Sleep for COVID-19: real-time analysis of all 7 studies

Sleep for COVID-19: real-time meta analysis of 7 studies

Covid Analysis (Preprint) (meta analysis)

• Statistically significant improvements are seen for mortality, hospitalization, recovery, and cases. 7 studies from 7 independent teams in 4 different countries show statistically significant improvements in isolation (6 for the most serious outcome).

• Meta analysis using the most serious outcome reported shows 35% [20‑48%] improvement. Results are similar for peer-reviewed studies.

• Studies analyze sleep quality before infection.

• No treatment, vaccine, or intervention is 100% available and effective for all variants. All practical, effective, and safe means should be used. Denying the efficacy of treatments increases mortality, morbidity, collateral damage, and endemic risk.

• All data to reproduce this paper and sources are in the appendix.

Covid Analysis et al., 8/12/2022, preprint, 1 author.

Health behaviours the month prior to COVID-19 infection and the development of self-reported long COVID and specific long COVID symptoms: A longitudinal analysis of 1,811 UK adults

Paul et al., medRxiv, doi:10.1101/2022.04.12.22273792 (Preprint)

Retrospective 1,811 COVID-19 patients in the UK, showing lower risk of self-reported long COVID with good sleep quality in the month before infection.

risk of long COVID, 67.3% lower, RR 0.33, p < 0.001, adjusted, OR converted to RR, very good/good vs. not good/very poor, multivariable, model 4, control prevalance approximated with overall prevalence.

risk of long COVID, 54.0% lower, RR 0.46, p = 0.002, adjusted, OR converted to RR, very good/good vs. average, multivariable, model 4, control prevalance approximated with overall prevalence.

Paul et al., 4/13/2022, retrospective, United Kingdom, preprint, survey, 2 authors.

COVID-19 illness in relation to sleep and burnout

Kim et al., BMJ Nutrition, Prevention & Health, doi:10.1136/bmjnph-2021-000228

Retrospective 2,884 high-risk healthcare workers in France, Germany, Italy, Spain, UK, and the USA, showing shorter sleep duration associated with increased risk of COVID-19 cases and severity.

risk of moderate/severe case, 17.0% lower, OR 0.83, p = 0.03, per extra hour of sleep, RR approximated with OR.

risk of case, 11.0% lower, OR 0.89, p = 0.003, per extra hour of sleep, model 3, RR approximated with OR.

Kim et al., 3/22/2022, retrospective, multiple countries, peer-reviewed, survey, mean age 48.0, 8 authors, study period 17 July, 2020 - 25 September, 2020.

Reduced Sleep in the Week Prior to Diagnosis of COVID-19 is Associated with the Severity of COVID-19

Huang et al., Nature and Science of Sleep, doi:10.2147/NSS.S263488

Retrospective 164 COVID-19 patients and 188 controls in China, showing the risk of severe cases associated with lack of sleep.

risk of severe case, 80.9% lower, RR 0.19, p = 0.02, higher quality sleep 12 of 127 (9.4%), lower quality sleep 4 of 9 (44.4%), NNT 2.9, adjusted, OR converted to RR, recommended vs. lack of sleep, multivariable.

Huang et al., 11/30/2021, retrospective, China, peer-reviewed, survey, 5 authors, study period 10 February, 2020 - 28 March, 2020.

Lifestyle and Comorbidity-Related Risk Factors of Severe and Critical COVID-19 Infection: A Comparative Study Among Survived COVID-19 Patients in Bangladesh

Mohsin et al., Infection and Drug Resistance, doi:10.2147/IDR.S331470

Retrospective 1,500 COVID+ patients in Bangladesh, showing lower risk of severe cases with good sleep.

risk of severe case, 37.9% lower, RR 0.62, p < 0.001, higher quality sleep 327 of 948 (34.5%), lower quality sleep 273 of 552 (49.5%), NNT 6.7, adjusted, OR converted to RR, sleep disturbance, multivariable.

Mohsin et al., 9/30/2021, retrospective, Bangladesh, peer-reviewed, survey, 10 authors, study period November 2020 - April 2021.

Poor sleep behavior burden and risk of COVID-19 mortality and hospitalization

Li et al., Sleep, doi:10.1093/sleep/zsab138

UK Biobank retrospective, 46,535 participants with sleep behavior assessed between 2006 and 2010, showing higher risk of hospitalization and mortality with poor sleep.

risk of death, 43.2% lower, OR 0.57, p = 0.02, fully adjusted model C, significant poor sleep burden, RR approximated with OR.

risk of hospitalization, 35.9% lower, OR 0.64, p = 0.008, fully adjusted model C, significant poor sleep burden, RR approximated with OR.

risk of hospitalization, 21.3% lower, OR 0.79, p = 0.02, fully adjusted model C, moderate poor sleep burden, RR approximated with OR.

Li et al., 6/18/2021, retrospective, USA, peer-reviewed, mean age 69.4, 8 authors, study period March 2020 - December 2020.

Predictors of incident viral symptoms ascertained in the era of COVID-19

Marcus et al., PLOS ONE, doi:10.1371/journal.pone.0253120

Prospective survey based study with 14,335 participants, showing risk of viral symptoms associated with shorter sleep duration.

risk of symptomatic case, 16.0% lower, OR 0.84, p < 0.001, adjusted, per extra hour sleep, multivariable, RR approximated with OR.

Marcus et al., 6/17/2021, prospective, multiple countries, peer-reviewed, survey, 12 authors, study period 26 March, 2020 - 3 May, 2020.

Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK)

Holt et al., Thorax, doi:10.1136/thoraxjnl-2021-217487

Prospective survey-based study with 15,227 people in the UK, showing reduced risk of COVID-19 cases with 8 hours sleep, with statistical significance when compared with ≥9 hours. NCT04330599. COVIDENCE UK.

risk of case, 12.3% lower, OR 0.88, p = 0.50, adjusted, fully adjusted, 8 hours vs. ≤6 hours, RR approximated with OR.

risk of case, 12.3% lower, OR 0.88, p = 0.33, adjusted, fully adjusted, 8 hours vs. 7 hours, RR approximated with OR.

risk of case, 22.5% lower, OR 0.78, p = 0.04, adjusted, fully adjusted, 8 hours vs. ≥9 hours, RR approximated with OR.

Holt et al., 3/30/2021, prospective, United Kingdom, peer-reviewed, 34 authors, study period 1 May, 2020 - 5 February, 2021, trial NCT04330599 (history) (COVIDENCE UK).

Antiandrogens	(meta)	Melatonin	(meta)
Aspirin	(meta)	Metformin	(meta)
Bamlaniv../e..	(meta)	Molnupiravir	(meta)
Bebtelovimab	(meta)	N-acetylcys..	(meta)
Bromhexine	(meta)	Nigella Sativa	(meta)
Budesonide	(meta)	Nitazoxanide	(meta)
Cannabidiol	(meta)	Nitric Oxide	(meta)
Casirivimab/i..	(meta)	Paxlovid	(meta)
Colchicine	(meta)	Peg.. Lambda	(meta)
Conv. Plasma	(meta)	Povidone-Iod..	(meta)
Curcumin	(meta)	Probiotics	(meta)
Diet	(meta)	Proxalutamide	(meta)
Ensitrelvir	(meta)	Quercetin	(meta)
Ensovibep	(meta)	Remdesivir	(meta)
Exercise	(meta)	Sleep	(meta)
Famotidine	(meta)	Sotrovimab	(meta)
Favipiravir	(meta)	Tixagev../c..	(meta)
Fluvoxamine	(meta)	Vitamin A	(meta)
Hydroxychlor..	(meta)	Vitamin C	(meta)
Iota-carragee..	(meta)	Vitamin D	(meta)
Ivermectin	(meta)	Zinc	(meta)
Lactoferrin	(meta)

Other Treatments		Global Adoption