Habitual short sleepers with comorbidities at increased risk of long COVID

1. In people with pre-existing medical conditions, there is a higher risk of long COVID in short sleepers compared with average-length sleepers.

2. Increasing habitual sleep may be a potential modifiable risk factor for long COVID in people with pre-existing conditions.

Evidence Rating Level: 1 (Excellent)

The risk of long COVID-19—defined as persisting symptoms and long-term sequelae after a COVID-19 infection—has been linked to pre-existing conditions such as chronic obstructive pulmonary disease, anxiety, depression, heart disease, hypertension, and diabetes. Habitual short sleep duration has been known to impair immune function and increase all-cause mortality. However, whether the risk of developing long COVID varies by sleep duration remains to be studied.

This study analyzed data from a large, multinational, cross-sectional survey of 13,461 individuals with confirmed COVID-19. 1,542 individuals reported long COVID which was defined as a history of confirmed or probable SARS-CoV-2 infection with at least 1 symptom lasting for over 3 months. Of those who had long COVID, 945 reported pre-existing medical conditions. Nighttime sleep duration was classified into 3 categories; average if slept 6 to 9 hours per night, short-duration if slept less than 6 hours on average per night, and long-duration if slept more than 9 hours on average per night. Multivariate logistic regression analyses were conducted to examine the association between sleep duration and long COVID. The primary outcome measured was a risk of developing long COVID.

Compared to participants who reported average sleep duration, the risk of long COVID was 3-fold higher for those that reported short sleep duration. There were also significantly more individuals with pre-existing cardiac conditions in the short sleeper category when compared with average and long sleepers. A limitation of the study is recall bias due to self-reported sleep data from the participants. Nonetheless, this study suggests that increasing nighttime sleep to average duration may be a potential modifiable risk factor for long COVID in people with comorbidities.

Click here to read this study in Journal of Clinical Sleep Medicine

Image: PD

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