Persistent Sleep Quality Deterioration among Post-COVID-19 Patients: Results from a 6-Month Follow-Up Study

Abstract

Background: To date, evidence about sleep disturbances among post-COVID-19 patients is limited. This study aimed to evaluate sleep quality after hospitalization due to SARS-CoV-2 infection. Methods: In-person follow-up was conducted in patients with prior hospitalization due to COVID-19 1(Τ1), 3(Τ2), and 6 (Τ3) months after hospital discharge. Patients were asked to complete questionnaires concerning sleep quality: the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Athens Insomnia Scale (AIS), the Fatigue Severity Scale (FSS), and the Stop-BANG (S-B) questionnaire. Results: In total, 133 patients were enrolled (mean age: 56.0 ± 11.48 years, 59.4% males). The most frequently reported comorbidity was arterial hypertension (29.8% of patients), while 37.4% of patients had no comorbidities. The majority of participants exhibited poor sleep quality (global PSQI ≥ 5) at T1 (84.3%), T2 (75.7%), and T3 (77.4%). Insomnia was observed in 56.5%, 53.5%, and 39.2% of participants, respectively (AIS ≥ 6). An FSS score ≥ 4 was observed in 51.2%, 33.7%, and 29.1% of participants at T1, T2, T3, respectively. Elapsed time was found to be negatively and independently associated with the global PSQI, PSQI C5-Sleep disturbance, PSQI C7-Daytime dysfunctions, FSS, and AIS after adjustment for possible confounders. No significant difference was found between groups with good and poor sleep quality (based on the global PSQI) with respect to gender (p = 0.110), age (p = 0.528), BMI (p = 0.816), smoking status (p = 0.489), hypertension (p = 0.427), severity of disease (p = 0.224), the Charlson Comorbidity Index (p = 0.827), or the length of hospital stay (p = 0.162). Participants with excessive daytime sleepiness (EDS) and patients with severe fatigue (FSS ≥ 4) were significantly younger. Females presented a higher rate of insomnia symptoms (55.7% vs. 44.3%, p < 0.001). Conclusions: Several sleep disturbances were observed after hospital discharge for COVID-19 pneumonia at certain time points; However, the improvement over time was remarkable in most domains of the assessed questionnaires.

Fatigue, sleepiness and sleep quality are SARS-CoV-2 variant independent in patients with long COVID symptoms

“…Poor sleep quality was common (> 60%) among long COVID patients in our study, that finding is consistent with other recent studies (Kalamara et al 2022 ; Merikanto et al 2023 ). Multiple factors could have a role in pathogenesis of sleep disturbances in long COVID (Crook et al 2021 ).…”

Assessment of Cognitive and Mood Changes in Older Survivors of COVID-19

“…Depression and anxiety levels increase in the elderly in the early period after COVID-19 (Mowla et al, 2022). However, mood and sleep symptoms regress within a few months after recovery (Chevinsky et al, 2021; Kalamara et al, 2022), In our study, depression and sleep quality were similar to the controls in all follow-ups of the patients. The absence of difference at 12 months was an expected finding, but the lack of difference in our early follow-up may be related to the inclusion of patients in the study after full recovery of their COVID-19 respiratory symptoms.…”

Prevalence of sleep pattern impairment post Covid-19

“…Perhaps, if the questionnaire is applied at later, where the virus has been eradicated or different conditions exist, the results may vary, which should be verified with more studies. Despite this, (Kalamara et al, 2022) a 6-month longitudinal study was done and it was verified that time had no effect on the ESS scale. This is reliable with what was earlier presented, since data prior to COVID-19 had a similar trend to the one we found.…”