How strongly a vaccine protects you may depend on getting enough sleep in the days before and after inoculation, finds a new meta-analysis examining the relationship between sleep duration and the body’s response to vaccination.

The multi-institution study published in Current Biology found that sleeping fewer than six hours per night around the time of vaccination was associated with a robust decrease in antibody response. Adults are typically recommended to get between seven and nine hours of sleep per night.

The meta-analysis included data on the association between sleep duration and antibody responses for the influenza and hepatitis vaccines. While comparable data on COVID-19 vaccination were not available, researchers said their study highlighted the need to identify simple behavioral interventions, such as sufficient sleep, that could improve the response to COVID-19 vaccination amid the ongoing pandemic.

The weakened antibody response in those with shortened sleep was “so profound” that it was similar to the decline in COVID-19 antibodies two months following vaccination with the Pfizer-BioNTech or Moderna shots, according to a press release by University of California, Los Angeles.

“We have previously found that cognitive behavioral therapy, as well as mindfulness, robustly improve insomnia and also normalize various aspects of immunity, although it is not yet known whether insomnia treatment can augment vaccination responses,” says Michael Irwin, MD, a study co-author and director of the Cousins Center for Psychoneuroimmunology at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at University of California, Los Angeles, in a press release.

The researchers also examined the data by sex, since women typically have a stronger vaccination response than men. There was a robust association between sleep duration and antibody response in men, but they said more data are needed for women because the studies did not control for variations in sex hormone levels, which are known to affect immune function.

Large-scale studies are also needed to determine when people should get sufficient sleep to promote an optimal vaccine response around the time of inoculation, the researchers say.

Other authors include Karine Spiegel, Amandine E. Rey, Anne Cheylus, Kirean Ayling, Christian Benedict, Tanja Lange, Aric A. Prather, Daniel J. Taylor, and Eve Van Cauter. The authors declared no competing interests directly related to this study.

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