Self-reported long COVID associated with sleep problems and poor sleep quality among adults in Germany: results of the German Health Update 2023 (GEDA 2023).

Abstract

Introduction: Long COVID refers to various long-term health impairments following a SARS-CoV-2 infection, including physical, cognitive, and psychological symptoms. Sleep problems are among the most prevalent neuropsychiatric symptoms of long COVID and can negatively affect daily functioning and quality of life. This study aims to investigate sleep onset problems, problems maintaining sleep and poor sleep quality in associations with long COVID among adults in Germany.

Methods: Analyses are based on data from the cross-sectional nationwide telephone interview survey "German Health Update" (GEDA 2023). Between March 2023 and February 2024, 9,310 adults (50.8% female, median age = 60.8 years) answered questions on any prior SARS-CoV-2 infection and long COVID status, as well as on sleep onset problems, problems maintaining sleep and poor sleep quality over the past 4 weeks. Weighted prevalence estimates for each sleep variable were calculated by self-reported SARS-CoV-2 infection and long COVID status. Multivariable logistic regressions were conducted, adjusted for age, sex, level of education, chronic conditions, depressive symptoms, COVID-19 vaccination status, and multiple SARS-CoV-2 infections.

Results: Participants with self-reported current long COVID reported higher proportions of sleep onset problems (32.6%), problems maintaining sleep (47.8%) and poor sleep quality (44.8%) compared to participants without a SARS-CoV-2 infection (20.0%, 30.8 and 24.1%, respectively) or prior infected participants without long COVID (13.8%, 23.8 and 20.0%, respectively). In multivariable logistic regression analyses, participants with self-reported current long COVID had an increased likelihood of experiencing problems maintaining sleep (adjusted odds ratio (aOR) = 1.73; 95% CI = 1.23-2.44) and a higher likelihood of poor sleep quality (aOR = 1.81; 95% CI = 1.29-2.55) compared to non-infected individuals; however, sleep onset problems were not associated with long COVID.

Discussion: Our findings from general population data suggest that adults with current long COVID have 1.7- to 1.8-fold higher odds of problems maintaining sleep and poor sleep quality than non-infected individuals. Given the potential impact on quality of life and physical and psychological functioning, sleep-related symptoms may represent an important target for clinical assessment and management in individuals with long COVID.