ABSTRACT
Objectives/Introduction: Sleep deprivation and sleep disorders have been related to a reduced or delayed antibody response following vaccination. However, studies in this field have provided inconsistent results, with some failing to show significant effects on antibody titers in these conditions. The possible reasons for the discrepancies on the results rely on methodological variability, including different sleeprelated conditions, diseases and time from vaccination to antibody assessment. This study intended to perform a systematic review and meta-analysis on the effects of sleep deprivation and sleep disorders on antibody response after vaccination. Method(s): Literature searches were performed at PubMed, Scopus and Web of Science, comprising two search domains, one related to sleep and other to vaccination. The records were screened in a twostep process (title and s, follow by full text analysis), by two independent reviewers. Eligibility criteria included individuals with previous diagnosis of a sleep disease or subjected to an experimental sleep deprivation schedule, which have undergone vaccination for a specific disease. The main outcome was the post-vaccinal antibody titers. The effects size for each article was calculated using standardized mean differences and the meta-analyses used the DerSimonian and Laird random effects model. Result(s): Out of 9009 identified records, six were included in the final sample. Among these, four were related to H1N1/influenza, one to hepatitis and one to COVID-19. Three studies evaluated the effects of sleep deprivation, two were related to obstructive sleep apnea and one was related to insomnia. The date since vaccination to antibody measurement varied from five days to one month. The results demonstrated a non-significant reduction in antibody titers due to sleep disorders (SDM: -0.206;CI95%: -0.783 to 0.071;p = 0.144). Conclusion(s): The results demonstrate that sleep disorders and sleep deprivation altogether do not lead into a significant reduction in the antibody titers after vaccination. However, the studies included are subjected to substantial methodological heterogeneity, and it is possible that significant effects would appear in more specific conditions (such as for specific sleep disorders, diseases and time points after vaccination).
ABSTRACT
Introduction: Sleep complaints are common in individuals with neurodevelopmental disorders. However, little is known about sleep alterations in children with cri du chat syndrome (CDC) and autism spectrum disorder (ASD) due to the social isolation resulting from the COVID-19 pandemic. Objective: To assess alterations in sleep quality and its associated parameters before and after quarantine resulting from COVID-19, comparing the results between CDC, ASD or neurotypical children. Methods: Sleep was investigated in 53 children with CDC and 106 with ASD using an adaptation of the Brief Infant Sleep Questionnaire (BISQ), assessing sleep patterns both before and during the COVID-19 pandemic. Data were evaluated in comparison to 160 neurotypical (NT) children. Results: Children with CDC and ASD already had higher chances of needing parental assistance to fall asleep, taking more than 30min to fall asleep and having a wake after sleep onset time (WASO) >30min when comparing to neurotypical children in the moment preceding quarantine. Having CDC significantly increased the odds of having awakenings during the night. During quarantine, the proportion of children sleeping in their own bedrooms had decreased and the odds of awakening during the night had increased in all groups. Children with CDC and ASD had significantly higher odds of taking more than 30min to fall asleep. The chance of having a WASO >30min increased in children with ASD but decreased in CDC ones. The quarantine period statistically increased the odds ratio of children having a sleep latency of >30min by nearly 5-fold for all groups. Conclusion: The CDC group presented worse sleep parameters overall, even before quarantine. In both the CDC and ASD group worse sleep indicators were found during the COVID-19 pandemic.
ABSTRACT
Introduction: Sleep disorders and anxiety are common complaints during childhood. Mothers' anxiety and depression symptoms might also affect children's sleep quality in a negative way. Considering that both sleep and anxiety disorders might be affected by environmental factors, the social distancing and other circumstances related to the COVID-19 pandemic might increase the prevalence of anxiety and sleep complaints among mothers and their children. Objective: To analyse the correlation between anxiety and sleep quality in mothers and children from 2 to 10 years old. Methods: Mothers of children from 2 to 10 years old were invited to participate. The participants filled an online survey through Google forms, including a socio-demographic survey, anxiety and sleep questionnaires, both of their own (as a self-report) and of their children. Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety and Stress Scale (DASS-21) were used to analyse symptoms on the mothers, while Children's Sleep Habits Questionnaire (CSHQ) and Child Behavior Checklist (CBCL - both 1/2-5 and 6-18 years old versions) were used to analyse the children. The questionnaire was made available from August 2020 to January 2021. Data analysis was based on a Spearman correlation matrix and statistical significance level was set at 5%. Results: A total of 179 mothers were included in this study. Self-reported sleep quality decreased during the pandemic in 55% of the mothers. In relation to children, 40% of mothers reported that they noticed worsening of their sleep quality and 63% reported increased anxiety symptoms. Positive statistic significant correlations were observed between maternal sleep quality (PSQI) and maternal anxiety symptoms (DASS-21) (rho: 0.578, p<0.001), and between both mothers (PSQI) and children (CSHQ) sleep quality (rho: 0.318, p<0.001). A correlation between maternal sleep quality and anxiety symptoms in the children (CBCL) was observed only for children from 6-10 years old (rho:0,399, p=0.001), but not for those from 2-5 years old. Conclusion: The COVID-19 pandemic has been a challenge to both maternal and children sleep and behavior. During this period, decreased sleep quality in the mothers was correlated with increased anxiety in both mothers and children, as well as with decreased sleep quality in the children.
ABSTRACT
Introduction: Previous studies have reported that sleep deprivation and sleep disorders may decrease the antibody response after vaccination for H1N1, influenza and hepatitis A. Since the emergence of the current pandemic, the same was wondered for vaccination against COVID-19. This possible effect would be especially relevant among older adults, who are subjected to a high prevalence of sleep disorders (mainly obstructive sleep apnea - OSA) and who are at increased risk for severe COVID-19. Objective: To evaluate the effect of OSA on IgG antibody response after vaccination against COVID-19 among older adults. Methods: This study was based on a convenience sample of older adults who underwent polysomnography at the Sleep Institute (São Paulo, Brazil). It was considered eligible those who were 60 years or older, were undergoing full night type-I polysomnography, and have been fully vaccinated against COVID-19. The following exclusion criteria was applied: previous COVID-19 diagnosis, less than 15 days between last vaccine shot and IgG testing, or CPAP use in the last 3 months. All eligible participants undergone blood sampling for anti-SARS-CoV-2 IgG analysis. The apnea-hypopnea index (AHI) was used to categorize the participants in the following groups: no/mild OSA (IAH < 15), moderate OSA (AHI ≥ 15 and < 30) and severe OSA (AHI ≥ 30). The association between IgG reactive status (seronegative or seropositive) and OSA was evaluated by a X2 test. Log-transformed IgG levels were compared among OSA severity groups using a 1-way ANOVA with Welch's correction. Statistical analyses were performed using Jamovi 1.6 and the significance level was set as p<0.05. Results: The final sample comprised 122 participants, of which 35 had no/mild OSA, 31 had moderate and 56 had severe OSA. Seronegative anti-SARS-CoV-2 IgG results were observed in 9.8% of the sample, and the median IgG levels was 273 AU/ mL (IQR: 744) with no statistically significant differences among OSA severity groups in neither case. Conclusion: OSA does not appear to affect IgG antibody response following vaccination against older adults. This is a positive result from a public health perspective, since even being at increased risk for negative COVID-19 outcomes, vaccination among individuals with OSA seems to be equally effective as among those without OSA.
ABSTRACT
Introduction: Sleep disorders and sleep deprivation induces decreased antibody response following vaccination for different viral diseases (including H1N1, influenza and hepatitis A). The same has been speculated for COVID-19. This study aimed to assess whether obstructive sleep apnea (OSA) reduces antibody levels after COVID-19 vaccination among older adults. Methods: This was a convenience-sample study composed of older adults (≥60 years old). Those who underwent polysomnography at the Sleep Institute (São Paulo, Brazil) and received complete COVID-19 vaccination schedule were considered eligible. Individuals with previous diagnosis of COVID-19, less than 15 days between vaccination and IgG testing, or CPAP use in the last 3 months were excluded. Anti-SARS-CoV-2 IgG levels were measured using a chemiluminescence assay. The participants were distributed in the following groups, according to their apneahypopnea index (AHI): no/mild OSA (AHI<15), moderate OSA (AHI≥15 and <30) and severe OSA (AHI≥30). The effects of OSA on IgG levels (ANOVA), the correlation between IgG levels and AHI (Spearman's correlation test) and the association between serostatus (positive vs. negative) and OSA severity levels (X2 test) were analysed. Results were considered as statistically significant when p<0.05. Results: The sample included 122 older adults (median age 72.0 - IQR: 5.7), of whom 35 (28.6%) had AHI no/mild OSA;31 (25.4%) had moderate OSA, and 56 (45.9%) had severe OSA. Oxford/ AstraZeneca was the most referred vaccine (n=111, 91.0%), followed by CoronaVac (n=9, 9.0%). Seropositive status (IgG count ≥50.0 AU/mL) was observed in 90.2% of the participants and the median IgG levels in the complete sample was 273.0 AU/ML (IQR: 744.0). No/mild, moderate and severe OSA groups presented IgG levels of 482.0 (IQR: 677.0), 285 (IQR: 884.0) and 181.0 (IQR: 598.0), respectively, with no statistical difference them (p=0.606). There was no statistically significant correlation between AHI index and IgG levels (Spearman's rho=-0.169, p=0.063) and no significant association between serostatus and OSA severity groups (X2=0.912;p=0.634). Conclusion: Anti-SARS-CoV-2 IgG levels after vaccination are not significantly affected by OSA among older adults. Thus, despite being at higher risk for severe cases, OSA does not decrease the antibody response following vaccination against COVID-19.