Healthy sleep and immune response to COVID-19 vaccination

Healthy sleep is integral to a strong immune system, and as COVID-19 vaccines are distributed, it’s important that people continue to get sufficient sleep for optimal immune response.

Sleep loss is associated with changes in several immune processes. Poor sleep may weaken your defenses against a virus, and it may affect how your body responds to a vaccine, increasing your risk for illness. For this reason, sleep deprivation in the age of a global pandemic is especially risky.

“As COVID-19 vaccines are being distributed, it is of utmost importance that patients continue to prioritize their sleep to maintain optimal health,” said American Academy of Sleep Medicine President Dr. Kannan Ramar. “Getting sufficient, high-quality sleep on a regular basis strengthens your body’s immune system and optimizes your response to a vaccine.”

There is extensive evidence of the link between sleep and immunity, and several studies have found an association between sleep duration and vaccination response. A 2020 study in the International Journal of Behavioral Medicine found that the flu vaccine appears to be more effective in people who get a sufficient duration of sleep for the two nights prior to receiving the shot. Other studies have made similar findings evaluating patients’ response to vaccines for hepatitis A and hepatitis B, concluding that shorter sleep duration before and after vaccination is associated with lower antibody response and a decreased likelihood of disease protection.

“The role of sleep in boosting innate and acquired immune response is significant. All people, particularly health workers, should be aware of the immunity-boosting effects of sleep. Studies have shown that normal sleep after vaccination strengthens the immune response against an invading antigen and this immunity boosting effect of sleep is clinically significant,” said Dr. Khurshid A. Khurshid, director of the UMMHC/UMMS Center for Neuromodulation at the University of Massachusetts Medical School. “A good night’s sleep before and after vaccination could be very advantageous.”

When we sleep, our body recovers from the day, working to repair muscles, organs and cells. Hormones are regulated that support our metabolism, immune response and other key physical functions. Our brain sorts and stores new information and prepares us mentally for the next day by regulating our mood.

For many though, the pandemic has negatively impacted sleep. One third (33%) of respondents to an AASM survey have experienced an impact to sleep quality, 30% have seen change in their ability to fall asleep, and 29% noted an impact to nightly amount of sleep. While it’s easy for stress and scheduling conflicts to interrupt nightly sleep, the AASM recommends that most adults should be sleeping at least 7 hours each night.

Follow these tips to get a better night’s sleep:

• Establish a bedtime and morning routine – Consider developing a nightly routine that evokes calm and relaxation, which may include reading, journaling or meditating. Even for those working remotely, allow ample time to wake, reflect and prepare for the day ahead.
• Ensure the bedroom is a space for sleep – Limit noise and distractions by making your bedroom quiet, dark and a little bit cool – and only use the bed for sleeping, not watching TV or reading.
• Set boundaries for blue light exposure – Consider setting a technology curfew by turning off your TV and other electronic devices 30 minutes to an hour before bedtime. Silence your notifications and charge your devices away from your bed so you are not tempted to look at social media or news alerts.
• Limit alcohol, caffeine and large meals before bedtime – Avoid consuming caffeine after lunch and avoid alcohol near bedtime, as both can disrupt sleep. If hungry after dinner, keep snacks small, sugar-free and easily digestible to avoid disrupting sleep.
• Sleep on it: try to get good sleep on the night after vaccination.

For PDFs of the AASM's 2019 and 2020 Sleep Prioritization Survey results, please visit https://aasm.org/about/newsroom/.

For more information on the importance of healthy sleep, visit SleepEducation.org.

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About the 2020 Survey

The July 2020 Sleep Prioritization Survey involved 2,007 adult participants. The sample consisted of 1,005 parents with children between the ages of five and 18 years old. The margin of error is +/- 2 percentage points with a confidence interval of 95 percent. Atomik Research, an independent market research agency, conducted the survey.

About the American Academy of Sleep Medicine

Established in 1975, the American Academy of Sleep Medicine (AASM) is advancing sleep care and enhancing sleep health to improve lives. The AASM has a combined membership of 11,000 accredited member sleep centers and individual members, including physicians, scientists and other health care professionals (aasm.org).