“Most previous observational studies have looked at the association between sleep and infection in a sample of the general population,” said Dr. Ingeborg Forthun. “We wanted to assess this association among patients in primary care, where we know that the prevalence of sleep problems is much higher than in the population at large.”
There is already evidence that sleep problems increase the likelihood of infection. In a recent study, participants who were intentionally infected with rhinovirus were less likely to acquire a cold if they reported getting enough sleep. Sleep disorders are prevalent and curable, and if a link to infection and a mechanism can be established, it may be possible to reduce antibiotic use and protect patients from infections before they occur. Yet, laboratory studies cannot replicate real-life situations.
Forthun and her colleagues handed a questionnaire to medical students and asked them to distribute it to patients in the waiting rooms of the general practitioners’ surgeries where the students were working.
In total, 1,848 questionnaires were collected throughout Norway. People were asked to explain their sleep quality how long they generally sleep, how well they believe they sleep, and when they prefer to sleep as well as whether they had any infections or took antibiotics in the previous three months. The survey also included a scale for detecting cases of persistent insomnia.
The Risk of Infection has Increased by a Quarter
Those who reported sleeping less than six hours per night were 27% more likely to report an infection, whereas those who reported sleeping more than nine hours were 44% more likely to report one. Fewer than six hours of sleep per night, or chronic insomnia, increased the likelihood of needing an antibiotic to treat an illness.
“The higher risk of reporting an infection among patients who reported short or long sleep duration is not that surprising as we know that having an infection can cause both poor sleep and sleepiness,” said Forthun. “But the higher risk of infection among those with a chronic insomnia disorder indicates that the direction of this relationship also goes in the other direction; poor sleep can make you more susceptible to an infection.”
Although there was some potential for bias in that people’s recall of sleep or recent health issues was not always perfect and no clinical information was collected from the doctors who later saw the patients, the study design allowed for data collection from a large study group experiencing real-world conditions.
She continued: “Insomnia is very common among patients in primary care but found to be under-recognized by general practitioners. Increased awareness of the importance of sleep, not only for general well-being but for patients’ health, is needed both among patients and general practitioners.”
- The association between self-reported sleep problems, infection, and antibiotic use in patients in general practice – (https:www.frontiersin.org/articles/10.3389/fpsyt.2023.1033034/full)