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

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

Research output: Contribution to journalArticleResearchpeer-review

10 Citations (Scopus)

Abstract

Background: Medical comorbidities increase the risk of severe acute COVID-19 illness. Although sleep problems are common after COVID-19 infection, it is unclear whether insomnia, poor sleep quality, and extremely long or short sleep increase risk of developing COVID-19 infection or hospitalization. Methods: The study used a cross-sectional survey of a diverse sample of 19,926 US adults. Results: COVID-19 infection and hospitalization prevalence rates were 40.1% and 2.9%, respectively. Insomnia and poor sleep quality were reported in 19.8% and 40.1%, respectively. In logistic regression models adjusted for comorbid medical conditions and sleep duration but excluding participants who reported COVID-19-associated sleep problems, poor sleep quality, but not insomnia, was associated with COVID-19 infection (adjusted odds ratio [aOR] 1.16; 95% CI, 1.07-1.26) and COVID-19 hospitalization (aOR 1.50; 95% CI, 1.18-1.91). In comparison with habitual sleep duration of 7-8 hours, sleep durations <7 hours (aOR 1.14; 95% CI, 1.06-1.23) and sleep duration of 12 hours (aOR 1.61; 95% CI, 1.12-2.31) were associated with increased odds of COVID-19 infection. Overall, the relationship between COVID-19 infection and hours of sleep followed a quadratic (U-shaped) pattern. No association between sleep duration and COVID-19 hospitalization was observed. Conclusion: In a general population sample, poor sleep quality and extremes of sleep duration are associated with greater odds of having had a COVID-19 infection; poor sleep quality was associated with an increased requirement of hospitalization for severe COVID-19 illness. These observations suggest that inclusion of healthy sleep practices in public health messaging may reduce the impact of the COVID-19 pandemic.

Original languageEnglish
Pages (from-to)780-788.e5
Number of pages14
JournalThe American Journal of Medicine
Volume136
Issue number8
DOIs
Publication statusPublished - Aug 2023

Keywords

  • COVID-19
  • Epidemiology
  • Hospitalization
  • Infection
  • Insomnia
  • Poor sleep quality
  • Sleep duration

Cite this