TY - JOUR
T1 - Insomnia, Poor Sleep Quality, and Sleep Duration and Risk for COVID-19 Infection and Hospitalization
AU - Quan, Stuart F.
AU - Weaver, Matthew D.
AU - Czeisler, Mark
AU - Barger, Laura K.
AU - Booker, Lauren A.
AU - Howard, Mark E.
AU - Jackson, Melinda L.
AU - Lane, Rashon I.
AU - McDonald, Christine F.
AU - Ridgers, Anna
AU - Robbins, Rebecca
AU - Varma, Prerna
AU - Wiley, Joshua F.
AU - Rajaratnam, Shantha M.W.
AU - Czeisler, Charles A.
N1 - Funding Information:
Funding: This work was supported by the Centers for Disease Control and Prevention. MÉC was supported by an Australian-American Fulbright Fellowship, with funding from The Kinghorn Foundation . The salary of LKB, MÉC, RR, and MDW were supported, in part, by NIOSH R01 OH011773 and NHLBI R56 HL151637 . RR also was supported in part by NHLBI K01 HL150339 .
Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/8
Y1 - 2023/8
N2 - 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.
AB - 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.
KW - COVID-19
KW - Epidemiology
KW - Hospitalization
KW - Infection
KW - Insomnia
KW - Poor sleep quality
KW - Sleep duration
UR - http://www.scopus.com/inward/record.url?scp=85160244434&partnerID=8YFLogxK
U2 - 10.1016/j.amjmed.2023.04.002
DO - 10.1016/j.amjmed.2023.04.002
M3 - Article
C2 - 37075878
AN - SCOPUS:85160244434
SN - 0002-9343
VL - 136
SP - 780-788.e5
JO - The American Journal of Medicine
JF - The American Journal of Medicine
IS - 8
ER -