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COVID-19 illness in relation to sleep and burnout
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  • Published on: 3 November 2023
    COVID-19 illness in relation to sleep and burnout: possible pathways to investigate

    In the article by Kim et al. on COVID-19 illness in relation to sleep and burnout, the investigators find that night time sleep duration, sleep problems and burnout may be risk factors for viral diseases such as COVID-19. This is not surprising as there are many mechanisms interfering with sleep deprivation and the sleep-wake cycle that can also interact with viral invasion. These include 1) the role of cytokines in sleep deprivation; 2) interactions with proteases that help regulate the sleep process and 3) diurnal variations in cytokines and immune protection. Firstly, many possible pathways for interactions of cytokines with sleep have been described (1). For instance, interleukin-1 beta (IL1) is increased during sleep deprivation (1), but also probably during long mask wear (2). As IL-1 is present in nasal fluid and breath condensate (3-5), a plausible mechanism could be that with a lack of sleep, and due to the insufficient ventilation during mask wear, IL-1 and upregulated trypsin (6) become enriched the airways. Trypsin promotes SARS-CoV-2 invasion in vitro in many host cell studies (7,8), but many other substrates in the breath condensate can possibly interfere (3). Astonishingly, one cannot find studies on the effects of prolonged mask wear on relevant substrates that are present in breath condensate. Also TNF is modulated during sleep (1), and hence deserves to be studied as well.

    Secondly, in sleep deprivation, proteolytic processes play an important r...

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    Conflict of Interest:
    None declared.