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, Massachusetts.
Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts.
J Clin Sleep Med. 2025 Feb 1;21(2):249-259. doi: 10.5664/jcsm.11322.
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 United States adults to determine the association of insomnia, poor sleep quality, and sleep duration with PASC. Three definitions of PASC were used based on post COVID-19 clinical features: COVID-19 Outbreak Public Evaluation Initiative (COPE) (≥ 3), National Institute for Health and Care Excellence (NICE) (≥ 1), and Researching COVID to Enhance Recovery (RECOVER) (scoring algorithm).
Prevalence rates of PASC were 21.9%, 38.9%, and 15.5% for COPE, NICE, and RECOVER PASC definitions, respectively. PASC was associated with insomnia in all 3 models after full adjustment with odds ratios and 95% confidence intervals (CIs) ranging from 1.30 (95% CI: 1.11-1.52, ≤ .05, RECOVER PASC score) to 1.52 (95% CI: 1.34-1.71, ≤ .001, NICE). Poor sleep quality was related to PASC in all models with adjusted odds ratios ranging from 1.77 (95% CI: 1.60-1.97, ≤ .001, NICE) to 2.00 (95% CI: 1.77-2.26, ≤ .001, COPE). Sleep < 6 hours was associated with PASC with adjusted odds ratios between 1.59 (95% CI: 1.40-1.80, ≤ .001, RECOVER PASC score) and 1.70 (95% CI: 1.53-1.89, ≤ .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 cross-sectionally associated with PASC and may be potential risk factors. Further longitudinal studies should be conducted.
Quan SF, Weaver MD, Czeisler MÉ, et al. Sleep and long COVID: preexisting sleep issues and the risk of post-acute sequelae of SARS-CoV-2 infection in a large general population using 3 different model definitions. . 2025;21(2):249-259.
失眠、睡眠质量差和睡眠时间过长或过短均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24,803名美国成年人进行横断面调查，以确定失眠、睡眠质量差和睡眠时间与PASC之间的关联。基于COVID-19后的临床特征，使用了三种PASC定义：COVID-19疫情公共评估倡议（COPE）（≥3）、英国国家卫生与临床优化研究所（NICE）（≥1）和新冠康复研究（RECOVER）（评分算法）。
对于COPE、NICE和RECOVER的PASC定义，PASC的患病率分别为21.9%、38.9%和15.5%。在所有三个模型中，经过全面调整后，PASC与失眠相关，优势比和95%置信区间（CI）范围为1.30（95%CI：1.11 - 1.52，P≤.05，RECOVER PASC评分）至1.52（95%CI：1.34 - 1.71，P≤.001，NICE）。在所有模型中，睡眠质量差与PASC相关，调整后的优势比范围为1.77（95%CI：1.60 - 1.97，P≤.001，NICE）至2.00（95%CI：1.77 - 2.26，P≤.001，COPE）。睡眠时间<6小时与PASC相关，调整后的优势比在1.59（95%CI：1.40 - 1.80，P≤.001，RECOVER PASC评分）和1.70（95%CI：1.53 - 1.89，P≤.001，COPE）之间。在任何模型中，睡眠时间≥9小时均与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与PASC存在横断面关联，可能是潜在风险因素。应进行进一步的纵向研究。
Quan SF, Weaver MD, Czeisler MÉ,等。睡眠与新冠长期症状：使用3种不同模型定义，在一大群普通人群中，既往存在的睡眠问题与SARS-CoV-2感染急性后遗症的风险。......2025；21(2)：249 - 259。
