https://doi.org/10.1016/j.bbih.2022.100426

How does the COVID-19 fuel insomnia?

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.

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

Coronavirus disease 2019 (COVID-19) started spreading at the end of 2019 and despite the immediate actions of various governments with strict control, more and more individuals became infected daily. Due to the uncertainty and insecurity that still exists around this pandemic, there is an acute need for information and knowledge of what severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection entails. Respiratory and other physical symptoms received most of the medical attention, however, infected patients were also at risk for developing psychiatric and mental health disorders, such as depression, anxiety, and sleep disturbances. Available research reports a so-called 'post-COVID-19 syndrome', which refers to new and/or persistent signs and symptoms for over 12 weeks, following SARS. The aim of the present review was to provide a general overview of the psychiatric symptoms developed during SARS-CoV-2 infection and their long-term outcome, highlighting that, through follow-up with surviving patients it was revealed that some of the psychiatric symptoms of COVID-19 persisted for a long time after discharge and were also associated with negative effects on global functioning and lower quality of life.

/pdf/acute-and-long-term-psychiatric-symptoms-associated-with-1ivpqyyb.pdf

Acute and long‑term psychiatric symptoms associated with COVID‑19 (Review).

Background: Sleep is a complex, reversible process that is responsible for the modulation of various physiological mechanisms. COVID-19-related sleep disorders are affecting different populations with a heterogenous prevalence, yet high rates among infected patients are frequently reported. The aim of the study is to assess the prevalence of insomnia in the early post-COVID-19 recovery period and explore the differences in the results acquired by the Athens Insomnia Scale (AIS) by gender and selected infection severity parameters. Methods: The data presented in the paper come from a prospective, observational study on COVID-19 complications (SILCOV-19) consisting of 200 COVID-19 patients. The AIS was used for the quantitative measurement of insomnia symptoms based on ICD-10 criteria. Results: 32% (n = 64) of all patients in the study group obtained results indicating sleep disturbances (>5 points on the scale), while 21.5% (n = 43) obtained results indicating insomnia (>10 points on the scale). The analysis of the results obtained by all patients in the AIS showed a significant correlation with the duration of symptoms (Spearman’s rank-order: R = 0.18; p < 0.05), but not with the number of days spent in the hospital or age. Women achieved a higher score in overall AIS, as well as in questions assessing total sleep time, well-being the next day, physical and mental fitness the next day, and sleepiness during the day (p < 0.05). Conclusions: the prevalence of insomnia in the early post-COVID-19 recovery period is high.

/pdf/prevalence-of-insomnia-in-the-early-post-covid-19-recovery-1gm34iia.pdf

Prevalence of Insomnia in the Early Post-COVID-19 Recovery Period

Background: SARS-CoV-2 induced COVID-19 Pandemic has not only disrupted many lives but continues to impact the mental, emotional and
physical well-being of people. Coronasomnia as the term suggests refers to insomnia kindled by the chronic stress of the pandemic.
Objectives: this study aimed to identify the sleep disturbances occurring due to the COVID-19 Pandemic, factors inuencing them, and their
association with relevant sociodemographic characteristics.
Material and Method: this was a questionnaire-based study and convenience sampling method and snowballing sampling techniques were used.
Statistical analysis was done using descriptive statistical tests such as Chi-square, P-value. For categorical data, percentages were used and
interpreted using graphs.
Result: Atotal of 882 individuals between the age group 18-65 participated in this study. Among them, 385 (43.6%) were male & 497 (56.3%) were
female. Of the total enrolled patients, 512 experienced sleeping difculties during the pandemic, the majority of which were females. Participants
who had been infected by or had family members who were infected by the COVID-19 virus experienced signicant sleeping difculties.
Decreased sunlight exposure and increased screen time were signicantly associated with sleeping difculties as well. intermittent/disrupted sleep
was predominant (22.1%) complaint. Lack of routine (23.6%) and a signicant increase in the level of stress (20.8%) played a pivotal role here.
Conclusion: the COVID-19 pandemic has posed an ominous threat to everyone's health. It sank its fangs, destroying not only our physical but also
our mental health. The remarkable increase in stress levels, disrupted routines, and constant sense of connement have left a crippling effect on
society. Yoga, exercise, music, and meditation are some of the various ammunition which can be used to overcome these adversities.

Coronasomnia: a pandemic within the pandemic

Introduction Some studies have highlighted the effect of COVID-19 infection on the quality of sleep; however, the data is limited. In this study, we investigated the prevalence of insomnia in patients who recently recovered from the COVID-19 infection to evaluate the prevalence and extent of its impact. Methods This longitudinal study was conducted from January 2021 to March 2021. A total of 500 patients admitted to the intensive care unit or isolation unit of COVID-19 were included in the study at the time of their discharge. The pre-COVID-19 sleep quality of the participants was inquired using the Pittsburgh Sleep Quality Index (PSQI). Post-COVID sleep quality was assessed at a 30-day follow-up. Sleep quality was considered poor if the global score was ≥5. Participants that failed to follow up were not included in the study. Results The mean PSQI score was significantly higher in the post-COVID-19 group compared to the pre-COVID-19 group (6.28 ± 2.11 vs. 3.22 ± 0.80; p-value Conclusion Insomnia has a significant prevalence in recovered COVID-19 patients after 30 days of follow-up. Hence, patients need to be counseled to follow up in case they experience poor sleep. To avoid the long-term negative impact on patients experiencing insomnia, timely identification and treatment are important.

Impact of COVID-19 Infection on Quality of Sleep.

Background Patients with acute decompensated heart failure are prone to recurrent exacerbation leading to poor quality of life when they do not respond to an optimal medical regimen. Due to the lack of linear positive inotropy response to increasing preload in heart failure patients, increasing preload is associated with poor outcomes. Partial occlusion of either IVC or SVC is a proposed novel treatment that can improve cardiac function or quality of life by altering preload/pressure in heart failure (HF) patients unresponsive to diuretics. Methods PubMed, Ovid (MEDLINE), and Cochrane database we searched using the MeSH terms including “Superior vena cava occlusion,” “Inferior vena cava occlusion,” “Heart failure exacerbation.” The inclusion criteria included studies that enrolled patients > 18 years with diagnosed NYHA II-IV HF with reduced ejection fraction (HFrEF) on optimal medical treatment (OMT). Results The analysis involved two studies with 14 patients; the mean age was 64.4 ± 10 and 100% males. The difference in the mean pulmonary pressures between pre-and-post VCO devices were 1.56 (95% CI 0.66–2.46, p-value = 0.006). There was no heterogeneity among the study of mean pulmonary pressures. With the use of VC occlusion devices, the mean difference in pulmonary artery systolic pressure decreased by 1.70 (95% CI 0.68–2.71, p-value = 0.001) (Fig. 1B). The heterogeneity of mean pressure was minimal 14%. Conclusion In conclusion, VCO can help decrease pulmonary pressure that can indirectly prevent heart failure exacerbations and possibly hospitalization in this cohort of patients.

https://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1059&context=abingtonfp

Fatir Murtaza

Papers

Impact of COVID-19 Infection on Quality of Sleep.

Partial vena cava occlusion (VCO) to counteract refractory heart failure: A new era in interventional heart failure strategy.