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0 0.5 1 1.5 2+ PASC, before and during 36% Improvement Relative Risk PASC, during pandemic 18% PASC, before pandemic 30% Sleep  Wang et al.  Prophylaxis  LONG COVID Does better sleep reduce the risk of Long COVID (PASC)? Retrospective 1,979 patients in the USA Lower PASC with higher quality sleep (p=0.00044) Wang et al., JAMA Network Open, May 2023 Favors good sleep Favors control

Multidimensional Sleep Health Prior to SARS-CoV-2 Infection and Risk of Post–COVID-19 Condition

Wang et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2023.15885
May 2023  
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Retrospective 1,979 nurses in the USA, showing lower risk of long COVID with better sleep quality.
risk of PASC, 36.0% lower, RR 0.64, p < 0.001, higher quality sleep 559, lower quality sleep 180, adjusted per study, healthy sleep before and during the pandemic, multivariable.
risk of PASC, 18.0% lower, RR 0.82, p = 0.03, adjusted per study, healthy sleep during the pandemic, multivariable.
risk of PASC, 30.0% lower, RR 0.70, p = 0.02, higher quality sleep 238, lower quality sleep 166, adjusted per study, healthy sleep before the pandemic, sleep score 5 vs. score 0 or 1, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Wang et al., 30 May 2023, retrospective, USA, peer-reviewed, 6 authors.
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Multidimensional Sleep Health Prior to SARS-CoV-2 Infection and Risk of Post-COVID-19 Condition
MD Siwen Wang, ScD Tianyi Huang, PhD, ScD Marc G Weisskopf, ScD Jae H Kang, MD, ScD Jorge E Chavarro, PhD Andrea L Roberts, Roberts Wang, Roberts Chavarro, Weisskopf, Chavarro Kang, Anthony Menor
IMPORTANCE The association of multiple healthy sleep dimensions with post-COVID-19 condition (PCC), also known as long COVID, has not been investigated. OBJECTIVE To examine whether multidimensional sleep health before and during the COVID-19 pandemic, prior to SARS-CoV-2 infection, was associated with the risk of PCC. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study (2015-2021) included Nurses' Health Study II participants who reported testing positive (n = 2303) for SARS-CoV-2 infection in a substudy series of COVID-19-related surveys (n = 32 249) between April 2020 and November 2021. After exclusion for incomplete information about sleep health and nonresponse to a question about PCC, 1979 women were included in the analysis. EXPOSURES Sleep health was measured both before (June 1, 2015, to May 31, 2017) and early (April 1 to August 31, 2020) in the COVID-19 pandemic. Prepandemic sleep score was defined according to 5 dimensions: morning chronotype (assessed in 2015), 7 to 8 hours of sleep per day, low insomnia symptoms, no snoring, and no frequent daytime dysfunction (all assessed in 2017). On the first COVID-19 substudy survey (returned between April and August 2020), average daily sleep duration and sleep quality for the past 7 days were queried. MAIN OUTCOMES AND MEASURES SARS-CoV-2 infection and PCC (Ն4 weeks of symptoms) were self-reported during 1 year of follow-up. Comparisons were examined between June 8, 2022, and January 9, 2023, using Poisson regression models. RESULTS Of the 1979 participants reporting SARS-CoV-2 infection (mean [SD] age, 64.7 [4.6] years; 1979 [100%] female; and 1924 [97.2%] White vs 55 [2.8%] other races and ethnicities), 845 (42.7%) were frontline health care workers, and 870 (44.0%) developed PCC. Compared with women who had a prepandemic sleep score of 0 or 1 (least healthy), those who scored 5 (most healthy) had a 30% lower risk of developing PCC (multivariable-adjusted relative risk, 0.70; 95% CI, 0.52-0.94; P for trend <.001). Associations did not differ by health care worker status. No or little daytime dysfunction prepandemic and good sleep quality during the pandemic were independently associated with a lower risk of PCC (relative risk, 0.83 [95% CI, 0.71-0.98] and 0.82 [95% CI, 0.69-0.99], respectively). Results were similar when PCC was defined as having 8 or more weeks of symptoms or as having ongoing symptoms at the time of PCC assessment. CONCLUSIONS AND RELEVANCE The findings indicate that healthy sleep measured prior to SARS-CoV-2 infection, both before and during the COVID-19 pandemic, may be protective against PCC. Future research should investigate whether interventions on sleep health may prevent PCC or improve PCC symptoms.
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