Self-reported long COVID associated with sleep problems and poor sleep quality among adults in Germany: results of the German Health Update 2023 (GEDA 2023).
Beyer A, Yessimova D, et al. • Frontiers in public health • 2026
Our findings from general population data suggest that adults with current long COVID have 1.7- to 1.8-fold higher odds of problems maintaining sleep and poor sleep quality than non-infected individuals, while sleep onset problems were not associated with long COVID.
Key Findings
Results
Adults with self-reported current long COVID had higher unadjusted prevalence of sleep onset problems, problems maintaining sleep, and poor sleep quality than both non-infected adults and previously infected adults without long COVID.
Current long COVID: sleep onset problems 32.6%, problems maintaining sleep 47.8%, poor sleep quality 44.8%.
Non-infected participants: 20.0%, 30.8% and 24.1%, respectively.
Previously infected participants without long COVID: 13.8%, 23.8% and 20.0%, respectively.
Weighted prevalence estimates were calculated by self-reported SARS-CoV-2 infection and long COVID status; sleep was assessed over the past 4 weeks.
Results
After adjustment, current long COVID was associated with higher odds of problems maintaining sleep compared with non-infected individuals.
Adjusted odds ratio (aOR) = 1.73; 95% CI = 1.23-2.44.
Models were adjusted for age, sex, education level, chronic conditions, depressive symptoms, COVID-19 vaccination status, and multiple SARS-CoV-2 infections.
Results
After adjustment, current long COVID was associated with higher odds of poor sleep quality compared with non-infected individuals.
aOR = 1.81; 95% CI = 1.29-2.55.
Multivariable logistic regression with the same covariate adjustment as above.
Results
Sleep onset problems were not significantly associated with current long COVID in multivariable analyses.
Despite higher crude prevalence (32.6% vs 20.0% in non-infected), the association did not remain after adjustment.
Adjustment included depressive symptoms and chronic conditions, among other covariates.
Methods
The study drew on a nationwide telephone survey of adults in Germany conducted over about one year.
GEDA 2023 is a cross-sectional nationwide telephone interview survey.
Data collected between March 2023 and February 2024.
9,310 adults (50.8% female, median age 60.8 years) answered questions on prior SARS-CoV-2 infection, long COVID status, and sleep.
Conclusions
The authors conclude that sleep-related symptoms may be an important target for clinical assessment and management in people with long COVID.
Rationale given is the potential impact of sleep problems on quality of life and on physical and psychological functioning.
Sleep problems are described as among the most prevalent neuropsychiatric symptoms of long COVID.
What This Means
This study used a nationwide telephone survey of 9,310 adults in Germany (2023–2024) to see whether people who say they currently have long COVID sleep worse than others. Participants were asked about trouble falling asleep, trouble staying asleep, and overall sleep quality over the past four weeks. People with current long COVID reported more of all three problems than people who had never been infected and those who had been infected but had no long COVID. For example, 44.8% of those with long COVID reported poor sleep quality, compared with 24.1% of never-infected people and 20.0% of previously infected people without long COVID.
After accounting for age, sex, education, chronic conditions, depressive symptoms, vaccination status, and number of infections, people with long COVID still had about 1.7 times the odds of trouble staying asleep and about 1.8 times the odds of poor sleep quality compared with never-infected people. Trouble falling asleep was not clearly linked to long COVID once these factors were considered.
This research suggests that sleep disturbance, especially trouble maintaining sleep and poor sleep quality, is a common part of long COVID and may be worth asking about in clinical care. Because the survey was a one-time snapshot and long COVID and sleep were self-reported, it cannot show that long COVID causes sleep problems.
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Beyer A, Yessimova D, Kümpel L, Eckert G, Schlack R, Neuhauser H, et al.. (2026). Self-reported long COVID associated with sleep problems and poor sleep quality among adults in Germany: results of the German Health Update 2023 (GEDA 2023).. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1814427