High risk of COVID-19 for doctors with sleep disorders

Insomnia, sleep disorders, and burnout were associated with higher odds of COVID-19 among physicians and other healthcare professionals who are frequently exposed to SARS-CoV-2 and approximately 2,900 clinicians. The survey showed.

Clinicians at high risk with three sleep disorders (nighttime sleep disorders, poor sleep continuity, and frequent use of sleeping pills) have almost twice as many COVIDs as non-sleep disorder clinicians- Had 19 risks (OR 1.88, 95% CI 1.17-3.01, P Trend = 0.22), Ph.D. in Medicine, Stamford, Connecticut, and co-author..

For every hour of sleep at night, the odds for COVID-19 decreased by 12% (OR 0.88, 95% CI 0.81-0.96)., P= 0.003) After adjusting the confounding factors, the researchers wrote: BMJ nutrition, prevention and health..

Clinicians who said they experienced burnout at work every day were also at increased risk of COVID-19 infection (OR 2.60, 95% CI 1.57-4.31). P Tendency = 0.001), longer disease duration (OR 2.98, 95% CI 1.10-8.05, P Trend = 0.02), and greater COVID-19 severity (OR 3.26, 95% CI 1.25-8.48, P Tendency = 0.02) Compared to those who did not report work burnout.

“We know that [lack of] Personal protective equipment, hand washing, and social distance are important risk factors for COVID-19, and this study is a less-studied non-hygiene association that may independently contribute to the risk of developing the disease. Emphasizes the importance of the factors.

“This work promotes an overall approach to health, such as optimizing sleep and reducing work stress, and protects healthcare professionals from current and future pandemics,” she said. Today’s MedPage.

“Sleep is essential for optimal immune function,” said Michael Irwin, MD, MD, UCLA Gefen School of Medicine, Los Angeles, who was not involved in the study. “During sleep, the immune system recovers and prepares the immune system to recognize and respond to infectious challenges during the day. In contrast, short sleep times and poor sleep quality are infectious. It impairs the ability to resist the challenge. For example, inoculation of standard doses of the virus weakens the immunity of vaccination. “

“In addition, sleep disorders may be a double-edged sword with COVID infection,” Irwin said. Today’s MedPage. “Sleep disorders not only reduce resistance to viral infections, but also trigger transcriptional pathways that induce an inflammatory cascade, exaggerated systemic markers of inflammation such as C-reactive protein, interleukin-6, and tumor necrosis factor. Causes production, increasing the risk of severity of COVID infection..“”

The findings are based on an online poll of clinicians frequently exposed to COVID-19 in the United States, Spain, Italy, France, Germany and the United Kingdom from July 17th to September 25th, 2020. During the night and day of the year before the pandemic, I slept with sleep problems or work burnout before the pandemic, and workplace exposure to COVID-19.

Almost all participants (95%) were doctors, most commonly emergency medicine, internal medicine, and pulmonologists. Their average age was 48 years and 72% were male. More than one-third (36.8%) came from the United States. Respondents averaged 6.7 hours of nighttime sleep and 0.9 hours of nap before the pandemic. Most people say that burnout is rare and occurs less than once a month to several times a month.

Of the 2,884 exposed health care workers who participated in the study, 568 were infected with COVID-19 based on self-reported symptoms or a positive swab test. Compared to the 2,316 controls, the 568 respondents with COVID-19 were slightly younger, more likely to be doctors, and more likely to practice internal medicine. They were more likely to report having less sleep at night, slightly longer naps during the day, and one or more sleep problems.

A significant dose-response relationship emerged between the frequency of burnout and COVID-19. Nap was associated with a 6% higher odds of SARS-CoV-2 infection, but the relationship varied from country to country, with a non-significant inverse correlation in Spain. After adjusting for the frequency of COVID-19 exposure, all associations remained significant.

The study evaluated pre-pandemic sleep, but habits have changed overall since the advent of COVID-19, said Dr. Rebecca Robilard of the University of Ottawa, Canada, who was not part of the study. .. “While more than 50% of people suffer from insomnia during a pandemic, sleep is affected in many different ways in different subgroups of the population,” Robilard said. Today’s MedPage.

“Many people plan to go to bed later, but some can’t sleep because they catch up in the morning, which limits their sleep,” she pointed out. “This is because we know that both delayed sleep schedules and shorter sleep times are associated with worsening health, such as how our bodies can recover from illness. is.”

There were some limitations to this study, Seidelmann and co-authors said. Participants self-reported exposures, results, and covariates. Recall bias may have led to inaccurate reports of sleep and nap times. Researchers did not define a time frame for the COVID-19 pandemic. Clinicians in the most severe cases of COVID-19 may not have been able to investigate due to illness, and unknown confounders may have influenced the results.