Researchers discover fascinating connection between COVID-19 and sleep

Originally published on Nautilus Magazine on January 21, 2021, but is now offline. Archived on Wayback Machine.

Those far down on the priority list for the COVID-19 vaccine have been on the lookout for anything that can help them avoid serious illness from the virus. According to recent research, an extremely simple thing may improve your odds against COVID-19: sleep.

Thanks to numerous studies on the effectiveness of repurposing existing drugs to treat COVID-19 symptoms, melatonin is quickly emerging as a potential coronavirus treatment. Melatonin, a hormone released by the body, helps regulate sleep. As an over-the-counter dietary supplement, melatonin is most commonly used to battle jet lag or insomnia and has also been found effective in treating migraines, high blood pressure, and anxiety.

A group of scientists at the Cleveland Clinic used artificial intelligence to study 26,779 individuals from a COVID-19 registry, 8,274 of whom were diagnosed as positive for SARS-CoV-2. Based on their findings, which were published in PLOS Biology journal, patients who took melatonin were 28% less likely to test positive for the coronavirus after adjusting for factors such as age, sex, race, smoking history, and other underlying diseases.

In African-Americans, the reduced likelihood of a positive coronavirus test result after melatonin usage is even higher at 52%. Melatonin usage also showed significant risk reduction in getting COVID-19 among diabetic patients, but there was no “significant association” found in patients with asthma or hypertension. 

The precise reason for melatonin’s positive effects has not been pinpointed, but much of the available research confirms it could be due to melatonin’s ability to calibrate the body’s immune system, along with its antioxidant and anti-inflammatory properties.

“The COVID-19 pandemic has infected hundreds of thousands and killed tens of thousands of individuals worldwide. The high mortality is caused by the uncontrolled innate immune response and destructive inflammation,” a study published in the Frontiers in Medicine journal states. “Melatonin is a molecule that negatively regulates the overreaction of the innate immune response and excess inflammation, promoting adaptive immune activity.”

To date, there are numerous research groups exploring the effectiveness of melatonin in the battle against COVID-19. There are eight clinical trials ongoing globally that aim to prove the connection of melatonin to quicker coronavirus recovery. A study from Columbia University revealed better survival outcomes for intubated patients who received melatonin treatment. If these studies bear fruit, melatonin could be the most affordable and most accessible over-the-counter medicine to counter COVID-19, according to the Atlantic.

“Melatonin may not directly promote the host defense system against the virus, but increase the tolerance of the host to the virus,” Dr. Feixiong Cheng, one of the researchers from the Cleveland Clinic team and lead author of the study, explained. “Increase in the tolerance of the host to the virus will reduce the tissue and organ damage of the host and allow the host to survive sufficiently long to develop adaptive immune response, particularly the specific antibody, and finally kill or help clean the virus from [the] body. There are many possible mechanisms of melatonin in treating COVID-19, and our group is actively investigating it using cell-based and pre-clinical models.”

Regarding how melatonin and sleep interact with the available COVID-19 vaccines, studies show promise. A team of researchers from the University of Toronto pegged melatonin as a “potential silver bullet” that can act as an adjuvant—a substance that helps create a stronger immune response in the body—capable of heightening the efficacy of COVID-19 vaccines.

Despite positive correlations thus far, Cheng warned that it’s still too soon to tell if melatonin is a fool-proof solution to COVID-19. He told the Atlantic that, much like any substance that has the ability to slow down the central nervous system, melatonin has sizable effects on the body’s makeup that should not be taken lightly. 

“It is very important to note these findings do not suggest people should start to take melatonin without consulting their physician,” Cheng said in a news release. “Large-scale observational studies and randomized controlled trials are critical to validate the clinical benefit of melatonin for patients with COVID-19, but we are excited about the associations put forth in this study and the opportunity to further explore them.”

According to Cheng, randomized controlled trials will involve comparing melatonin to an inactive placebo to figure out the treatment’s effects and appropriate dose.

The positive effects of melatonin exhibited in the study could point to another factor causing improvements in COVID-19 recovery, according to Cheng. The issue may not be the need to take melatonin supplements, but instead facilitating better melatonin production in the body. We need sleep to stay healthy, particularly during the COVID-19 pandemic.

The Department of Neurology at Johns Hopkins University has reportedly been inundated with consult requests for people suffering from insomnia for months. There has been a recent surge in requests from people who have recovered from COVID-19, many of whom are experiencing symptoms including debilitating headaches, brain fog, muscular weakness, changes in attention, and sleep disruption.

“We’re seeing referrals from doctors because the disease itself affects the nervous system,” Rachel Salas, a neurologist at Johns Hopkins University, told the Atlantic. “I expect this is just the beginning of long-term effects we’re going to see for years to come.”

Taking a sleep-aid to help regulate your circadian rhythm has its perks, but the majority of sleep scientists agree that the best method to attain better quality sleep is not medicinal or supplemental. Asim Shah, a psychiatry and behavioral sciences professor at Baylor College of Medicine, believes that “a key to healthy pandemic sleep is to deliberately build routines.” 

Shah suggests waking up and going to bed at roughly the same time, regardless of whether it’s a weekday or a weekend. Taking vitamin D is also good, but getting actual sunlight early in the day is better. Try to avoid blue light exposure for an hour before bedtime and maintain meaningful connections with friends and loved ones, no matter how far away they are geographically. 

Sources: The Atlantic, WebMD, PLOS Biology, Frontiers in Medicine, ClinicalTrials.gov, medRxiv, Healthline, Diseases, ScienceDaily