In a new JAMA study, researchers found that people who had healthy sleep patterns prior to a Covid infection — both before and after the Covid-19 pandemic began — may have a lower risk of suffering from long Covid.
If certain Covid symptoms persist for more than four weeks after testing negative, it is known as long Covid. At present, anywhere between 20% to 70% of people might have long Covid with symptoms like depression, chronic fatigue syndrome or myalgic encephalitis, persistent cough, and brain fog.
On the other hand, sleep issues also have a high prevalence worldwide. It is estimated that around one in three people struggle with poor quality sleep and sleep disorders which might lead to long term physical and/or psychiatric issues. Prior studies have linked poor sleep patterns to severe COVID-19 outcomes like hospitalization and even higher mortality.
“The COVID-19 pandemic compounded both the severity of preexisting sleep disorders and the high prevalence of sleep disturbances,” the researchers wrote. “Unhealthy sleep dimensions have been linked to chronic low-grade inflammation and immune aberrations, which have been implicated in postviral fatigue syndrome.”
To delve deeper, the team used data from the Nurses’ Health Study II (NHS II) and included more than 32,000 participants in their analysis. With the help of questionnaires, they measured each participant’s sleep health before the pandemic from June 2015 to May 2017 and then, during the pandemic (from April 1 to August 31 2020).
The researchers asked participants how frequently they had trouble falling asleep and if they woke up several times at night. Other questions included if the participants used to wake up earlier than planned or had trouble getting back to sleep after waking up too early in the morning. The participants answered each question by rating the severity of their sleep issues on a scale of 0 to 5 or higher if they faced sleep issues more times per week. The team also took into account if the participants might have experienced fatigue or concentration issues during daytime to understand their sleep quality better.
Out of all the participants, 2303 of them tested positive for Covid. A total of 870 participants had long Covid symptoms. “Participants who had a healthier pre-pandemic (2015- 2017) sleep score were more likely to be older and white, have a lower BMI, and adhere to a healthier lifestyle (high diet quality score, high physical activity level, and never smoking) and less likely to have type 2 diabetes, hypertension, and asthma,” the researchers observed in their study. “ Compared with participants who had a sleep score of 0 or 1, those who scored 5 had a 30% lower risk of developing long Covid.”
They further found that daytime dysfunction (fatigue or concentration related issues) before the pandemic and sleep quality during the pandemic was associated with a higher risk of developing long Covid. But surprisingly, sleep duration was not significantly associated with long Covid risk. “Future research should investigate whether improving sleep health may prevent or alleviate long Covid symptoms,” they concluded.