An international study of post-COVID sleep health

Abstract

Objectives: COVID-19 has infected millions of people worldwide, with growing evidence that individuals with a history of infection may continue to show persistent post-COVID symptoms (long COVID). The aim of this study was to investigate sleep health in an international sample of individuals who reported previously testing positive for COVID-19.

Design: Cross-sectional.

Setting: Online survey distributed online between March and June 2021.

Participants: A total of 1001 individuals who reported a positive diagnosis of COVID-19 across different geographical regions, including North and South America, Sub-Saharan Africa, and Europe.

Measurements: Self-reported sleep health, using the Regulatory Satisfaction Alertness Timing Efficiency Duration scale, as recalled before a COVID-19 diagnosis and also reported currently.

Results: Individuals reported worse overall current sleep health, with lower ratings across the 6 dimensions of sleep health (sleep regularity, satisfaction, alertness, timing, efficiency, and duration) compared to their ratings as recalled before COVID-19 infection. Greater severity of COVID-19 symptoms was the strongest predictor of poor current sleep health (P < .001), independent of demographics, presence of a pre-existing chronic health condition, and time since infection. Poor current sleep health was associated with poorer current quality of life (P < .001).

Conclusions: Poor current sleep health is evident in individuals with a history of COVID-19, particularly those with more severe symptoms at the time of their COVID-19 infection and is associated with a poorer quality of life. Clinicians and researchers should assess sleep health in COVID-19 patients and investigate long-term associations with their mental and physical health, as well as potential benefits of improving sleep in this population.

Keywords: COVID-19; General population; Long COVID; Quality of life; Sleep.

Fig. 1

Participants’ sleep health (total scores in the Regulatory Satisfaction Alertness Timing Efficiency Duration (RU-SATED) questionnaire, mean (SD); n = 1001) as recalled before their COVID-19 diagnosis and reported currently. Current RU-SATED scores were significantly lower (P < .01), indicating a poorer sleep health, compared to scores as recalled before a COVID-19 diagnosis.

Fig. 2

Percentage of participants rating the 6 dimensions of sleep health (regularity of sleep, satisfaction with sleep, alertness, timing, sleep efficiency, and sleep duration) as 0 (never/rarely), 1 (sometimes), or 2 (usually/always) as recalled before their COVID-19 diagnosis (panel A) compared with the current time (panel B). Participants rated all sleep health dimensions as lower during current times compared to before COVID-19 diagnosis (see text for details).