Association of sleep quality with fatigue in post Covid-19 patients in an Indian population

Abstract

Objectives To assess the quality of sleep in recently recovered Covid-19 and long Covid cases, also to determine its associations with fatigue and pain. Methods Post-Covid cases (n = 201) and controls (n = 206) were assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire for sleep quality, Fatigue Severity Scale (FSS) for fatigue, and Numeric Pain Rating Scale (NPRS) for pain in this observational study. Results Global PSQI score was higher (p = <0.001) among cases (5.7 ± 5.1, 95%CI 5.0, 6.4) than controls (2.1 ± 2.0, 95%CI 1.8, 2.4). Normal sleep latency was observed in 56(27.9%) patients and 164(79.6%) controls (p < 0.001). FSS score higher (p = <0.001) among cases (16.8 ± 10.2, 95%CI 15.4, 18.2) against controls (10.9 ± 4.1, 95%CI10.3, 11.4). The FSS scores in mild, moderate, and severe Covid were 14.3 ± 8.1, 22.1 ± 10.8, and 22.8 ± 13, respectively (p < 0.001), and higher in the elderly (20.7 ± 12.1) and middle-aged (19.6 ± 10.3) than in younger (13.9 ± 8.3) (p ≤ 0.001) cases. The global PSQI score was positively correlated with the FSS (r = 0.755, p < 0.001) and NPRS scores (r = 0.657, p < 0.001). NPRS score correlated with the FSS score (r = 0.710, p < 0.001). FSS and global PSQI scores were higher in the Long Covid group (p < 0.001). Conclusion Significantly poor sleep quality was observed in post-Covid-19 individuals including Long Covid being positively associated with fatigue and pain.