Disclosures:
Wang reports no financial disclosures. Please see the study for all other authors’ relevant disclosures.
Key takeaways:
- Healthy sleep habits before SARS-CoV-2 infection may reduce the risk for long COVID.
- One researcher told Healio the healthy sleep components that were most strongly associated with lower risk for long COVID.
Having healthy sleep before being infected with SARS-CoV-2 may help protect against long COVID, according to the results of research published in JAMA Network Open.
Unhealthy sleep dimensions like daytime sleepiness, snoring and sleep apnea, late chronotype or a short or long duration of sleep have been prospectively linked to COVID-19 mortality, susceptibility and severity, the researchers wrote. Additional research has also linked excessive daytime sleepiness, extreme sleep duration and insomnia as causal risk factors for the severity of COVID-19.
Hypothesizing that healthier sleep is connected to a lower risk for long COVID, Wang and colleagues conducted a prospective cohort study to assess if multidimensional sleep health before SARS-CoV-2 infection was associated with long COVID risk.
The study included 1,979 participants, all of whom were women, and 97.2% of whom were white, from the Nurses’ Health Study II (2015-2021) who reported testing positive for SARS-CoV-2 infection. Later, 40% developed long COVID.
Sleep health was measured before (from 2015 to 2017) and early into the COVID-19 pandemic (April to August 2020). The researchers defined pre-pandemic sleep scores according to five characteristics: morning chronotype; low insomnia symptoms; no snoring; 7 to 8 hours of sleep per day; and no frequent daytime dysfunction.
Wang and colleagues found that having healthy sleep before being infected with SARS-CoV-2 may help prevent long COVID. For example, those who followed most aspects of healthy sleep before being infected with SARS-COV-2 had about a 30% lower risk for long COVID compared with people who did not have healthy sleep, they found.
The healthy sleep components “most strongly associated with a lower risk for long COVID were having enough sleep every day and good sleep quality,” Wang said. “Chronic diseases, such as asthma and heart diseases, or hospitalization due to COVID-19 did not explain these findings.”
Good sleep quality during the pandemic and little to no daytime dysfunction pre-pandemic were independently linked to a lower risk for long COVID, with respective relative risk values of 0.82 (95% CI, 0.69-0.99) and 0.83 (95% CI, 0.71 -0.98).
“Our study raises the possibility that simple steps such as setting a regular bedtime; shutting off screens and removing electronic devices before bedtime; avoiding caffeine, large meals, and alcohol late in the day to improve sleep hygiene may reduce risk of long COVID,” Wang said.
