Insomnia, Poor Sleep Quality and Sleep Duration, and Risk for COVID-19 Infection and Hospitalization

Quan, Stuart F.; Weaver, Matthew D.; Czeisler, Mark É; Booker, Lauren; Jackson, Melinda L.; Lane, Rashon I.; McDonald, Christine F; Ridgers, Anna; Robbins, Rebecca; Varma, Prerna; Wiley, Joshua F.; Rajaratnam, Shantha M W; Czeisler, Charles A.

doi:10.1016/j.amjmed.2023.04.002

Cited by 12 publications

(14 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The relationship between COVID-19 incidence and previous sleep quality should also be noted. A recent study by Quan et al [35] found that both insomnia and poor sleep quality were associated with a higher risk of COVID-19 infection. The association was stronger for poor sleep quality than for insomnia, and the former was also linked to a higher risk of COVID-19-related hospitalization.…”

Section: Discussionmentioning

confidence: 98%

Sleep Disturbances as a Consequence of Long COVID-19: Insights from Actigraphy and Clinimetric Examinations—An Uncontrolled Prospective Observational Pilot Study

Tański,

Tomasiewicz,

Jankowska-Polańska

2024

JCM

View full text Add to dashboard Cite

The COVID-19 pandemic represents a global health and social challenge. However, the impact of a SARS-CoV-2 infection itself on mental health and sleep quality remains poorly understood. The purpose of the present uncontrolled prospective observational pilot study was to evaluate the impact of past COVID-19 disease on the incidence of quantitative and qualitative sleep disturbances. A group of 61 subjects (37 female, 24 male) reported sleep disturbances that had lasted for at least one month and had started after recovery from COVID-19. The study used self-reported instruments: the Epworth Sleepiness Scale (ESS) and Insomnia Severity Index (ISI), as well as an objective method—actigraphy—for quantitative analysis of sleep architecture. It was shown that sleep disturbances most commonly started after recovery (68.3%, n = 41) and lasted for more than one month (83.6%, n = 51). ESS scores of 7.8 ± 5.0 points indicate moderate daytime sleepiness, and ISI scores of 16.3 ± 5.8 points denote moderate insomnia. ESS scores were negatively correlated with total time in bed (r = −0.3780, p = 0.003), total sleep time (r = −0.2969, p = 0.020), and wakefulness after sleep onset (r = −0.2654, p = 0.039). In addition, ESS scores were correlated negatively with the respondents’ age (B = −0.17, p = 0.000) and time from COVID-19 onset. A positive correlation was found between wakefulness after sleep onset and ESS scores (B = −0.05, p = 0.039). ISI scores were positively correlated with time in bed (r = 0.3275, p = 0.010). Female gender was found to be a significant predictor of insomnia’s severity (B = 2.159, t = 3.04, p = 0.004). In conclusion, patients with a history of COVID-19 report long-lasting sleep disturbances that do not subside spontaneously. In the patient group studied, moderate levels of daytime sleepiness and insomnia were found. The most frequently reported problems included irregular sleep, frequent awakenings, and difficulty maintaining sleep, while normal sleep duration was preserved. These findings underscore the need for continued attention to the long-term consequences of COVID-19 on sleep health and emphasize the importance of targeted interventions to address these enduring sleep disturbances in affected individuals.

show abstract

Section: Discussionmentioning

confidence: 98%

Sleep Disturbances as a Consequence of Long COVID-19: Insights from Actigraphy and Clinimetric Examinations—An Uncontrolled Prospective Observational Pilot Study

Tański,

Tomasiewicz,

Jankowska-Polańska

2024

JCM

View full text Add to dashboard Cite

show abstract

“…Second, inadequate sleep is often accompanied by other risk factors for COVID-19, such as obesity, diabetes, cardiovascular disease, and respiratory disorders [ 29 – 31 ]. These comorbidities have been identified as independent risk factors for severe COVID-19 outcomes [ 32 – 34 ].…”

Section: Discussionmentioning

confidence: 99%

Sleep disturbance increases the risk of severity and acquisition of COVID-19: a systematic review and meta-analysis

Shafiee,

Jafarabady,

Rajai

et al. 2023

Eur J Med Res

View full text Add to dashboard Cite

Background Understanding the association between sleep quality and COVID-19 outcomes is crucial for effective preventive strategies and patient management. This systematic review aims to evaluate the impact of sleep quality as a risk factor for acquiring COVID-19 infection and the severity of the disease. Methods A comprehensive search of electronic databases was conducted to identify relevant studies published from the inception of the COVID-19 pandemic which was 31st of December 2019 until 30 April 2023. Studies investigating the relationship between sleep quality and COVID-19 infection, or disease severity were included. Random effect meta-analysis was performed with odds ratios (OR) and their 95% confidence intervals (95% CI) as effect measures. Results Out of the initial 1,132 articles identified, 12 studies met the inclusion criteria. All studies were observational studies (cohort, case–control, and cross-sectional). The association between sleep quality and COVID-19 infection risk was examined in 6 studies, The results of our meta-analysis showed that participants with poor sleep quality showed a 16% increase regarding the risk of COVID-19 acquisition (OR 1.16; 95% CI 1.03, 1.32; I2 = 65.2%, p = 0.02). Our results showed that participants with poor sleep quality showed a 51% increase in the incidence of primary composite outcome (OR 1.51; 95% CI 1.25, 1.81; I2 = 57.85%, p < 0.001). The result of our subgroup analysis also showed significantly increased risk of mortality (RR 0.67; 95% CI 0.50, 0.90; I2 = 31%, p = 0.008), and disease severity (OR 1.47; 95% CI 1.19, 1.80; I2 = 3.21%, p < 0.001) when comparing poor sleep group to those with good sleep quality. Conclusion This study highlights a significant association between poor sleep quality and an increased risk of COVID-19 infection as well as worse disease clinical outcomes.

show abstract

“…As in our previously analyses in this cohort, we defined a positive history of COVID-19 infection as an affirmative response to having tested positive for COVID-19, a clinical diagnosis of COVID-19, or loss of taste or smell. 11,19 Participants were considered to have OSA if they endorsed currently having the condition whether treated or not or if they had two or more symptoms of OSA. 11 Vaccination status was dichotomized as Boosted (>2 vaccinations) or Not Boosted ( ≤ 2 vaccinations).…”

Section: Statistical Analysesmentioning

confidence: 99%

Association of Obstructive Sleep Apnea with Post-Acute Sequelae of SARS-CoV-2 infection (PASC)

Quan,

Weaver,

Czeisler

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Obstructive sleep apnea (OSA) is associated with COVID-19 infection. Fewer investigations have assessed OSA as a possible risk for the development of Post-Acute Sequelae of SARS-CoV-2 infection (PASC). Research Question: In a general population, is OSA associated with increased odds of PASC-related symptoms and with an overall definition of PASC? Study Design: Cross-sectional survey of a general population of 24,803 U.S. adults. Results: COVID-19 infection occurred in 10,324 (41.6%) participants. Prevalence rates for a wide variety of persistent (> 3 months post infection) putative PASC-related physical and mental health symptoms ranged from 6.5% (peripheral edema) to 19.6% (nervous/anxious). In logistic regression models adjusted for demographic, anthropometric, comorbid medical and socioeconomic factors, OSA was associated with all putative PASC-related symptoms with the highest adjusted odds ratios (aOR) being fever (2.053) and nervous/anxious (1.939) respectively. Elastic net regression identified the 13 of 37 symptoms most strongly associated with COVID-19 infection. Four definitions of PASC were developed using these symptoms either weighted equally or proportionally by their regression coefficients. In all 4 logistic regression models using these definitions, OSA was associated with PASC (range of aORs: 1.934-2.071); this association was mitigated in those with treated OSA. In the best fitting overall model requiring ≥3 symptoms, PASC prevalence was 21.9%. Conclusion: In a general population sample, OSA is associated with the development of PASC-related symptoms and a global definition of PASC. A PASC definition requiring the presence of 3 or more symptoms may be useful in identifying cases and for future research.

show abstract

Insomnia, Poor Sleep Quality and Sleep Duration, and Risk for COVID-19 Infection and Hospitalization

Cited by 12 publications

References 38 publications

Sleep Disturbances as a Consequence of Long COVID-19: Insights from Actigraphy and Clinimetric Examinations—An Uncontrolled Prospective Observational Pilot Study

Sleep Disturbances as a Consequence of Long COVID-19: Insights from Actigraphy and Clinimetric Examinations—An Uncontrolled Prospective Observational Pilot Study

Sleep disturbance increases the risk of severity and acquisition of COVID-19: a systematic review and meta-analysis

Association of Obstructive Sleep Apnea with Post-Acute Sequelae of SARS-CoV-2 infection (PASC)

Contact Info

Product

Resources

About