COVID-19 infection and sleep health: findings from the nationally representative COVID-19's Unequal Racial Burden survey.

Abstract

Study objectives: To estimate overall and racial/ethnic-specific associations between COVID-19 infection status and sleep health.

Methods: We analyzed online survey data collected from December 2020 to February 2021 among Asian, Black, Latino (English- and Spanish-speaking), and White adults (n = 1,000 each), along with American Indian/Alaska Native, Native Hawaiian/Pacific Islander, and multiracial adults (n = 500). COVID-19 infection (confirmed, probable, suspected), based on self-reported data on symptoms and infected contacts, was classified using World Health Organization definitions. Sleep disturbances were categorized as "yes" (mild/moderate/severe) vs "no" (normal). Weighted analyses were used to generate nationally representative estimates within each racial/ethnic group. Adjusting for sociodemographic and health behaviors, Poisson regression with robust variance estimated prevalence ratios and confidence intervals for sleep disturbances among individuals with vs without a COVID-19 infection in the overall population and by gender, ability to get health care, and race/ethnicity.

Results: Among 5,359 eligible participants, 24% had a COVID-19 infection. COVID-19 infection was associated with a 32% higher prevalence of sleep disturbances (PR = 1.32 [95% confidence interval: 1.22-1.42]). The higher prevalence of sleep disturbances among women with vs without COVID-19 (PR = 1.32 [1.19-1.45]) was similar to men (PR = 1.34 [1.18-1.53]). COVID-19 infection was associated with an even higher prevalence of sleep disturbances among participants who reported being able vs unable to get needed health care. COVID-sleep associations were higher among American Indian/Alaska Native (PR = 1.64 [1.30-2.09]), Native Hawaiian/Pacific Islander (PR = 1.53 [1.24-1.90]), and English-speaking Latino (PR = 1.49 [1.20-1.86]) adults compared to White adults (PR = 1.14 [0.93-1.41]), although confidence intervals overlapped.

Conclusions: COVID-19 infections may lead to sleep disturbances among US adults.

Citation: Alhasan DM, Gaston SA, Strassle PD, Nápoles AM, Jackson CL. COVID-19 infection and sleep health: findings from the nationally representative COVID-19's Unequal Racial Burden survey. J Clin Sleep Med. 2025;21(6):1053-1063.