Insomnia and sleep duration on COVID-19 susceptibility and hospitalization: A Mendelian randomization study

Front Public Health. 2022 Sep 30:10:995664. doi: 10.3389/fpubh.2022.995664. eCollection 2022.

Abstract

Background: Sleep disturbance including insomnia and sleep duration is associated with an increased risk of infectious. With the ongoing coronavirus disease 2019 (COVID-19) pandemic, it is important to explore potential causal associations of sleep disturbance on COVID-19 susceptibility and hospitalization.

Method: Insomnia and sleep duration were selected as exposure. Outcomes included susceptibility and hospitalization for COVID-19. Two sample mendelian randomization design was used to assess causality between sleep and COVID-19. Inverse variance weighted method was used as main analysis method to combine the ratio estimates for each instrumental variable to obtain the causal effect. Cochran's Q statistic was used to test for global heterogeneity. MR-Egger and weighting median estimator (WME) were used as sensitivity analysis to ensure the stability and reliability of the results. MR-Egger intercept term was used to test the mean pleiotropy. In addition, the direct effects of insomnia and sleep duration on COVID-19 susceptibility and hospitalization were estimated using multivariable mendelian randomization (MVMR).

Results: Univariate MR provided no evidence of a causal associations of insomnia on COVID-19 susceptibility (OR = 1.10, 95% CI:0.95, 1.27; p = 0.21) and hospitalization (OR = 0.61, 95% CI:0.40, 0.92; p = 0.02); as does sleep duration (ORCOIVD - 19susceptibility = 0.93, 95% CI:0.86, 1.01; p = 0.07; ORCOIVD - 19 hospitalization = 1.21, 95% CI: 0.99, 1.47; p = 0.08). MVMR results showed that insomnia may be a risk factor for increased susceptibility to COVID-19 (OR = 1.65, 95% CI: 1.34, 2.05; p <0.001); and sleep duration was also associated with increased COVID-19 susceptibility (OR = 1.31, 95% CI: 1.18, 1.46; p < 0.001).

Conclusion: Insomnia and extreme sleep duration may risk factors for increased COVID-19 susceptibility. Relieving insomnia and maintaining normal sleep duration may be powerful measures to reduce COVID-19 infections.

Keywords: COVID-19; Mendelian randomization; causal inference; insomnia; sleep duration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / epidemiology
  • Genome-Wide Association Study
  • Hospitalization
  • Humans
  • Mendelian Randomization Analysis / methods
  • Reproducibility of Results
  • Sleep
  • Sleep Initiation and Maintenance Disorders* / epidemiology