Data suggests that the immune response to vaccination is reduced in those who get less than six hours of sleep before they get the shot, especially in younger men.
“Good sleep not only amplifies but may also extend the duration of protection of the vaccine,” said senior author Eve Van Cauter, professor emeritus at the University of Chicago’s Department of Medicine, in a statement.
“Research that used objective measures of sleep deprivation, such as that of a sleep lab, found a decrease in the ability to respond to the vaccine that was particularly and statistically significant in males, but not females,” said study co-author Dr. Michael Irwin, distinguished professor of psychiatry and biobehavioral sciences at the UCLA Geffen School of Medicine.
According to the research published in Current Biology:
Insufficient sleep (<6 hours/night) around vaccination reduces the antibody response
- The reduction is similar to the waning of COVID-19 vaccine antibodies over 2 months
- The association seems robust in men, but more data are needed in women
- Optimizing sleep duration around the time of vaccination may boost antibody response
The Guardian reported:
The research found strong evidence that sleeping for less than six hours reduces the immune response to vaccination in men – although the effect was more variable in women, probably due to fluctuating sex hormone levels.
“We know from immunology studies that sex hormones influence the immune system,” said Spiegel. “In women, immunity is influenced by the state of the menstrual cycle, the use of contraceptives, and [whether they have gone through menopause], but unfortunately, none of the studies that we summarised had any data about sex hormone levels.”
When both sexes were taken into account, the effect of short sleep was comparable to the waning of the antibody response to the Pfizer/BioNTech vaccine after two months. The researchers said: “If similar to the influenza and hepatitis vaccines … then insufficient sleep around the time of Covid-19 vaccination may reduce antibody titers in the same range as the waning of the response to the most commonly administered vaccine over two months.”
They also found that the immunological impact of insufficient sleep was greater for adults aged 18 to 60, compared with older adults.
The study concludes, “As suggested by our meta-analysis, adequate amounts of sleep (at least 6 h/night) during the days surrounding the time of vaccination may enhance the humoral response to diverse strains of viruses. Such recommendation of obtaining adequate sleep duration is realistic as at-home behavioral sleep extension has proven to be feasible, acceptable, and efficient in a variety of populations. The National Sleep Foundation recommends 7 to 9 h of sleep for healthy adults and 7 to 8 h of sleep for adults > 65 years. However, large-scale studies are needed (1) to define the time window before and after vaccination where optimizing sleep duration is most likely beneficial, (2) to delineate the impact of sex hormones in the relationship between sleep duration and antibody response to vaccination in women, and (3) to estimate the amount of sleep debt capable of adversely affecting the response. Therefore, collecting information about sleep duration around the time of vaccination and about sex hormone levels in the millions of people who will receive vaccines and boosters against COVID-19 and other viruses is an unprecedented opportunity to study the role played by sleep duration in vaccine response.”
The study did not include analysis of antibody response to Covid-19 vaccines, because there are not yet adequate studies on sleep in Covid-vaccinated people, Irwin said. But he believes the results would still apply.
“How we stimulate the immune system is the same whether we’re using an mRNA vaccine for Covid-19, or an influenza, hepatitis, typhoid or pneumococcal vaccine,” Irwin said. “It’s a prototypical antibody or vaccine response, and that’s why we believe we can generalize to Covid.”
The team did perform an analysis which showed that, if a person arrived for a Covid-19 vaccination without adequate sleep, their antibody response to the vaccine would be weakened by the equivalent of two months — based entirely on their body’s initial response.
“You would have already lost two months of immunity, so to speak, even though you just got the shot,” Irwin said. “If you have a poor immune response, you are less likely to get full protection from Covid.”
More studies are needed to detect the nuances of poor sleep’s impact on the immune system, Zee said. Still, the information supports current practice in her sleep clinic.
“I already tell my patients to get regular sleep to enhance immune function,” she said. “Now we have even stronger evidence to give this type of advice.”