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Sheldon Cohen, PhD; William J. Doyle, PhD; Cuneyt M. Alper, MD; Denise Janicki-Deverts, PhD; Ronald B. Turner, MD

Arch Intern Med. 2009;169(1):62-67.

Background  Sleep quality is thought to be an important predictor of immunity and, in turn, susceptibility to the common cold. This article examines whether sleep duration and efficiency in the weeks preceding viral exposure are associated with cold susceptibility.

Methods  A total of 153 healthy men and women (age range, 21-55 years) volunteered to participate in the study. For 14 consecutive days, they reported their sleep duration and sleep efficiency (percentage of time in bed actually asleep) for the previous night and whether they felt rested. Average scores for each sleep variable were calculated over the 14-day baseline. Subsequently, participants were quarantined, administered nasal drops containing a rhinovirus, and monitored for the development of a clinical cold (infection in the presence of objective signs of illness) on the day before and for 5 days after exposure.

Results  There was a graded association with average sleep duration: participants with less than 7 hours of sleep were 2.94 times (95% confidence interval [CI], 1.18-7.30) more likely to develop a cold than those with 8 hours or more of sleep. The association with sleep efficiency was also graded: participants with less than 92% efficiency were 5.50 times (95% CI, 2.08-14.48) more likely to develop a cold than those with 98% or more efficiency. These relationships could not be explained by differences in prechallenge virus-specific antibody titers, demographics, season of the year, body mass, socioeconomic status, psychological variables, or health practices. The percentage of days feeling rested was not associated with colds.

Conclusion  Poorer sleep efficiency and shorter sleep duration in the weeks preceding exposure to a rhinovirus were associated with lower resistance to illness.

Author Affiliations: Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania (Drs Cohen and Janicki-Deverts); Department of Otolaryngology, Children's Hospital of Pittsburgh and University of Pittsburgh School of Medicine (Drs Doyle and Alper); and Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville (Dr Turner).

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