Effect of sleep disorders on post-vaccination antibody response - A systematic review and meta-analysis

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).