Abstract
Study objectives: This study assessed changes in sleep quality before and after the peak of the SARS-CoV-2 pandemic in community dwellers enrolled in the Atahualpa Project.
Methods: Atahualpa residents aged ≥40 years were eligible if they had a Pittsburgh Sleep Quality Index (PSQI) 9 months before the pandemic and a lateral flow-based test for identification of SARS-CoV-2 antibodies during the peak of the pandemic. Six months later, individuals completed a follow-up PSQI. The independent relationship between SARS-CoV-2 infection and deterioration in sleep quality was assessed by fitting logistic mixed models for longitudinal data.
Results: Of 639 participants (mean age at baseline: 59 ± 12.8 years), 325 (51%) had SARS-CoV-2 antibodies. A total of 185 (29%) individuals at baseline and 311 (49%) at follow-up were poor sleepers (p < 0.001). Mixed logistic regression models demonstrated a significant increase in poor sleepers at follow-up (odds ratio [OR]: 2.85; 95% CI: 2.16 to 3.75), which was more marked among SARS-CoV-2 seropositive subjects (OR: 3.8; 95% CI: 2.48 to 5.81). The adjusted proportion of poor sleepers increased from 29% to 56.2% (95% CI: 50.9% to 61.6%) among SARS-CoV-2 seropositive individuals, but only to 40.7% (95% CI: 35.3% to 46.1%) in their seronegative counterparts (p < 0.001). Likewise, progression from a good to a poor sleeper status was higher among seropositive individuals than in their seronegative counterparts (38.1% vs 22.3%; p < 0.001), after adjusting for relevant covariates.
Conclusions: This study shows a deleterious effect of SARS-CoV-2 in sleep quality. An effect of SARS-CoV-2 in disrupting sleep-related pathways cannot be ruled out.
Trial registration: The Atahualpa Project has been registered at ClinicalTrials.gov; the identifier number is NCT01627600 , and the date was: 10/02/2012 (https://clinicaltrials.gov/ct2/show/NCT01627600?cond=Atahualpa&draw=2&rank=1). The Sleep Disorders substudy has been registered at ClinicalTrials.gov; the identifier number is NCT01877616 , and the date was: 06/13/2013 (https://clinicaltrials.gov/ct2/show/NCT01877616?cond=Atahualpa&draw=2&rank=4).
Keywords: COVID-19; Coronavirus-19; Pittsburgh Sleep Quality Index; SARS-CoV-2; sleep quality.
【저자키워드】 COVID-19, SARS-CoV-2, Coronavirus-19, Sleep quality., Pittsburgh Sleep Quality Index, 【초록키워드】 pandemic, SARS-COV-2 infection, progression, Deterioration, SARS-CoV-2 antibodies, SARS-CoV-2 antibody, Sleep, pathway, Community, age, Follow-up, Quality, covariates, seronegative, Deleterious, Odds ratio, sleep quality, index, Longitudinal data, Logistic, significant increase, individual, logistic regression model, Registered, participant, seropositive individuals, Pittsburgh, independent, enrolled, proportion, adjusted, changes in, demonstrated, disrupting, Atahualpa, baseline, eligible, seropositive individual, seropositive subject, the SARS-CoV-2, 【제목키워드】 pandemic, Prospective Study, Deterioration, Sleep, Older, the SARS-CoV-2,