Eltoum Ayah I, Begum Rahima, Gold Laura S, Patel Payal B, Andrews James S
Department of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
Department of Radiology, University of Washington, Seattle, Washington, United States of America.
Mental Health Sci. 2025 Sep;3(3). doi: 10.1002/mhs2.70027. Epub 2025 Jun 30.
Cognitive impairment following COVID-19 infection is common and risk factors remain poorly understood. Sleep disturbance increases risk of cognitive impairment in the general population, and sleep disturbance is common after COVID-19. While prior literature has extensively explored the relationship between sleep and cognition, few studies have addressed the temporality of this association and how one may contribute to the other over time. This study assessed whether new sleep disturbance at 1-month is associated with risk of cognitive impairment at 6-months after COVID-19 hospitalization.
English-speaking adults aged ≥18 years at the University of Washington Medical Center who survived to 1-month post-COVID-19 hospitalization were enrolled. Self-reported sleep disturbance, cognitive function, cognitive abilities, and fatigue severity at 1- and 6-months after discharge were assessed by the Patient-Reported Outcomes Measurement Information System (PROMIS) short forms. Linear and logistic regression models analyzed associations of new sleep disturbance at 1-month with cognitive function, cognitive abilities, and fatigue severity outcomes at 6-months.
Participants (n=120) had mean age of 56.5±15.7 years, and 35% developed new sleep disturbance at 1-month. Among those with versus without new sleep disturbance at 1-month, 74% versus 40%, 76% versus 37%, and 64% versus 50% developed significant worsening in cognitive function, cognitive abilities, and fatigue severity at 6 months, respectively.
In this single-center observational cohort, new sleep disturbance at 1-month post-COVID-19 hospitalization was associated with subsequent significant worsening in cognitive function, cognitive abilities, and fatigue severity at 6-months. Thus, new sleep disturbance may be a risk factor for persistent neurocognitive impairment after COVID-19. Additional studies should validate these relationships and examine whether improving sleep quality may reduce the risk of cognitive impairment in these patients.
新型冠状病毒肺炎（COVID-19）感染后的认知障碍很常见，但其风险因素仍知之甚少。睡眠障碍会增加普通人群认知障碍的风险，且COVID-19感染后睡眠障碍很常见。虽然先前的文献广泛探讨了睡眠与认知之间的关系，但很少有研究涉及这种关联的时间性以及随着时间推移一方如何影响另一方。本研究评估了COVID-19住院1个月时出现的新发睡眠障碍是否与6个月时的认知障碍风险相关。
招募了华盛顿大学医学中心年龄≥18岁、COVID-19住院后存活至1个月的成年英语使用者。出院后1个月和6个月时，通过患者报告结局测量信息系统（PROMIS）简表评估自我报告的睡眠障碍、认知功能、认知能力和疲劳严重程度。线性和逻辑回归模型分析了1个月时新发睡眠障碍与6个月时认知功能、认知能力和疲劳严重程度结局之间的关联。
参与者（n = 120）的平均年龄为56.5±15.7岁，35%的参与者在1个月时出现新发睡眠障碍。在1个月时有新发睡眠障碍与无新发睡眠障碍的参与者中，分别有74%与40%、76%与37%、64%与50%在6个月时认知功能、认知能力和疲劳严重程度出现显著恶化。
在这个单中心观察性队列中，COVID-19住院后1个月时的新发睡眠障碍与6个月时认知功能、认知能力和疲劳严重程度随后的显著恶化相关。因此，新发睡眠障碍可能是COVID-19后持续性神经认知障碍的一个风险因素。更多研究应验证这些关系，并研究改善睡眠质量是否可降低这些患者认知障碍的风险。
