Summary of COVID-19 sleep studies


46,535 patient sleep study: 43% lower mortality (p=0.02) and 36% lower hospitalization (p=0.008).
UK Biobank retrospective, 46,535 participants with sleep behavior assessed between 2006 and 2010, showing higher risk of hospitalization and mortality with poor sleep.

Jun 2021, Sleep, https://academic.oup.com/sleep/article/doi/10.1093/sleep/zsab138/6304657, https://c19p.org/li13

221 patient sleep study: 67% lower severe cases (p=0.01).
Retrospective 221 COVID-19 patients showing an association between high-risk obstructive sleep apnea and COVID-19 severity.

Oct 2024, J. Clinical Medicine, https://www.mdpi.com/2077-0383/13/21/6415, https://c19p.org/atceken

136 patient sleep study: 81% lower severe cases (p=0.02).
Retrospective 164 COVID-19 patients and 188 controls in China, showing the risk of severe cases associated with lack of sleep.

Nov 2021, Nature and Science of Sleep, https://www.dovepress.com/reduced-sleep-in-the-week-prior-to-diagnosis-of-covid-19-is-associated-peer-reviewed-article-NSS, https://c19p.org/huang5sl

sleep study: 39% lower mortality (p=0.001), 32% lower hospitalization (p<0.0001), and 7% fewer cases (p=0.04).
FinnGen Mendelian randomization study showing higher risk of COVID-19 mortality, hospitalization, and infection with insomnia.

Jul 2022, Sleep Medicine, https://www.sciencedirect.com/science/article/pii/S1389945722005536, https://c19p.org/jones

68,896 patient sleep study: 19% lower mortality (p=0.0008), 15% lower hospitalization (p<0.0001), and 23% lower long COVID (p<0.0001).
Prospective study of 68,896 UK Biobank participants with COVID-19 showing adherence to a healthy lifestyle prior to infection, characterized by 10 factors including adequate physical activity and sleep, not smoking, and a healthy BMI, was associated with a significantly lower risk of mortality, hospitalization, and post-COVID multisystem sequelae. Risk decreased monotonically for increasing numbers of healthy lifestyle factors from 5-10. Reduced risks were evident across cardiovascular, metabolic, neurologic, respiratory, and other disorders over 210 days following infection, during both acute and post-acute phases, regardless of age, sex, ethnicity, test setting, vaccination status, or SARS-CoV-2 variant.

Jan 2024, Nature Communications, https://www.nature.com/articles/s41467-024-50495-7, https://c19p.org/wang24sl

5,197 patient sleep study: 40% fewer cases (p=0.01).
Retrospective 5,197 Greek adults over 65. After adjustment for confounders, COVID-19 infection was independently associated with poor sleep, low physical activity, low Mediterranean diet adherence, living in urban areas, smoking, obesity, depression, anxiety, stress, and poor health-related quality of life.

Nov 2023, Diseases, https://www.mdpi.com/2079-9721/11/4/165, https://c19p.org/pavlidousl

1,811 patient sleep study: 67% lower long COVID (p<0.0001).
Retrospective 1,811 COVID-19 patients in the UK, showing lower risk of self-reported long COVID with good sleep quality in the month before infection.

Apr 2022, medRxiv, https://www.medrxiv.org/content/10.1101/2022.04.12.22273792, https://c19p.org/paul

1,979 patient sleep study: 36% lower long COVID (p=0.0004).
Retrospective 1,979 nurses in the USA, showing lower risk of long COVID with better sleep quality.

May 2023, JAMA Network Open, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805380, https://c19p.org/wang17

1,500 patient sleep study: 38% lower severe cases (p<0.0001).
Retrospective 1,500 COVID+ patients in Bangladesh, showing lower risk of severe cases with good sleep.

Sep 2021, Infection and Drug Resistance, https://www.dovepress.com/lifestyle-and-comorbidity-related-risk-factors-of-severe-and-critical--peer-reviewed-fulltext-article-IDR, https://c19p.org/mohsin

2,884 patient sleep study: 17% fewer moderate/severe cases (p=0.03) and 11% fewer cases (p=0.003).
Retrospective 2,884 high-risk healthcare workers in France, Germany, Italy, Spain, UK, and the USA, showing shorter sleep duration associated with increased risk of COVID-19 cases and severity.

Mar 2021, BMJ Nutrition, Prevention & Health, https://nutrition.bmj.com/content/4/1/132.info, https://c19p.org/kim5

315 patient sleep study: 36% fewer cases (p=0.04).
Case control study in China with 105 cases and 210 matched controls, showing COVID-19 cases associated with lack of sleep.

Nov 2020, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241540, https://c19p.org/gao5sl

14,335 patient sleep study: 16% fewer symptomatic cases (p=0.0007).
Prospective survey based study with 14,335 participants, showing risk of viral symptoms associated with shorter sleep duration.

Jun 2021, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0253120, https://c19p.org/marcussl

2,586 patient sleep study: 32% fewer symptomatic cases (p=0.09).
Analysis of 2,586 participants of a running injury prevention RCT in the Netherlands, showing higher risk of COVID-19 symptoms with sleep disturbance.

Oct 2020, J. Science and Medicine in Sport, https://www.sciencedirect.com/science/article/pii/S144024402030788X, https://c19p.org/cloostermansl

1,847 patient sleep study: 17% fewer moderate/severe cases (p=0.06) and 7% lower long COVID (p=0.51).
Retrospective 1,847 COVID+ patients in Poland, showing lower moderate/severe cases with improved sleep, without statistical significance. Hospitalized patients were excluded.

Oct 2022, Frontiers in Medicine, https://www.frontiersin.org/articles/10.3389/fmed.2022.1036556/full, https://c19p.org/plywaczewskasl

15,227 patient sleep study: 12% fewer cases (p=0.5).
Prospective survey-based study with 15,227 people in the UK, showing reduced risk of COVID-19 cases with 8 hours sleep, with statistical significance when compared with ≥9 hours.

Mar 2021, Thorax, https://thorax.bmj.com/content/early/2021/11/02/thoraxjnl-2021-217487, https://c19p.org/holtsl

468,569 patient sleep study: 3% lower mortality (p=0.91).
Retrospective 468,569 adults in the UK, showing no significant difference in COVID-19 mortality based on sleep quality.

Aug 2021, Brain, Behavior, and Immunity, https://www.sciencedirect.com/science/article/pii/S088915912100180X, https://c19p.org/ahmadi2sl