Giulia Vivaldi, Mohammad Talaei, John Blaikley, Callum Jackson, Paul E Pfeffer, Seif O Shaheen, Adrian R Martineau
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We assessed post-infection sleep duration using multilevel mixed models. We collected sleep data from participants using a subset of questions from the Pittsburgh Sleep Quality Index. We defined long COVID as unresolved symptoms at least 12 weeks after infection. COVIDENCE UK is registered with ClinicalTrials.gov, NCT04330599.</p><p><strong>Results: </strong>We included 3994 participants in our long COVID risk analysis, of whom 327 (8.2%) reported long COVID. We found an inverse relationship between pre-infection sleep quality and risk of long COVID (medium vs good quality: OR 1.37, 95% CI 1.04 to 1.81; medium-low vs good: 1.55, 1.12 to 2.16; low vs good: 1.94, 1.11 to 3.38). Greater variability in pre-infection sleep efficiency was also associated with long COVID when adjusted for infection severity (OR per percentage-point increase 1.07, 1.02 to 1.12). 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引用次数: 0
摘要
背景：受感染前回顾性睡眠数据和感染后随访较少的限制，对睡眠与长时间COVID之间双向关系的研究受到限制。因此，我们使用前瞻性收集的月度数据来评估感染前睡眠特征如何影响长COVID的风险，并跟踪SARS-CoV-2感染后一年内睡眠时间的变化。方法：COVID-19 UK是一项基于人群的英国成人COVID-19前瞻性研究。我们纳入了有SARS-CoV-2感染证据的非住院参与者，并使用逻辑回归来估计感染前睡眠特征与长COVID之间关联的调整后ORs。我们使用多层混合模型评估感染后的睡眠时间。我们使用匹兹堡睡眠质量指数的问题子集来收集参与者的睡眠数据。我们将长冠状病毒定义为感染后至少12周未解决的症状。COVIDENCE UK已在ClinicalTrials.gov注册，注册号为NCT04330599。结果：我们在做多COVID风险分析中纳入了3994名参与者，其中327名（8.2%）报告做多COVID。我们发现感染前睡眠质量与长期COVID风险呈反比关系(中等与良好质量：OR 1.37, 95% CI 1.04至1.81；中低vs好：1.55,1.12 - 2.16；低vs好：1.94,1.11 vs 3.38)。根据感染严重程度调整后，感染前睡眠效率的较大差异也与较长的COVID相关（OR增加1.07、1.02至1.12）。我们评估了6860名参与者感染后的睡眠时间，与感染前相比，感染后第一个月的睡眠时间增加了0.11小时（95% CI 0.09至0.14），感染越严重，睡眠时间增加越多。1个月后，睡眠时间基本上恢复到感染前的水平，尽管在报告长期感染的人中，睡眠时间的波动持续了长达6个月。结论：虽然在感染SARS-CoV-2之前睡眠质量差与此后长期COVID的风险增加有关，但在这些非住院病例中，感染后睡眠时间的变化不大，而且通常很快得到解决。试验注册号：NCT04330599。
Bidirectional relationship between sleep problems and long COVID: a longitudinal analysis of data from the COVIDENCE UK study.
Background: Studies into the bidirectional relationship between sleep and long COVID have been limited by retrospective pre-infection sleep data and infrequent post-infection follow-up. We therefore used prospectively collected monthly data to evaluate how pre-infection sleep characteristics affect risk of long COVID and to track changes in sleep duration during the year after SARS-CoV-2 infection.
Methods: COVIDENCE UK is a prospective, population-based UK study of COVID-19 in adults. We included non-hospitalised participants with evidence of SARS-CoV-2 infection and used logistic regression to estimate adjusted ORs for the association between preinfection sleep characteristics and long COVID. We assessed post-infection sleep duration using multilevel mixed models. We collected sleep data from participants using a subset of questions from the Pittsburgh Sleep Quality Index. We defined long COVID as unresolved symptoms at least 12 weeks after infection. COVIDENCE UK is registered with ClinicalTrials.gov, NCT04330599.
Results: We included 3994 participants in our long COVID risk analysis, of whom 327 (8.2%) reported long COVID. We found an inverse relationship between pre-infection sleep quality and risk of long COVID (medium vs good quality: OR 1.37, 95% CI 1.04 to 1.81; medium-low vs good: 1.55, 1.12 to 2.16; low vs good: 1.94, 1.11 to 3.38). Greater variability in pre-infection sleep efficiency was also associated with long COVID when adjusted for infection severity (OR per percentage-point increase 1.07, 1.02 to 1.12). We assessed post-infection sleep duration in 6860 participants, observing a 0.11 hour (95% CI 0.09 to 0.14) increase in the first month after infection compared with pre-infection, with larger increases for more severe infections. After 1 month, sleep duration largely returned to pre-infection levels, although fluctuations in duration lasted up to 6 months after infection among people reporting long COVID.
Conclusions: While poor-quality sleep before SARS-CoV-2 infection associates with increased risk of long COVID thereafter, changes in sleep duration after infection in these non-hospitalised cases were modest and generally quick to resolve.
期刊介绍：
BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
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