Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.
Department of Anesthesiology and Pain Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
BMC Public Health. 2023 Nov 28;23(1):2352. doi: 10.1186/s12889-023-17258-3.
Self-rated health (SRH) is widely recognized as a clinically significant predictor of subsequent mortality risk. Although COVID-19 may impair SRH, this relationship has not been extensively examined. The present study aimed to examine the correlation between habitual sleep duration, changes in sleep duration after infection, and SRH in subjects who have experienced SARS-CoV-2 infection.
Participants from 16 countries participated in the International COVID Sleep Study-II (ICOSS-II) online survey in 2021. A total of 10,794 of these participants were included in the analysis, including 1,509 COVID-19 individuals (who reported that they had tested positive for COVID-19). SRH was evaluated using a 0-100 linear visual analog scale. Habitual sleep durations of < 6 h and > 9 h were defined as short and long habitual sleep duration, respectively. Changes in habitual sleep duration after infection of ≤ -2 h and ≥ 1 h were defined as decreased or increased, respectively.
Participants with COVID-19 had lower SRH scores than non-infected participants, and those with more severe COVID-19 had a tendency towards even lower SRH scores. In a multivariate regression analysis of participants who had experienced COVID-19, both decreased and increased habitual sleep duration after infection were significantly associated with lower SRH after controlling for sleep quality (β = -0.056 and -0.058, respectively, both p < 0.05); however, associations between current short or long habitual sleep duration and SRH were negligible. Multinomial logistic regression analysis showed that decreased habitual sleep duration was significantly related to increased fatigue (odds ratio [OR] = 1.824, p < 0.01), shortness of breath (OR = 1.725, p < 0.05), diarrhea/nausea/vomiting (OR = 2.636, p < 0.01), and hallucinations (OR = 5.091, p < 0.05), while increased habitual sleep duration was significantly related to increased fatigue (OR = 1.900, p < 0.01).
Changes in habitual sleep duration following SARS-CoV-2 infection were associated with lower SRH. Decreased or increased habitual sleep duration might have a bidirectional relation with post-COVID-19 symptoms. Further research is needed to better understand the mechanisms underlying these relationships for in order to improve SRH in individuals with COVID-19.
自我报告的健康状况（SRH）被广泛认为是预测随后死亡风险的临床重要指标。尽管 COVID-19 可能会影响 SRH，但这种关系尚未得到广泛研究。本研究旨在探讨经历 SARS-CoV-2 感染的受试者中，习惯性睡眠时间、感染后睡眠时间变化与 SRH 之间的相关性。
2021 年，来自 16 个国家的参与者参加了国际 COVID-19 睡眠研究-II（ICOSS-II）在线调查。共有 10794 名参与者被纳入分析，其中包括 1509 名 COVID-19 个体（报告 COVID-19 检测呈阳性）。SRH 使用 0-100 线性视觉模拟量表进行评估。<6 小时和>9 小时的习惯性睡眠时间分别定义为短和长习惯性睡眠时间。感染后习惯性睡眠时间的变化≤-2 小时和≥1 小时分别定义为减少和增加。
患有 COVID-19 的参与者的 SRH 评分低于未感染的参与者，而 COVID-19 症状更严重的参与者的 SRH 评分倾向于更低。在对经历过 COVID-19 的参与者进行的多变量回归分析中，感染后习惯性睡眠时间的减少和增加与控制睡眠质量后较低的 SRH 显著相关（β=-0.056 和-0.058，均 p<0.05）；然而，当前的短或长习惯性睡眠时间与 SRH 之间的关联可以忽略不计。多项逻辑回归分析表明，习惯性睡眠时间减少与疲劳增加（比值比[OR]=1.824，p<0.01）、呼吸急促（OR=1.725，p<0.05）、腹泻/恶心/呕吐（OR=2.636，p<0.01）和幻觉（OR=5.091，p<0.05）显著相关，而习惯性睡眠时间增加与疲劳增加（OR=1.900，p<0.01）显著相关。
SARS-CoV-2 感染后习惯性睡眠时间的变化与 SRH 较低有关。习惯性睡眠时间的减少或增加可能与 COVID-19 后症状呈双向关系。需要进一步研究以更好地了解这些关系的机制，从而提高 COVID-19 患者的 SRH。
