Quan Stuart F, Weaver Matthew D, Czeisler Mark É, Barger Laura K, Booker Lauren A, Howard Mark E, Jackson Melinda L, Lane Rashon I, McDonald Christine F, Ridgers Anna, Robbins Rebecca, Varma Prerna, Wiley Joshua F, Rajaratnam Shantha M W, Czeisler Charles A
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.
Division of Sleep Medicine, Harvard Medical School, Boston, MA.
medRxiv. 2024 Jun 21:2024.06.20.24309263. doi: 10.1101/2024.06.20.24309263.
Insomnia, poor sleep quality and extremes of sleep duration are associated with COVID-19 infection. This study assessed whether these factors are related to Post-Acute Sequelae of SARS-CoV-2 infection (PASC).
Cross-sectional survey of a general population of 24,803 U.S. adults to determine the association of insomnia, poor sleep quality and sleep duration with PASC.
Prevalence rates of PASC among previously COVID-19 infected participants for three definitions of PASC were COPE (21.9%), NICE (38.9%) and RECOVER PASC Score (15.3%). PASC was associated with insomnia in all 3 models in fully adjusted models with adjusted odds ratios (aORs) and 95% confidence intervals (CI) ranging from 1.30 (95% CI: 1.11-1.52, p≤0.05, PASC Score) to 1.52 (95% CI: 1.34-1.71, p≤0.001, (NICE). Poor sleep quality was related to PASC in all models with aORs ranging from 1.77 (95% CI: 1.60-1.97, p≤0.001, NICE) to 2.00 (95% CI: 1.77-2.26, p≤0.001, COPE). Sleep <6 hours was associated with PASC with aORs between 1.59 (95% CI: 1.40-1.80, p≤0.001, PASC Score) to 1.70 (95% CI: 1.53-1.89, p≤0.001, COPE). Sleep ≥ 9 hours was not associated with PASC in any model. Although vaccination with COVID-19 booster decreased the likelihood of developing PASC, it did not attenuate associations between insomnia, poor sleep quality and short sleep duration with PASC in any of the models.
Insomnia, poor sleep quality and short sleep duration are potential risk factors for PASC. Interventions to improve sleep may decrease the development of PASC.
失眠、睡眠质量差和睡眠时间过长或过短都与新型冠状病毒肺炎（COVID-19）感染有关。本研究评估了这些因素是否与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的急性后遗症（PASC）相关。
对24803名美国成年人的普通人群进行横断面调查，以确定失眠、睡眠质量差和睡眠时间与PASC之间的关联。
对于PASC的三种定义，既往感染过COVID-19的参与者中PASC的患病率分别为：COPE定义为21.9%，NICE定义为38.9%，RECOVER PASC评分定义为15.3%。在所有3个模型的完全调整模型中，PASC与失眠相关，调整后的优势比（aORs）和95%置信区间（CI）范围为1.30（95%CI：1.11-1.52，p≤0.05，PASC评分）至1.52（95%CI：1.34-1.71，p≤0.001，NICE）。在所有模型中，睡眠质量差与PASC相关，aORs范围为1.77（95%CI：1.60-1.97，p≤0.001，NICE）至2.00（95%CI：1.77-2.26，p≤0.001，COPE）。睡眠时间<6小时与PASC相关，aORs在1.59（95%CI：1.40-1.80，p≤0.001，PASC评分）至1.70（95%CI：1.53-1.89，p≤0.001，COPE）之间。睡眠时间≥9小时在任何模型中均与PASC无关。尽管接种COVID-19加强针降低了发生PASC的可能性，但在任何模型中，它都没有减弱失眠、睡眠质量差和睡眠时间短与PASC之间的关联。
失眠、睡眠质量差和睡眠时间短是PASC的潜在危险因素。改善睡眠的干预措施可能会减少PASC的发生。
