Night work, sleep disruption and long-COVID risk: a population-based cohort study
Abstract
OBJECTIVE: Circadian and sleep disruption may increase the risk and severity of SARS-CoV-2 infections, but the role of night shift work and disturbed sleep in the development of long-COVID remains inadequately investigated. We prospectively examined the association of night work and sleep disturbances with risk of long-COVID. METHODS: We followed participants of the COVICAT study, a population-based cohort of adults in Catalonia, Spain between 2021 and 2023. Night shift work and sleep characteristics were assessed in 2021. Long-COVID was defined as the report of persistent symptoms (>3 months) after a SARS-CoV-2 infection. Poisson regression analysis was performed to evaluate the independent and joint effects of night shift work and sleep disturbances including chronic insomnia with risk of long-COVID. Analyses were stratified by sex, body mass index and chronotype. RESULTS: During the two-year follow-up, 284 of the 1899 newly infected participants reported long-COVID symptoms. Compared to day workers, night shift workers had 88% higher risk of developing long-COVID [95% confidence interval (CI) 1.29–2.72], after adjusting for potential confounders. The risk further increased among night workers with obesity. Chronic insomnia in the general population was associated with 42% increased risk of long-COVID (95% CI 1.12–1.78). Night workers with chronic insomnia had a 2.7 fold higher long-COVID risk (95% CI 1.60–4.51) compared to day workers without chronic insomnia. Associations persisted in various sensitivity analyses. CONCLUSIONS: Our findings from a large prospective cohort indicate that night shift work and poor sleep are independently and jointly associated with a higher risk of long-COVID.
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BibTeX
@article{papantoniou2026night,
title = {{Night work, sleep disruption and long-COVID risk: a population-based cohort study}},
author = {Kyriaki Papantoniou and Ana Espinosa and Marianna Karachaliou and Camille Lassale and Gemma Castaño-Vinyals and Barbara N Harding and Sara De Matteis and Kurt Straif and Eva Alonso-Nogués and Carlota Dobaño and Gemma Moncunill and Natalia Blay and Susana Iraola-Guzmán and Rafael de Cid and Judith Garcia-Aymerich and Manolis Kogevinas},
journal = {Scandinavian Journal of Work, Environment \& Health},
year = {2026},
month = aug,
doi = {10.5271/sjweh.4318},
url = {https://doi.org/10.5271/sjweh.4318},
note = {CC BY},
}
RIS
TY - JOUR
TI - Night work, sleep disruption and long-COVID risk: a population-based cohort study
AU - Kyriaki Papantoniou
AU - Ana Espinosa
AU - Marianna Karachaliou
AU - Camille Lassale
AU - Gemma Castaño-Vinyals
AU - Barbara N Harding
AU - Sara De Matteis
AU - Kurt Straif
AU - Eva Alonso-Nogués
AU - Carlota Dobaño
AU - Gemma Moncunill
AU - Natalia Blay
AU - Susana Iraola-Guzmán
AU - Rafael de Cid
AU - Judith Garcia-Aymerich
AU - Manolis Kogevinas
PY - 2026
DA - 2026/08/01
JO - Scandinavian Journal of Work, Environment & Health
DO - 10.5271/sjweh.4318
UR - https://doi.org/10.5271/sjweh.4318
AB - OBJECTIVE: Circadian and sleep disruption may increase the risk and severity of SARS-CoV-2 infections, but the role of night shift work and disturbed sleep in the development of long-COVID remains inadequately investigated. We prospectively examined the association of night work and sleep disturbances with risk of long-COVID. METHODS: We followed participants of the COVICAT study, a population-based cohort of adults in Catalonia, Spain between 2021 and 2023. Night shift work and sleep characteristics were assessed in 2021. Long-COVID was defined as the report of persistent symptoms (>3 months) after a SARS-CoV-2 infection. Poisson regression analysis was performed to evaluate the independent and joint effects of night shift work and sleep disturbances including chronic insomnia with risk of long-COVID. Analyses were stratified by sex, body mass index and chronotype. RESULTS: During the two-year follow-up, 284 of the 1899 newly infected participants reported long-COVID symptoms. Compared to day workers, night shift workers had 88% higher risk of developing long-COVID [95% confidence interval (CI) 1.29–2.72], after adjusting for potential confounders. The risk further increased among night workers with obesity. Chronic insomnia in the general population was associated with 42% increased risk of long-COVID (95% CI 1.12–1.78). Night workers with chronic insomnia had a 2.7 fold higher long-COVID risk (95% CI 1.60–4.51) compared to day workers without chronic insomnia. Associations persisted in various sensitivity analyses. CONCLUSIONS: Our findings from a large prospective cohort indicate that night shift work and poor sleep are independently and jointly associated with a higher risk of long-COVID.
SN - 0355-3140
SN - 1795-990X
ER -