690 An Analysis of Objective and Subjective Sleep and Infection Symptoms of Medical Personnel Working through the COVID-19 Pandemic

Eldringhoff, Hannah; Mickelson, Carolyn; Moore, Lonique; Pirner, Maddison; Doyle, Scott; Mantua, Janna; Mckeon, Ashlee

INTRODUCTION: There is a well-established connection between sleep and the immune system, and in the midst of a global pandemic, it is vital to understand the relationship between COVID-19 symptomatology and sleep. While our communities practice safety protocols, medical personnel working on the COVID-19 response effort are at high risk for exposure and contraction. This creates an urgent need to better understand whether sleep may contribute to COVID-19 symptom onset, severity, and recovery. This study examined the relationship between subjective and objective sleep during infection. METHODS: Fifty volunteers (age 35.15±9.97) considered high risk for COVID-19 participated in the study. The sample consisted mostly of medical personnel (93.27%) working through the pandemic. Over six months, participants completed monthly surveys and daily logs via Qualtrics. These surveys included questions about sleep, infection symptoms, COVID-19 tests and diagnoses, and mood. Wrist-worn actigraphy was collected continuously throughout the study. Sleep duration, latency, wake after sleep onset, and efficiency were processed using Philips Actiware 6.0. Actigraphy and survey data were analyzed using SPSS v. 25. RESULTS: Sixty-two percent of participants experienced infection symptoms. Those experiencing symptoms were significantly more likely to report having poorer sleep quality t(255.59)=5.78, p=<.001, poorer mood upon waking t(258.03)=6.53, p=<.001, feeling less alert upon waking t(255.61)=4.56, p=<.001, and spending more time awake at night t(2.66.98)=-7.29, p=<.001. Results showed that compared to those asymptomatic, participants with cough t(2164)=2.07, p=.039, diarrhea t(2161)=2.51, p=.012, and headache t(106.18)=7.05, p=<.001 all had significantly less total sleep time, while those with body aches spent significantly more time awake at night t(2164)=2.10, p=.036. CONCLUSION: This preliminary examination of the data broadly suggests that medical personnel experiencing infection symptoms may have difficulty obtaining adequate sleep. Further, specific infection symptoms may share a stronger relationship with key sleep parameters than others. These findings support further testing of the bi-direction relationship between infection symptoms and sleep. Results from this research will contribute to enhancing prevention, detection, and treatment guidance related to future domestic and globally-experienced infections. SUPPORT (IF ANY): Support for this study comes from there Military Operational Medicine Research Program of the United States Army Medical Research and Development Command.