Wearable-derived sleep measurements are associated with Long-COVID in the RECOVER adult cohort

Caution: This preprint is a work in progress that has not been peer-reviewed. It should not be relied upon to guide clinical practice or health behaviors, and it should not be reported in news media as established information. We will update this web page if this preprint becomes a peer-reviewed publication. (Not all research reports move past the preprint stage.)

View Preprint on PubMed

Published

September 2025

Journal

Research Square

Abstract

Wearables yield a wide array of sleep-related measures that are relevant to Long COVID. We leveraged wearables-derived sleep measures (WDSM) to identify differences between individuals with Long COVID (LC) versus individuals with possible or no LC in the RECOVER adult cohort. We found significant associations between LC and reduced heart rate variability measured during sleep and increased nightly variability in sleep duration after adjusting for confounders. Moreover, LC was independently associated with lower sleep efficiency, greater variability of nighttime sleep timing, higher resting heart rate, lower respiratory rate during rapid eye movement (REM) sleep, prolonged REM sleep onset latency, worse global physical and mental health. Cluster analysis identified distinct multidimensional patterns of WDSM that are associated with LC and quality of life. Together, the strong association between WDSM, or WDSM clusters, with LC provides a potential biomarker for future validation efforts to detect LC and monitor treatment effectiveness.

Authors

Sairam Parthasarathy, Shari Brosnahan, Solveig Sieberts, Elias Neto, Yanling Li, Meghasyam Tummalacherla, Heather-Elizabeth Brown, Sy-Miin Chow, Jessilyn Dunn, Monika Haack, Shekh Md Islam, Marissa Jacobs-Diggs, Yihang Jiang, Joe Kossowsky, Aric Prather, Nadia Raytselis, Nima Salimi, Mirna Ayache, Logan Bartram, Jacqueline Becker, Alicia Chung, James DelAlcazar, Valerie Flaherman, Kelly Gibson, Minjoung Go, Ramkiran Gouripeddi, Jenny Han, Mathew Hoffman, Sarah Jolley, J Kelly, Ziad Koberssy, Jerry Krishnan, Adeyinka Laiyemo, Joyce Lee-Iannotti, Emily Levitan, Diego Mazzotti, Grace McComsey, Alem Mehari, Megumi Okomura, Thomas Patterson, Michael Peluso, Bharati Prasad, Orlando Quintero, A Ryerson, Prachi Singh, Upinder Singh, Monica Verduzco-Gutierrez, Peter Whitesell, Natasha Williams, Juan Wisnivesky, Janet Mullington, Susan Redline, Elizabeth Karlson

Keywords

Digital Health; Heart Rate Variability; Long COVID; PASC; Sleep; Wearables