Prospective associations of long COVID with sleep health nearly 3 years after SARS-CoV-2 infection: a statewide representative cohort study.

STUDY

OBJECTIVES

While many adults with long COVID experience sleep problems, the long-term relationship between long COVID and sleep remains poorly understood. We investigated how long COVID is prospectively associated with sleep duration, sleep quality, and sleep disturbance using a population-based cohort of Michigan adults with COVID-19 (N = 2406).

METHODS

Long COVID was defined at baseline as reporting a recovery time of 90 days or more after the initial infection and sleep outcomes were assessed at follow-up 1 and 2, approximately 1.5 and 3 years after the initial infection. We estimated linear and multinomial logistic regression models with sleep duration as continuous and categorical variables, respectively. Then, we conducted multinomial logistic regression models for sleep quality and modified Poisson regression for moderate-to-severe sleep disturbance.

RESULTS

Long COVID was prospectively associated with a shorter sleep duration by 0.35 hours (95% CI = -0.53% to -0.17%) at follow-up 1. Relative to sleeping 6-9 hours, long COVID was associated with sleeping less than 6 hours at follow-up 1 (adjusted relative risk ratio [aRRR]: 3.27; 95% CI = 2.16% to 4.96%) and follow-up 2 (aRRR: 1.91; 95% CI = 1.28% to 2.85%). Additionally, long COVID had a strong association with poor-to-very poor sleep quality at both follow-up periods relative to very good-to-fair sleep quality at both follow-up periods. Long COVID was also associated with a 1.53 times higher risk of moderate-to-severe sleep disturbance (95% CI = 1.23% to 1.91%).

CONCLUSION

Long COVID was prospectively associated with unhealthy sleep outcomes 3 years after onset. There is a need to enhance sleep health among individuals with long COVID.