Groggy during the day? Feeling burned out at work? That could put you at increased risk for COVID-19 and more severe illness, a new study suggests.
"We found that lack of sleep at night, severe sleep problems and high level of burnout may be risk factors for COVID-19" for frontline health care workers, according to a team led by Dr. Sara Seidelmann, an assistant professor of clinical medicine at Columbia College of Physicians and Surgeons, Stamford Hospital, Conn.
One expert who wasn't connected to the research said the findings made sense.
"This study reconfirms several items that have been suspected about the relationship of sleep, stress and infectious diseases," said Dr. Thomas Kilkenny, who directs sleep medicine at Staten Island University Hospital in New York City. "The researchers demonstrate, in a very comprehensive way, that both sleep deprivation through lack of sleep increases both the risk of developing COVID 19 but also the duration of the illness."
Prior research has found that poor sleep and job burnout are linked with a greater risk for a variety of viral and bacterial infections, so the authors of this new study wanted to find out if they're also risk factors for COVID-19.
In this latest study, published March 22 in the journal BMJ Nutrition Prevention & Health, they analyzed the responses of nearly 2,900 health care workers in the United States, France, Germany, Italy, Spain and Britain. All had participated in an online survey from July 17 to Sept. 25, 2020. Of those health care workers, 568 reported having gotten infected with the new coronavirus.
The health care workers averaged between 6 and 7 hours of sleep a night.
The study couldn't prove cause-and-effect, but after the researchers accounted for other factors, they concluded that every extra hour of sleep at night was associated with a 12% lower risk of the worker getting COVID-19.
However, whenthat extra hour of shuteye took place was crucial. An extra hour of sleep via daytime napping was associated with a 6% higher risk of getting COVID-19, the team noted in a journal news release.
According to Kilkenny, that shows that "staffers that needed to take naps during the day -- a surrogate for lack of sleep -- were also at an increased risk for the disease."
About 1 in 4 (24%) of the people who went on to contract COVID-19 had already reported long-term difficulties sleeping at night, compared with about 1 in every 5 (21%) of those who hadn't gotten the illness.
Seidelmann's group also found that 5% of those with COVID-19 had three or more sleep problems -- including difficulties falling asleep, staying asleep, or needing to use sleeping pills on three or more nights of the week -- compared with 3% of those without COVID-19.
People with those three sleep problems were 88% more likely to develop COVID-19 than those with no sleep problems, the study found.
Another finding was that 5.5% of those with COVID-19 reported daily work burnout, compared with 3% of those without COVID-19. Compared to those with no burnout, those with daily burnout had twice the risk of getting COVID-19, and they were about 3 times more likely to have severe COVID-19 and to take longer to recover.
Dr. Harly Greenberg is chief of pulmonary, critical care and sleep Medicine at Northwell Health, in Great Neck, N.Y. He wasn't involved in the research, but said it "adds to the mounting literature that sleep is much more than simply withdrawing from the environment; rather it is an essential and active biological process that restores brain function including memory, mood, cognition and resiliency to stress."
The study is also "consistent with research that shows that insufficient sleep has important adverse effects on immune health, which increases susceptibility to infection and other health problems," Greenburg said. "This study highlights the importance of preserving sleep in the overall effort to enhance well-being during this difficult time."
The U.S. Centers for Disease Control and Prevention has more on COVID-19.
SOURCES: BMJ Nutrition Prevention & Health, news release, March 22, 2021