Healthcare worker burnout and sleep disturbance associated with increased risk of infection, severe COVID-19

As healthcare professionals are already at high risk of coronavirus infection while treating patients with the disease, the researchers tried to determine if sleep and burnout could serve as additional risk factors for COVID-19 among these populations. They conducted an online survey of health professionals who regularly contact patients with COVID-19 (N = 2884), such as those in emergency or intensive care units, 6 countries (France, Germany, Italy, Spain, the United Kingdom, and the United States).

Respondents surveyed from July 17 to September 25, 2020, each participant provided information on demographic data, sleep (number of hours of sleep at night, hours of napping during the day, sleep problems), burnout from work, and exposure to COVID-19. The researchers used multivariable linear and logistic regression models to assess the association between sleep, burnout, and COVID-19.

Of the study cohort, 568 health workers had COVID-19, while the remaining 2,316 served as controls. It has been noted that the infected are somewhat younger, probably doctors and more likely to practice internal medicine. Further, infected subjects were more likely to report fewer hours of sleep at night, slightly more daytime hours of napping, 1 or more sleep problems, and burnout from work at least monthly.

After adjusting for confusion, the researchers found that each additional hour of nighttime sleep was associated with a 12% lower probability of COVID-19 infection (odds ratio). [OR], 0.88; 95% CI, 0.81-0.96; Str = .003). In contrast, a one – hour increase in daily napping hours was associated with a 6% higher risk of COVID-19 (OR, 1.06; 95% CI, 1.01-1.12; Str = .03), but the association varied by country, with an insignificant inverse association established in Spain.

Significantly, participants who reported 3 sleep problems (difficulty sleeping at night, poor sleep continuity, frequent use of sleeping pills) were associated with almost twice the quotas on COVID-19 (OR, 1.88; 95% CI, 1 , 17-3.01; Strtrend = .22).

In addition to sleep problems, daily reporting of burnout was associated with more than 2 times the likelihood of COVID-19 (OR, 2.60; 95% CI, 1.57-4.31, Strtrend = .001), as well as significantly longer duration (OR, 2.98; 95% CI, 1.10-8.05, Strtrend = .02) and severity (OR, 3.26; 95% CI, 1.25-8.48; Strtrend = .02), compared to reporting that it did not burn.

These associations remained significant after adjusting the frequency of exposure to COVID-19.

“This study points to an often overlooked area of ​​well-being: the need for quality sleep and charging time to prevent burnout and its consequences,” said Minha Rajput-Ray, MBChB, medical director of NNEdPro Global Center for Nutrition & Health, which co-owns the journal. with BMJ, in a statement. “From the perspective of occupational and life medicine, a better understanding of the effects of shift work and sleep is essential for the benefit of health care staff and other key workers.”


Kim H, Hegde S, LaFiura C, et al. COVID-19 disease related to sleep and burnout. BMJ Nutr Previous Health. Published on March 22, 2021 doi: 10.1136 / bmjnph-2021-000228