Influences of sleep and lifestyle factors on the risk for covid-19 infections, from internet survey of 10,000 Japanese business workers

Abstract

We conducted an internet survey to assess sociodemographic variables, lifestyle factors, sleep problems, and comorbidities for sleep apnea syndrome (SAS) in COVID-19 and influenza (FLU) infections. Data from 10,323 workers (50.0% male) were analyzed. COVID-19 was diagnosed in 144 subjects (COVID-19+), and 8,693 were classified as not suspected to be infected (COVID-19−). SAS had been diagnosed in 35.4% of the COVID-19+ subjects, but only 231 (2.7%) of the 8,693 COVID-19− subjects. COVID-19+ subjects were more susceptible to FLU (35.4%) compared to COVID-19− subjects (3.0%). A multivariate analysis revealed that higher risks of COVID-19+ were linked to the following factors: going out without a face mask (OR 7.05, 95% CI 4.53–11.00), FLU+ (OR 6.33, 95% CI 3.80–10.54), excessive exercise before going to sleep (OR 2.10, 95% CI 1.63–2.70), SAS+ (OR 5.08, 95% CI 2.88–8.94), younger age (OR 1.05, 95% CI 1.03–1.07), falling sleep while sitting or talking with someone (OR 3.70, 95% CI 2.30–5.95), and use of hypnotics (OR 2.28, 95% CI 1.20–4.30). Since sleep impairment played a relatively small role in COVID-19+/SAS− subjects, we assume that SAS itself was a more significant risk factor for COVID-19 infection rather than sleep impairment. A better understanding of the mechanisms that result in increased susceptibility to COVID-19 in SAS is vital for helping prevent COVID-19.