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

P, Li; Zheng, Xi; Ulsa, Ma Cherrysse; Yang, Hao-Hsiang; Scheer, Frank A.J.L.; Rutter, Martin K.; Hu, Kun; Gao, Lei

doi:10.1093/sleep/zsab138

Cited by 25 publications

(26 citation statements)

References 11 publications

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“…Due to the lack of specialized questionnaires of sleep, such as PSQI or FIRST at the baseline survey of UK Biobank, we instead used an algorithm based on self‐reported sleep quality information that was first introduced in 2020 for UK Biobank cohort (Fan et al, 2020 ). This algorithm has been used widely since 2020 and was used to make an index for sleep with 5 sleep‐related items (Fan et al, 2020 ; Li, Zheng, et al, 2021 ; Li, Xue, et al, 2021 ) or 4 items (Sambou et al, 2021 ), and showed the capacity as an alternative approach to reflect the sleep patterns of the participants of UK Biobank. Therefore, to optimize the sleep quality assessment in the UK Biobank, we used six self‐reported sleep behaviors in this study: snoring, chronotype, daytime sleepiness, sleep duration, and insomnia that were used in 5‐item sleep score (Fan et al, 2020 ) and the “difficulties in getting up in the morning” pattern that was found to be related to the risk of terminated health‐span (Sambou et al, 2021 ) to enhance the measurement of sleep quality and the capacity of the below‐mentioned sleep index (Table S11 ).…”

Section: Methodsmentioning

confidence: 99%

Role of sleep quality in the acceleration of biological aging and its potential for preventive interaction on air pollution insults: Findings from the UK Biobank cohort

et al. 2022

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Sleep has been associated with aging and relevant health outcomes, but the causal relationship remains inconclusive. In this study, we investigated the associations of sleep behaviors with biological ages (BAs) among 363,886 middle and elderly adults from UK Biobank. Sleep index (0 [worst]–6 [best]) of each participant was retrieved from the following six sleep behaviors: snoring, chronotype, daytime sleepiness, sleep duration, insomnia, and difficulties in getting up. Two BAs, the KDM‐biological age and PhenoAge, were estimated by corresponding algorithms based on clinical traits, and their residual discrepancies with chronological age were defined as the age accelerations (AAs). We first observed negative associations between the sleep index and the two AAs, and demonstrated that the change of AAs could be the consequence of sleep quality using Mendelian randomization with genetic risk scores of sleep index and BAs. Particularly, a one‐unit increase in sleep index was associated with 0.104‐ and 0.119‐year decreases in KDM‐biological AA and PhenoAge acceleration, respectively. Air pollution is another key driver of aging. We further observed significant independent and joint effects of sleep and air pollution (PM2.5 and NO2) on AAs. Sleep quality also showed a modifying effect on the associations of elevated PM2.5 and NO2 levels with accelerated AAs. For instance, an interquartile range increase in PM2.5 level was associated with 0.009‐, 0.044‐, and 0.074‐year increase in PhenoAge acceleration among people with high (5–6), medium (3–4), and low (0–2) sleep index, respectively. Our findings elucidate that better sleep quality could lessen accelerated biological aging resulting from air pollution.

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Section: Methodsmentioning

confidence: 99%

Role of sleep quality in the acceleration of biological aging and its potential for preventive interaction on air pollution insults: Findings from the UK Biobank cohort

et al. 2022

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“… 24 It was also documented that preexisting EDS was significantly associated with the risk of mortality and hospitalization in patients infected by COVID-19. 25 Thus, there could be a close link between COVID-19 and EDS, albeit that the underlying mechanism remained unclear.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccine Could Trigger the Relapse of Secondary Hypersomnia

Wu¹,

Li²,

Xue³

et al. 2021

NSS

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The coronavirus disease (COVID-19) has brought significant social and economic disruptions and devastating impacts on public health, and vaccines are being developed to combat the disease. Timely vaccination may prevent complications and morbidity but may also potentially result in unforeseen outcomes in some special clinical populations. We report on a case of hypersomnia relapse after the COVID-19 vaccination, with the aim of informing the development of the guideline on vaccination in specific groups. A 19-year old female presented with persistent daytime sleepiness after receiving the COVID-19 vaccine. She had a known history of hypersomnia secondary to infectious mononucleosis but has fully recovered for 8 months. A series of examinations were performed on this patient. Neurologic and psychiatric examinations were unremarkable. Despite normal nocturnal subjective sleep quality (Pittsburgh Sleep Quality Index score = 5, Insomnia Severity Index score = 7), her Epworth sleepiness scale score (15) suggested an abnormal level of subjective sleepiness. Consistent with the subjective report, the objective assessment by Multiple Sleep Latency Test found mean sleep latency was 1.3 min with no sleep onset rapid-eye-movement (REM) period. We speculate that COVID-19 vaccine may potentially trigger the relapse of hypersomnia. The immune memory could be an explanation for the increased response to vaccine in patients with secondary hypersomnia. Caution should be warranted when administering COVID-19 vaccine in patients with hypersomnia secondary to infections.

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“…First, a composite dichotomized measure for DSB burden was constructed by re-coding the answers for the two questions: "Not having poor DSB burden (0)" if participants answered "never/rarely" for both questions, and "Having DSB burden (1)" if otherwise. 27,28 It was considered missing when participants did not answer (or prefer not to answer) both questions, or answered one of them whereas answered "never/rarely" for the other question. Additionally, we further divided those who have DSB burden (ie, being scored "1" using the above dichotomized coding approach) into two groups.…”

Section: Assessment Of Daytime Sleep Behavior Burdenmentioning

confidence: 99%

Daytime Sleep Behaviors and Cognitive Performance in Middle- to Older-Aged Adults Living with and without HIV Infection

P¹,

L²,

Gao³

et al. 2022

NSS

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We investigated whether daytime sleep behaviors (DSBs) such as frequent daytime sleepiness or napping are associated with worse cognitive performance, and whether HIV infection moderates this relationship. Methods: Among 502,507 participants in the UK Biobank study, we identified 562 people living with HIV infection (PLWH; M age = 50.51±7.81; 25.09% female; 78.83% white) and extracted 562 uninfected controls who matched on age, sex, ethnic background, social-economic status, and comorbidities. DSB burden was assessed based on answers to two questions on DSBs. Participants who answered "sometimes" or "often/usually" to one of them were considered to have poor DSB burden, or otherwise were considered not having any. A composite cognition score was computed by averaging the available standardized individual test results from four neurocognitive tests: ie, a reaction time test for information processing speed, a pairs matching test for visual episodic memory, a fluid intelligence test for reasoning, and a prospective memory test. Mixed-effects models with adjustment for the variables used in extracting matched uninfected controls were performed to test the hypotheses. Results: Having poor DSB burden was associated with a 0.15 -standard deviation (SD) decrease in cognitive performance (p = 0.006). People living with HIV infection (PLWH) also performed worse on the cognitive tasks than uninfected controls, with an effect size similar to that of having poor DSB burden (p = 0.003). HIV infection significantly modified the negative association between DSB burden and cognition (p for interaction: 0.008). Specifically, the association between DSB burden and cognition was not statistically significant in uninfected controls, whereas PLWH who reported having poor DSB burden had a 0.28 -SD decrease in cognitive performance compared to PLWH who did not. Conclusion: HIV infection significantly increased the adverse association between DSBs and cognitive performance. Further studies are needed to investigate the potential mechanisms that underlie this interaction effect and whether poor DSBs and worse cognitive performance are causally linked.

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

Cited by 25 publications

References 11 publications

Role of sleep quality in the acceleration of biological aging and its potential for preventive interaction on air pollution insults: Findings from the UK Biobank cohort

Role of sleep quality in the acceleration of biological aging and its potential for preventive interaction on air pollution insults: Findings from the UK Biobank cohort

COVID-19 Vaccine Could Trigger the Relapse of Secondary Hypersomnia

Daytime Sleep Behaviors and Cognitive Performance in Middle- to Older-Aged Adults Living with and without HIV Infection

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