Browsing by Author "Landtblom, Anne Marie"
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- Associations between changes in habitual sleep duration and lower self-rated health among COVID-19 survivors: findings from a survey across 16 countries/regionsPublication . Matsui, Kentaro; Chung, Frances; Bjelajac, Adrijana Koscec; Merikanto, Ilona; Korman, Maria; Mota-Rolim, Sérgio; Cunha, Ana Suely; Bjorvatn, Bjørn; Xue, Pei; Benedict, Christian; Morin, Charles M.; Espie, Colin A.; Landtblom, Anne Marie; Penzel, Thomas; De Gennaro, Luigi; Holzinger, Brigitte; Hrubos-Strøm, Harald; Leger, Damien; Bolstad, Courtney J.; Nadorff, Michael R.; Plazzi, Giuseppe; Reis, Catia; Chan, Ngan Yin; Wing, Yun Kwok; Yordanova, Juliana; Dauvilliers, Yves; Partinen, Markku; Inoue, YuichiBackground: Self-rated health (SRH) is widely recognized as a clinically significant predictor of subsequent mortality risk. Although COVID-19 may impair SRH, this relationship has not been extensively examined. The present study aimed to examine the correlation between habitual sleep duration, changes in sleep duration after infection, and SRH in subjects who have experienced SARS-CoV-2 infection. Methods: Participants from 16 countries participated in the International COVID Sleep Study-II (ICOSS-II) online survey in 2021. A total of 10,794 of these participants were included in the analysis, including 1,509 COVID-19 individuals (who reported that they had tested positive for COVID-19). SRH was evaluated using a 0-100 linear visual analog scale. Habitual sleep durations of < 6 h and > 9 h were defined as short and long habitual sleep duration, respectively. Changes in habitual sleep duration after infection of ≤ -2 h and ≥ 1 h were defined as decreased or increased, respectively. Results: Participants with COVID-19 had lower SRH scores than non-infected participants, and those with more severe COVID-19 had a tendency towards even lower SRH scores. In a multivariate regression analysis of participants who had experienced COVID-19, both decreased and increased habitual sleep duration after infection were significantly associated with lower SRH after controlling for sleep quality (β = −0.056 and −0.058, respectively, both p < 0.05); however, associations between current short or long habitual sleep duration and SRH were negligible. Multinomial logistic regression analysis showed that decreased habitual sleep duration was significantly related to increased fatigue (odds ratio [OR] = 1.824, p < 0.01), shortness of breath (OR = 1.725, p < 0.05), diarrhea/nausea/vomiting (OR = 2.636, p < 0.01), and hallucinations (OR = 5.091, p < 0.05), while increased habitual sleep duration was significantly related to increased fatigue (OR = 1.900, p < 0.01). Conclusions: Changes in habitual sleep duration following SARS-CoV-2 infection were associated with lower SRH. Decreased or increased habitual sleep duration might have a bidirectional relation with post-COVID-19 symptoms. Further research is needed to better understand the mechanisms underlying these relationships for in order to improve SRH in individuals with COVID-19.
- Associations between obesity, a composite risk score for probable long COVID, and sleep problems in SARS-CoV-2 vaccinated individualsPublication . Xue, Pei; Merikanto, Ilona; Delale, Eva A.; Bjelajac, Adrijana; Yordanova, Juliana; Chan, Rachel N. Y.; Korman, Maria; Mota-Rolim, Sérgio A.; Landtblom, Anne Marie; Matsui, Kentaro; Reis, Catia; Penzel, Thomas; Inoue, Yuichi; Nadorff, Michael R.; Holzinger, Brigitte; Morin, Charles M.; Espie, Colin A.; Plazzi, Giuseppe; Gennaro, Luigi De; Chung, Frances; Bjorvatn, Bjørn; Wing, Yun Kwok; Dauvilliers, Yves; Partinen, Markku; Benedict, ChristianBackground: Preliminary data suggests that obesity might hasten the decline in mRNA vaccine-induced immunity against SARS-CoV-2. However, whether this renders individuals with obesity more susceptible to long COVID symptoms post-vaccination remains uncertain. Given sleep’s critical role in immunity, exploring the associations between obesity, probable long COVID symptoms, and sleep disturbances is essential. Methods: We analyzed data from a survey of 5919 adults aged 18 to 89, all of whom received two SARS-CoV-2 mRNA vaccinations. Participants were categorized into normal weight, overweight, and obesity groups based on ethnicity-specific BMI cutoffs. The probability of long COVID was evaluated using the Post-Acute Sequelae of SARS-CoV-2 (PASC) score, as our survey did not permit confirmation of acute SARS-CoV-2 infection through methods such as antibody testing. Additionally, sleep patterns were assessed through questionnaires. Results: Participants with obesity exhibited a significantly higher adjusted odds ratio (OR) of having a PASC score of 12 or higher, indicative of probable long COVID in our study, compared to those with normal weight (OR: 1.55, 95% CI: 1.05, 2.28). No significant difference was observed for overweight individuals (OR: 0.92 [95% CI: 0.63, 1.33]). Both obesity and probable long COVID were associated with increased odds of experiencing a heightened sleep burden, such as the presence of obstructive sleep apnea or insomnia (P < 0.001). However, no significant interaction between BMI and probable long COVID status was found. Conclusions: Even post-vaccination, individuals with obesity may encounter a heightened risk of experiencing prolonged COVID-19 symptoms. However, confirming our observations necessitates comprehensive studies incorporating rigorous COVID infection testing, such as antibody assays - unavailable in our anonymous survey. Additionally, it is noteworthy that the correlation between probable long COVID and sleep disturbances appears to be independent of BMI.
- Estimation bias and agreement limits between two common self-report methods of habitual sleep duration in epidemiological surveysPublication . Korman, Maria; Zarina, Daria; Tkachev, Vadim; Merikanto, Ilona; Bjorvatn, Bjørn; Bjelajac, Adrijana Koscec; Penzel, Thomas; Landtblom, Anne Marie; Benedict, Christian; Chan, Ngan Yin; Wing, Yun Kwok; Dauvilliers, Yves; Morin, Charles M.; Matsui, Kentaro; Nadorff, Michael; Bolstad, Courtney J.; Chung, Frances; Mota-Rolim, Sérgio; Gennaro, Luigi De; Plazzi, Giuseppe; Yordanova, Juliana; Holzinger, Brigitte; Partinen, Markku; Reis, CátiaAccurate measurement of habitual sleep duration (HSD) is crucial for understanding the relationship between sleep and health. This study aimed to assess the bias and agreement limits between two commonly used short HSD self-report methods, considering sleep quality (SQ) and social jetlag (SJL) as potential predictors of bias. Data from 10,268 participants in the International COVID Sleep Study-II (ICOSS-II) were used. Method-Self and Method-MCTQ were compared. Method-Self involved a single question about average nightly sleep duration (HSDself), while Method-MCTQ estimated HSD from reported sleep times on workdays (HSDMCTQwork) and free days (HSDMCTQfree). Sleep quality was evaluated using a Likert scale and the Insomnia Severity Index (ISI) to explore its influence on estimation bias. HSDself was on average 42.41 ± 67.42 min lower than HSDMCTQweek, with an agreement range within ± 133 min. The bias and agreement range between methods increased with poorer SQ. HSDMCTQwork showed less bias and better agreement with HSDself compared to HSDMCTQfree. Sleep duration irregularity was − 43.35 ± 78.26 min on average. Subjective sleep quality predicted a significant proportion of variance in HSDself and estimation bias. The two methods showed very poor agreement and a significant systematic bias, both worsening with poorer SQ. Method-MCTQ considered sleep intervals without adjusting for SQ issues such as wakefulness after sleep onset but accounted for sleep irregularity and sleeping in on free days, while Method-Self reflected respondents’ interpretation of their sleep, focusing on their sleep on workdays. Including an SQ-related question in surveys may help bidirectionally adjust the possible bias and enhance the accuracy of sleep-health studies.
- Persistent short nighttime sleep duration is associated with a greater post-COVID risk in fully mRNA-vaccinated individualsPublication . Xue, Pei; Merikanto, Ilona; Chung, Frances; Morin, Charles M.; Espie, Colin; Bjorvatn, Bjørn; Cedernaes, Jonathan; Landtblom, Anne Marie; Penzel, Thomas; Gennaro, Luigi de; Holzinger, Brigitte; Matsui, Kentaro; Hrubos-Strøm, Harald; Korman, Maria; Leger, Damien; Mota-Rolim, Sérgio; Bolstad, Courtney J.; Nadorff, Michael; Plazzi, Giuseppe; Reis, Cátia; Chan, Rachel Ngan Yin; Wing, Yun Kwok; Yordanova, Juliana; Bjelajac, Adrijana Koscec; Inoue, Yuichi; Partinen, Markku; Dauvilliers, Yves; Benedict, ChristianShort nighttime sleep duration impairs the immune response to virus vaccination, and long nighttime sleep duration is associated with poor health status. Thus, we hypothesized that short (<6 h) and long (>9 h) nighttime sleepers have a higher post-COVID risk than normal nighttime sleepers, despite two doses of mRNA vaccine (which has previously been linked to lower odds of long-lasting COVID-19 symptoms). Post-COVID was defined as experiencing at least one core COVID-19 symptom for at least three months (e.g., shortness of breath). Multivariate logistic regression adjusting for age, sex, BMI, and other factors showed in 9717 respondents (age span 18–99) that two mRNA vaccinations lowered the risk of suffering from post-COVID by about 21% (p < 0.001). When restricting the analysis to double-vaccinated respondents (n = 5918), short and long sleepers exhibited a greater post-COVID risk than normal sleepers (adjusted OR [95%-CI], 1.56 [1.29, 1.88] and 1.87 [1.32, 2.66], respectively). Among respondents with persistent sleep duration patterns during the pandemic compared to before the pandemic, short but not long sleep duration was significantly associated with the post-COVID risk (adjusted OR [95%-CI], 1.59 [1.24, 2.03] and 1.18 [0.70, 1.97], respectively). No significant association between sleep duration and post-COVID symptoms was observed in those reporting positive SARS-CoV-2 test results (n = 538). Our findings suggest that two mRNA vaccinations against SARS-CoV-2 are associated with a lower post-COVID risk. However, this protection may be less pronounced among those sleeping less than 6 h per night. Our findings warrant replication in cohorts with individuals with confirmed SARS-CoV-2 infection.
- Sleep symptoms are essential features of long-COVID – comparing healthy controls with COVID-19 cases of different severity in the international COVID sleep study (ICOSS-II)Publication . Merikanto, Ilona; Dauvilliers, Yves; Chung, Frances; Wing, Yun Kwok; de Gennaro, Luigi; Holzinger, Brigitte; Bjorvatn, Bjørn; Morin, Charles M.; Penzel, Thomas; Benedict, Christian; Koscec Bjelajac, Adrijana; Chan, Ngan Yin; Espie, Colin A.; Hrubos-Strøm, Harald; Inoue, Yuichi; Korman, Maria; Landtblom, Anne Marie; Léger, Damien; Matsui, Kentaro; Mota-Rolim, Sergio; Nadorff, Michael R.; Plazzi, Giuseppe; Reis, Cátia; Yordanova, Juliana; Partinen, MarkkuMany people report suffering from post-acute sequelae of COVID-19 or “long-COVID”, but there are still open questions on what actually constitutes long-COVID and how prevalent it is. The current definition of post-acute sequelae of COVID-19 is based on voting using the Delphi-method by the WHO post-COVID-19 working group. It emphasizes long-lasting fatigue, shortness of breath and cognitive dysfunction as the core symptoms of post-acute sequelae of COVID-19. In this international survey study consisting of 13,628 subjects aged 18–99 years from 16 countries of Asia, Europe, North America and South America (May–Dec 2021), we show that post-acute sequelae of COVID-19 symptoms were more prevalent amongst the more severe COVID-19 cases, i.e. those requiring hospitalisation for COVID-19. We also found that long-lasting sleep symptoms are at the core of post-acute sequelae of COVID-19 and associate with the COVID-19 severity when COVID-19 cases are compared with COVID-negative cases. Specifically, fatigue (61.3%), insomnia symptoms (49.6%) and excessive daytime sleepiness (35.8%) were highly prevalent amongst respondents reporting long-lasting symptoms after hospitalisation for COVID-19. Understanding the importance of sleep-related symptoms in post-acute sequelae of COVID-19 has a clinical relevance when diagnosing and treating long-COVID.
- The association of insomnia with long COVID: an international collaborative study (ICOSS-II)Publication . Chen, Si Jing; Morin, Charles M.; Ivers, Hans; Wing, Yun Kwok; Partinen, Markku; Merikanto, Ilona; Holzinger, Brigitte; Espie, Colin A.; De Gennaro, Luigi; Dauvilliers, Yves; Chung, Frances; Yordanova, Juliana; Vidović, Domagoj; Reis, Catia; Plazzi, Giuseppe; Penzel, Thomas; Nadorff, Michael R.; Matsui, Kentaro; Mota-Rolim, Sergio; Leger, Damien; Landtblom, Anne Marie; Korman, Maria; Inoue, Yuichi; Hrubos-Strøm, Harald; Chan, Ngan Yin; Bjelajac, Adrijana Koscec; Benedict, Christian; Bjorvatn, BjørnObjective: There is evidence of a strong association between insomnia and COVID-19, yet few studies have examined the relationship between insomnia and long COVID. This study aimed to investigate whether COVID-19 patients with pre-pandemic insomnia have a greater risk of developing long COVID and whether long COVID is in turn associated with higher incident rates of insomnia symptoms after infection. Methods: Data were collected cross-sectionally (May–Dec 2021) as part of an international collaborative study involving participants from 16 countries. A total of 2311 participants (18–99 years old) with COVID-19 provided valid responses to a web-based survey about sleep, insomnia, and health-related variables. Log-binomial regression was used to assess bidirectional associations between insomnia and long COVID. Analyses were adjusted for age, sex, and health conditions, including sleep apnea, attention and memory problems, chronic fatigue, depression, and anxiety. Results: COVID-19 patients with pre-pandemic insomnia showed a higher risk of developing long COVID than those without pre-pandemic insomnia (70.8% vs 51.4%; adjusted relative risk [RR]: 1.33, 95% confidence interval [CI]: 1.07–1.65). Among COVID-19 cases without pre-pandemic insomnia, the rates of incident insomnia symptoms after infection were 24.1% for short COVID cases and 60.6% for long COVID cases (p <.001). Compared with short COVID cases, long COVID cases were associated with an increased risk of developing insomnia symptoms (adjusted RR: 2.00; 95% CI: 1.50–2.66). Conclusions: The findings support a bidirectional relationship between insomnia and long COVID. These findings highlight the importance of addressing sleep and insomnia in the prevention and management of long COVID.