Long COVID was linked to worse sleep. Even three years later.
People say: “Does long COVID still affect sleep years later?” We read the study.
Cohort study. 2,406 people. long COVID measured at baseline (median 4.4 months after onset); sleep at follow-up 1 (median 18.4 months) and follow-up 2 (median 34.9 months after onset); surveys June 2020 - Feb 2025.
People were watched for years. Nobody was told what to do. A clue, not proof.
Who: Non-institutionalised Michigan adults with a PCR-confirmed SARS-CoV-2 infection (March 2020 - May 2022) who completed all three surveys; weighted 15.2% had long COVID; 38% aged 18-34, 55% female, 74% non-Hispanic White
- Sleep problems, ~3 yrs+53%higher risk
- Poor sleep, both timeshigherself-reported
- Avg sleep, 1.5 yrs-21 minunclear by year 3
More to know, from our read of the paper:
- Observational: linked, not proven. Everyone in the study had COVID; the comparison is long COVID (recovery took 90+ days or not yet recovered) vs recovered within 90 days, NOT vs people who never had COVID
- Both long COVID (self-reported recovery time) and all sleep outcomes are SELF-REPORTED; no sleep trackers
- Pre-COVID sleep problems could not be adjusted for; authors say poor sleep may itself raise long COVID risk, so associations may be overestimated
- Baseline response rate 32.1%; analysis restricted to people who answered all 3 surveys (2,406 of 5,521); weighted for attrition/nonresponse
- Average sleep was 0.35 h (21 min) shorter at ~1.5 years but the gap was no longer statistically significant at ~3 years (-0.16 h, CI -0.38 to 0.06)
Long COVID went with worse sleep, years later.
Researchers followed 2,406 Michigan adults who had a confirmed COVID infection, surveying them about 1.5 and 3 years later. Long COVID meant taking 90 days or more to recover. At about 3 years, long COVID was linked to a 53% higher risk of moderate-to-severe sleep problems, and poor sleep quality at both check-ins was more common. Average sleep was 21 minutes shorter at 1.5 years, but that gap was no longer clear at 3 years. Everything was self-reported and pre-COVID sleep wasn't known: linked, not proven.
Ryu S, Slocum EM, Whittington B, Zavala Arciniega L, Ahmed S, Fleischer NL (2026). Prospective associations of long COVID with sleep health nearly 3 years after SARS-CoV-2 infection: a statewide representative cohort study. Sleep.
Design: Cohort study · prospective population-based cohort (Michigan COVID-19 Recovery Surveillance Study, MI CReSS), weighted to the state's PCR-confirmed cases; linear, multinomial logistic and modified Poisson regression; linked, not proven
Goals:
We read the abstract and the full text of this paper and checked every number on this page against it (16 facts, checked on 2026-10-29). The study design is named above. Cohort and other observational studies are described as linked, not proven. Found an error? Email theis@onestudyaday.com.
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