How did the prolonged COVID-19 affect sleep patterns?

Among them were hypersomnia, insomnia, and circadian rhythms. sleepy Disorders discussed by the panel at SLEEP 2023 as being associated with post-coronavirus acute sequelae (PASC). PASC is defined as “symptoms occurring in an individual with a probable or confirmed history of infection”. [COVID-19] According to the World Health Organization, it usually occurs within three months of the onset of COVID-19, symptoms last at least two months, and cannot be explained by alternative diagnoses. The effects of long-term COVID-19 infection on neurological disorders, including sleep, have been studied, and the latest data were presented at this panel discussion.

An estimated 6% (95% CI, 5.3-5.9) of adults in the United States are currently experiencing long-term COVID-19 symptoms, according to data presented by Cyram Parthasalathie, M.D., Ph.D., professor of medicine at the University of Arizona at Tucson. It is said that Alterations in sleep patterns have been reported during the COVID-19 pandemic, prompting researchers to investigate its effects long-term.

Hypersomnia in long-term COVID-19

Sleep disturbances and sleep apnea are strongly associated with PASC, and people with multiple infections and more virulent strains of the virus are at higher risk of PASC, Parthasarathy said.

This was made clear by evidence of an association between PASC and hypersomnia presented by Matthew B. Maas, M.D., Chief of Hospital Neurology, Northwestern University Neurology.

“If any of you have a severe acute illness and find yourself hanging around in bed, limping, not moving, not sleeping…you are not alone. Bugs have the same problem. I have it,” Maas joked as he began his presentation. How sick animals of all kinds become hypersomnia when injured or sick. Maas said this is especially true for patients infected with COVID-19.

Patients with “normal” wakefulness who were sick were found to be less active and less rhythmic than healthy patients, Maas said. “And when people come out of these diseases and come out on the other side to recovery, the consequences are different changes to their functional abilities and quality of life,” he said. “And one of the typical consequences of this is persistent sleep disturbance, fatigue, and hypersomnia during the day.”

The disease is rarely confined to a single organ system, Maas said, and treating the initial disease alone rarely returns patients to baseline. Hypersomnia has proven to be one of the more persistent features of long-term COVID-19. According to published research data, people who complain of hypersomnia after COVID-19 are more likely to have other neurological disorders, with a median of six individual neurological symptoms attributed to PASC. , the study found that 87% reported four or more symptoms. By Maas. Fatigue (94.9%), brain fog (89.7%) and insomnia (74.4%) were most commonly reported.

But Maas said there is still much that scientists don’t know about this connection. “One of the realities is that we need to be candid about how much we don’t know, how much biology is so uncertain for us, and how we have to deal with it.” he says.

Correlations between insomnia and long-term COVID-19

Daniel J. Buice, M.D., Ph.D., UPMC Endowed Chair of Sleep Medicine at the University of Pittsburgh, presented information about the link between insomnia and PASC. The nationwide increase in searches for insomnia during the pandemic prompted researchers to consider a potential link between the two disorders.

Prevalence estimates for insomnia during the COVID-19 pandemic were published by Buysse, which compiled data from various meta-analyses and studies. “And it turns out pretty rough[ly] An average of about 25% or 30% of the population reported having insomnia during the COVID-19 pandemic, which is not far from the usual estimates of insomnia in the population,” he said. Stated.

However, in published studies, the prevalence of insomnia among healthcare workers was significantly higher, averaging around 35% to 40%. All these studies had high heterogeneity.

Symptoms of clinical insomnia were found in 36.7% (95% CI, 36.0-37.4) of individuals surveyed during the pandemic in 14 countries, whereas the likelihood of insomnia disorder was 17.4% (95% CI , 16.9-17.9). Another study found a 26.7% increase in insomnia during the pandemic.

“But people generally slept well, and the vast majority of them stayed asleep,” Buis said. “Sometimes it went into mild insomnia. However, two-thirds of these people overall had subsyndromic or severe symptoms during the pandemic.”

Buysse also presented data from studies conducted in 16 countries, showing that PASC symptoms were more prevalent in more severe COVID-19 patients, with fatigue (61.3%) at the core of PASC, Sleep symptoms such as insomnia symptoms (49.6%) were found. , excessive daytime sleepiness (35.8%). Another study found that the group with the best sleep health had a 30% lower risk of post-COVID-19 symptoms than those with the worst sleep health.

Buysse concluded that insomnia is a common symptom of PASC, with a high prevalence of insomnia during and after COVID-19. Insomnia and poor sleep health may also predict an individual’s PASC. However, he stressed that there is still no known cure for PASC-related insomnia.

“I think future treatments should focus on: [incorporating] patient’s perspective. We need to recognize that we don’t have all the answers, that patient symptoms are more complex than we are used to, and that we do our best to be adaptable, listen and mind. We need to keep open and help these patients,” he said.

Disorders resulting from COVID-19 infection and PASC symptoms have few treatment options, but recognizing the link between PASC and neurological disorders, such as sleep disturbances, may be of interest in the future of treatment for this disorder. is an important first step towards Hypersomnia and insomnia are just two examples of how PASC has affected people with COVID-19 in the past, and there is ongoing research into PASC and COVID-19 in general over time. It serves as a reminder that we need it.