Association of sleep duration and quality with immunological response after vaccination against severe acute respiratory syndrome coronavirus‐2 infection
Abstract:Summary
Growing evidence suggests that sleep could affect the immunological response after vaccination. The aim of this prospective study was to investigate possible associations between regular sleep disruption and immunity response after vaccination against coronavirus disease 2019 (COVID‐19). In total, 592 healthcare workers, with no previous history of COVID‐19, from eight major Greek hospitals were enrolled in this study. All subjects underwent two Pfizer–BioNTech messenger ribonucleic acid (mR… Show more
“…This large and representative example of HCWs represents a rather young and overall healthy population with only around 20% of participants reporting dissatisfaction with their sleep, while in the adult population dissatisfactory sleep is generally more common with more than 40% reporting some insomnia symptoms before the COVID-19 pandemic and more than 50% of the population during the pandemic in 2020 (Morin et al, 2021). The insomnia prevalence of 36% and the short sleep duration of only six hours in the first study investigating the association of sleep variables and the immunogenicity of COVID-19 vaccines might explain why the authors found a significant impact of the AIS and PSQI scores on antibody levels at some time points after adjustment for potential confounders (Athanasiou et al, 2023). It must be considered that both clinical scores include an item on sleep duration (Buysse et al, 1989).…”
Section: Discussionmentioning
confidence: 99%
“…Expert advice had been given that shift workers should avoid vaccinations on shift days and hospital inpatients should consider rescheduling their vaccinations due to the sleep disruptions associated with hospitalization (Zhu et al, 2021). However, the first and only previous study investigating the effects of sleep on antibody levels following COVID-19 vaccinations found no correlation between the duration of sleep two days prior and one day after the vaccination with antibody levels (Athanasiou et al, 2023). In light of this and our data, and because COVID-19 vaccinations represent an essential disease prevention measure (Benenson et al, 2021), COVID-19 vaccines should be applied in a timely manner.…”
Section: Discussionmentioning
confidence: 99%
“…However, data on the relationship between sleep and immunogenicity of COVID-19 vaccinations is still sparse. To our knowledge, currently the first has recently been conducted in a small cohort of Greek healthcare workers (HCWs) (Athanasiou et al, 2023). Surprisingly, night shifts two days before or one day after COVID-19 vaccination did not affect antibody levels.…”
Section: Introductionmentioning
confidence: 99%
“…Surprisingly, night shifts two days before or one day after COVID-19 vaccination did not affect antibody levels. However, the Athens Insomnia Scale (AIS) (Soldatos et al, 2000) and the PSQI predicted antibody levels after the first and second vaccination (Athanasiou et al, 2023), yet to a smaller degree than other established factors such as age and smoking. Considering that the study participants were assessed during the peak of the COVID-19 pandemic and severely sleep deprived with an average sleep duration of only six hours per night, it remains unclear if the effects were mediated by sleep duration, sleep quality or other factors such as mental health.…”
Sleep modulates the immune response and sleep loss can reduce the immunogenicity of certain vaccinations. Vice versa immune responses impact sleep. We aimed to investigate the influence of mental health and sleep quality on the immunogenicity of COVID-19 vaccinations and, conversely, of COVID-19 vaccinations on sleep quality.The prospective CoVacSer study monitored mental health, sleep quality, and Anti-SARS-CoV-2-Spike IgG titres in a cohort of 1,082 healthcare workers from the 29thof September 2021 to the 19thof December 2022. Questionnaires and blood samples were collected before, 14 days, and three months after the third COVID-19 vaccination. In 154 participants the assessments were also conducted before and 14 days after the fourth COVID-19 vaccination.Healthcare workers with psychiatric disorders had slightly lower Anti-SARS-CoV-2-Spike IgG levels before the third COVID-19 vaccination. However, this effect was mediated by higher median age and body mass index in this subgroup. Antibody titres following the third and fourth COVID-19 vaccination (‘booster vaccinations’) were not significantly different between subgroups with and without psychiatric disorders. Sleep quality did not affect the humoral immunogenicity of the COVID-19 vaccinations. Moreover, the COVID-19 vaccinations did not impact self-reported sleep quality.Our data suggests that in a working population neither mental health nor sleep quality relevantly impact the immunogenicity of COVID-19 vaccinations and that COVID-19 vaccinations are not a precipitating factor for insomnia. The findings from this large-scale real-life cohort study will inform clinical practice regarding the recommendation of COVID-19 booster vaccination for individuals with mental health and sleep problems.
“…This large and representative example of HCWs represents a rather young and overall healthy population with only around 20% of participants reporting dissatisfaction with their sleep, while in the adult population dissatisfactory sleep is generally more common with more than 40% reporting some insomnia symptoms before the COVID-19 pandemic and more than 50% of the population during the pandemic in 2020 (Morin et al, 2021). The insomnia prevalence of 36% and the short sleep duration of only six hours in the first study investigating the association of sleep variables and the immunogenicity of COVID-19 vaccines might explain why the authors found a significant impact of the AIS and PSQI scores on antibody levels at some time points after adjustment for potential confounders (Athanasiou et al, 2023). It must be considered that both clinical scores include an item on sleep duration (Buysse et al, 1989).…”
Section: Discussionmentioning
confidence: 99%
“…Expert advice had been given that shift workers should avoid vaccinations on shift days and hospital inpatients should consider rescheduling their vaccinations due to the sleep disruptions associated with hospitalization (Zhu et al, 2021). However, the first and only previous study investigating the effects of sleep on antibody levels following COVID-19 vaccinations found no correlation between the duration of sleep two days prior and one day after the vaccination with antibody levels (Athanasiou et al, 2023). In light of this and our data, and because COVID-19 vaccinations represent an essential disease prevention measure (Benenson et al, 2021), COVID-19 vaccines should be applied in a timely manner.…”
Section: Discussionmentioning
confidence: 99%
“…However, data on the relationship between sleep and immunogenicity of COVID-19 vaccinations is still sparse. To our knowledge, currently the first has recently been conducted in a small cohort of Greek healthcare workers (HCWs) (Athanasiou et al, 2023). Surprisingly, night shifts two days before or one day after COVID-19 vaccination did not affect antibody levels.…”
Section: Introductionmentioning
confidence: 99%
“…Surprisingly, night shifts two days before or one day after COVID-19 vaccination did not affect antibody levels. However, the Athens Insomnia Scale (AIS) (Soldatos et al, 2000) and the PSQI predicted antibody levels after the first and second vaccination (Athanasiou et al, 2023), yet to a smaller degree than other established factors such as age and smoking. Considering that the study participants were assessed during the peak of the COVID-19 pandemic and severely sleep deprived with an average sleep duration of only six hours per night, it remains unclear if the effects were mediated by sleep duration, sleep quality or other factors such as mental health.…”
Sleep modulates the immune response and sleep loss can reduce the immunogenicity of certain vaccinations. Vice versa immune responses impact sleep. We aimed to investigate the influence of mental health and sleep quality on the immunogenicity of COVID-19 vaccinations and, conversely, of COVID-19 vaccinations on sleep quality.The prospective CoVacSer study monitored mental health, sleep quality, and Anti-SARS-CoV-2-Spike IgG titres in a cohort of 1,082 healthcare workers from the 29thof September 2021 to the 19thof December 2022. Questionnaires and blood samples were collected before, 14 days, and three months after the third COVID-19 vaccination. In 154 participants the assessments were also conducted before and 14 days after the fourth COVID-19 vaccination.Healthcare workers with psychiatric disorders had slightly lower Anti-SARS-CoV-2-Spike IgG levels before the third COVID-19 vaccination. However, this effect was mediated by higher median age and body mass index in this subgroup. Antibody titres following the third and fourth COVID-19 vaccination (‘booster vaccinations’) were not significantly different between subgroups with and without psychiatric disorders. Sleep quality did not affect the humoral immunogenicity of the COVID-19 vaccinations. Moreover, the COVID-19 vaccinations did not impact self-reported sleep quality.Our data suggests that in a working population neither mental health nor sleep quality relevantly impact the immunogenicity of COVID-19 vaccinations and that COVID-19 vaccinations are not a precipitating factor for insomnia. The findings from this large-scale real-life cohort study will inform clinical practice regarding the recommendation of COVID-19 booster vaccination for individuals with mental health and sleep problems.
“…While sarcoidosis may not, overall, increase the risk of adverse outcomes from respiratory infections, the burden of super-imposed infectious events may be higher for patients with sarcoidosis who often have reduced physiologic reserve and/or quality of life impairments. The results of recent research highlight the importance of sleep quantity in contributing to vaccine efficacy for the COVID-19 vaccine, with the evolving understanding that sleep acts as a ‘natural adjuvant’ to enhance short-term immune responses and long-term immune memory [45–48,49 ▪▪ ,50]. As patients with sarcoidosis have increased risk of impaired sleep [51,52] counselling patients on sleep practices during the pre and post vaccination weeks may be especially beneficial.…”
Section: Clinical Management: Minimizing the Burden Of Infections In ...mentioning
Purpose of review
To summarize data from recent reports about risks and outcomes of the infections most often reported in patients with sarcoidosis.
Recent findings
Rates of fungal infections and other severe infections are higher in patients with sarcoidosis compared to controls. Immunosuppression further increases the risk for an infection requiring hospitalization. In contrast, outcomes of coronavirus disease 2019 (COVID-19) are not worse unless lung impairment or other comorbidities are present.
Summary
Tuberculosis, fungal infections, and other severe infections requiring hospital admission are, fortunately, relatively rare in patients with sarcoidosis who live in nonendemic regions. However, ongoing vigilance is required when the course of sarcoidosis is atypical or inexplicably progressive, as costs are high when these infections are missed. In contrast, COVID-19 and other respiratory viral illnesses are common, including among patients with sarcoidosis. When organ impairment is minimal, an underlying diagnosis of sarcoidosis does not appear to increase the risk of severe COVID-19, but patients may have higher risks due to comorbidities, which are important factors to address in routine sarcoidosis care. The burden from respiratory viral events, including impacts on quality of life and life functionality including work capacity, is unknown and is important to measure.
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