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Sleep disturbance affects inflammatory resolution in Long COVID.
Larissa C Engert1, Rammy Dang2, Surya Daniel2
1Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
Prostaglandins, Leukotrienes, and Essential Fatty Acids
|February 6, 2026
Summary
Sleep disturbance in Long COVID patients is linked to impaired inflammatory resolution pathways. Targeting these pathways may help reduce chronic inflammation and symptoms in Long COVID.
Area of Science:
- Immunology
- Sleep Medicine
- Infectious Disease Epidemiology
Background:
- Sleep disturbance is a prevalent symptom in Long COVID, contributing to a pro-inflammatory state.
- Dysregulation of lipid-derived specialized pro-resolving mediators (SPMs) is implicated in chronic inflammation during Long COVID.
Purpose of the Study:
- To investigate the role of sleep disturbance in the inflammatory resolution process in individuals with Long COVID.
- To explore the association between sleep quality and levels of SPMs in Long COVID patients.
Main Methods:
- A cohort of 39 participants (31 Long COVID, 8 controls) underwent a 14-day at-home and 1-day in-laboratory assessment.
- Sleep disturbance was quantified using PROMIS Sleep Disturbance T-scores.
- Fasting blood samples were analyzed for lipid mediators, including SPMs, using generalized linear mixed models.
Main Results:
- Long COVID participants exhibited significantly higher sleep disturbance compared to controls.
- Pro-inflammatory prostaglandin E2 (PGE2) levels were elevated in Long COVID patients.
- Individuals with Long COVID and high sleep disturbance showed reduced levels of key SPMs, such as 17-HDHA, 17R/S-RvD1, 15R-LXB4, and PD1n-3DPA.
Conclusions:
- Sleep disturbance in Long COVID may hinder the body's natural inflammatory resolution mechanisms.
- Interventions aimed at promoting inflammatory resolution, particularly in Long COVID patients with sleep disturbances, could be a therapeutic target for managing inflammation and symptoms.
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