (TNF-alpha) and IL-10 cytokines in long-term insomnia. Thirty-three long-term/chronic insomnia patients (male, 22; female, 11) aged 47-61 years were initially recruited. Seven of them who were infected with microbial agents were excluded from the study. Of the 26 free of infectious agents only 21 (female, 5; male, 16) were successfully monitored. Age-matched apparently healthy non-insomnia subjects (male, 25; female, 25) free of the infectious agents were recruited as control. Plasma TNF-alpha, IL-10, HBsAg, anti-HCV, and HIVp24 antigen were assayed by ELISA method while determination of Mycobacterium tuberculosis was by Ziehl–Neelsen staining of sputum and Plasmodium spp. by thick blood Giemsa staining. Of the 33 insomnia patients initially recruited, 21.2% (7) were infected with microbial agents (Plasmodium spp., 6.1% (2); HCV, 3.0% (1); HBV, 6.1% (2); Mycobacterium tuberculosis, 3.0% (1); Plasmodium spp. + HBV, 3.0% (1); and HIVp24, 0). Twenty-one chronic insomnia patients were finally investigated on cytokines. There were significantly higher mean plasma values of TNF-alpha and IL-10 cytokines in chronic insomnia patients before treatment than the values obtained in the control subjects (p 0.05). The results also showed a significantly lower mean plasma value of TNF-alpha cytokine in chronic insomnia patients after treatment than the values obtained in the patients before treatment. There were no significant differences in the mean plasma values of IL-10 cytokines in chronic insomnia patients before and after treatment (p 0.05). There was a significant increase in plasma TNF-alpha and IL-10 cytokines in long-term insomnia patients before treatment while plasma TNF-alpha significantly decreased after treatment, and no significant difference was obtained in the plasma IL-10 before and after treatment. TNF-alpha could be a good investigative index of insomnia.
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