Mental health scienceSep 2, 2025

Sleep Problems Linked to Thinking Difficulties in COVID-19 Hospital Survivors

Long Covid Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Jun 28, 2026

Abstract

Essence

New sleep disturbance 1 month after COVID-19 hospitalization was associated with worse cognitive and fatigue outcomes at 6 months.

Evidence

This single-center observational cohort of 120 adult COVID-19 hospitalization survivors used PROMIS measures and found that patients with new sleep disturbance at 1 month more often had significant worsening in cognitive function (74% vs 40%), cognitive abilities (76% vs 37%), and fatigue severity (64% vs 50%) by 6 months.

Caveat

Because sleep and cognition were self-reported in a single-center cohort, the study shows association rather than proving that early sleep disturbance causes later neurocognitive decline.

Simplified

STUDY OBJECTIVES: Cognitive impairment following COVID-19 infection is common and risk factors remain poorly understood. Sleep disturbance increases risk of cognitive impairment in the general population, and sleep disturbance is common after COVID-19. While prior literature has extensively explored the relationship between sleep and cognition, few studies have addressed the temporality of this association and how one may contribute to the other over time. This study assessed whether new sleep disturbance at 1-month is associated with risk of cognitive impairment at 6-months after COVID-19 hospitalization.

METHODS: English-speaking adults aged ≥18 years at the University of Washington Medical Center who survived to 1-month post-COVID-19 hospitalization were enrolled. Self-reported sleep disturbance, cognitive function, cognitive abilities, and fatigue severity at 1- and 6-months after discharge were assessed by the Patient-Reported Outcomes Measurement Information System (PROMIS) short forms. Linear and logistic regression models analyzed associations of new sleep disturbance at 1-month with cognitive function, cognitive abilities, and fatigue severity outcomes at 6-months. ®

RESULTS: Participants (n=120) had mean age of 56.5±15.7 years, and 35% developed new sleep disturbance at 1-month. Among those with versus without new sleep disturbance at 1-month, 74% versus 40%, 76% versus 37%, and 64% versus 50% developed significant worsening in cognitive function, cognitive abilities, and fatigue severity at 6 months, respectively.

CONCLUSIONS: In this single-center observational cohort, new sleep disturbance at 1-month post-COVID-19 hospitalization was associated with subsequent significant worsening in cognitive function, cognitive abilities, and fatigue severity at 6-months. Thus, new sleep disturbance may be a risk factor for persistent neurocognitive impairment after COVID-19. Additional studies should validate these relationships and examine whether improving sleep quality may reduce the risk of cognitive impairment in these patients.