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Association of sleep duration and quality with immunological response after vaccination against severe acute respiratory syndrome coronavirus-2 infection |
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| Authors: | Nikolaos Athanasiou Katerina Baou Eleni Papandreou Georgia Varsou Anastasia Amfilochiou Elisavet Kontou Athanasia Pataka Konstantinos Porpodis Ioanna Tsiouprou Evangelos Kaimakamis Serafeim-Chrysovalantis Kotoulas Evgenia Katsibourlia Christina Alexopoulou Izolde Bouloukaki Meropi Panagiotarakou Aspasia Dermitzaki Nikolaos Charokopos Kyriakh Pagdatoglou Kallirroi Lamprou Sofia Pouriki Foteini Chatzivasiloglou Zoi Nouvaki Alexandra Tsirogianni Ioannis Kalomenidis Paraskevi Katsaounou Emmanouil Vagiakis |
| Affiliation: | 1. First Intensive Care Unit (ICU) Department, Evaggelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece;2. Sleep Laboratory, First ICU Clinic, Evaggelismos Hospital, Athens, Greece 4th Pulmonary Department, Sotiria General Hospital of Chest Diseases of Athens, Athens, Greece;3. Department of Critical Care, O Agios Dimitrios, General Hospital of Thessaloniki, Thessaloniki, Greece;4. Sleep Laboratory, Sismanogleio Amalia Phlemink General Hospital, Athens, Greece;5. Immunology-Histocompatibility Department, Evaggelismos General Hospital, Athens, Greece;6. Respiratory Failure Unit, Aristotle University of Thessaloniki George Papanikolaou Hospital, Thessaloniki, Greece;7. Pulmonary Department-Oncology Unit, George Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;8. Pulmonary Department, Aristotle University of Thessaloniki, George Papanikolaou General Hospital, Thessaloniki, Greece;9. 1st Intensive Care Unit, George Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;10. Department of Immunology – Histocompatibility, George Papanikolaou Hospital, Thessaloniki, Greece;11. Intensive Care Unit, University Hospital of Heraklion, Crete, Greece;12. Primary Health Care Center of Kastelli, Sleep Disorders Center, Department Of Thoracic Medicine, University Of Crete, Heraklion, Greece;13. Virology Laboratory, University Hospital of Heraklion, Crete, Greece;14. Pulmonary Department, General Hospital Of Trikala, Greece;15. Pulmonary Department, General Oncologic Hospital Of Athens, Athens, Greece;16. Intensive Care Unit, Sotiria General Hospital of Chest Diseases of Athens, Athens, Greece;17. Intensive Care Unit, General Hospital of Nikaia – Peiraia Agios Panteleimon, Athens, Greece;18. First Intensive Care Unit (ICU) Department, Evaggelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece Sleep Laboratory, First ICU Clinic, Evaggelismos Hospital, Athens, Greece |
| Abstract: | Growing evidence suggests that sleep could affect the immunological response after vaccination. The aim of this prospective study was to investigate possible associations between regular sleep disruption and immunity response after vaccination against coronavirus disease 2019 (COVID-19). In total, 592 healthcare workers, with no previous history of COVID-19, from eight major Greek hospitals were enrolled in this study. All subjects underwent two Pfizer–BioNTech messenger ribonucleic acid (mRNA) COVID-19 vaccine BNT162b2 inoculations with an interval of 21 days between the doses. Furthermore, a questionnaire was completed 2 days after each vaccination and clinical characteristics, demographics, sleep duration, and habits were recorded. Blood samples were collected and anti-spike immunoglobulin G antibodies were measured at 20 ± 1 days after the first dose and 21 ± 2 days after the second dose. A total of 544 subjects (30% males), with median (interquartile range [IQR]) age of 46 (38–54) years and body mass index of 24·84 (22.6–28.51) kg/m2 were eligible for the study. The median (IQR) habitual duration of sleep was 6 (6–7) h/night. In all, 283 participants (52%) had a short daytime nap. In 214 (39.3%) participants the Pittsburgh Sleep Quality Index score was >5, with a higher percentage in women (74·3%, p < 0.05). Antibody levels were associated with age (r = −0.178, p < 0.001), poor sleep quality (r = −0.094, p < 0.05), insomnia (r = −0.098, p < 0.05), and nap frequency per week (r = −0.098, p < 0.05), but after adjusting for confounders, only insomnia, gender, and age were independent determinants of antibody levels. It is important to emphasise that insomnia is associated with lower antibody levels against COVID-19 after vaccination. |
| Keywords: | COVID-19 healthcare workers immunological response sleep vaccination |