Nearly 3 in 5 people worldwide have suffered sleep problems during COVID pandemic

Authors: by Study Finds South West News Service writer William Janes contributed to this report

TEMPE, Ariz. — Find yourself struggling to fall asleep and stay asleep more often during the pandemic? You’re far from alone. In fact, sleeping issues are burdening people around the world, with more than nearly six out of 10 people across the globe suffering from poor sleep during COVID, new research shows.

The study involving people from 79 countries around the globe reveals that 56.5 percent of people have experienced some kind of sleep disturbance in the pandemic. Almost two-thirds of those polled dealt with a “delayed sleep” pattern, which was associated with little change in sleep duration or time spent in bed, but a later bedtime and increased nightmares and naps.

The second most common sleep pattern change, experienced by one in five people, was the “sleep lost and fragmented” pattern. Scientists say these people went to bed later and had a shorter time in bed attempting to sleep – in essence, their sleep was restricted, lower in quality, and they were less likely to compensate for it with naps. Women are more likely to experience this disruption than men, results show.

Around one in 10 tended to be “sleep opportunists,” meaning they had significantly restricted sleep opportunities before the pandemic, but spent a lot more time in bed and had the longest sleep duration compared to any of the others. Despite the better sleep, those people also reported the greatest change in their daily routines, which was associated with a lower likelihood of being employed and greater family stress.

The least common sleep pattern was “dysregulated and distressed.” This was experienced by 5 percent of people surveyed. These individuals had the worst sleep deterioration along with more nightmares and naps, and had the worst insomnia symptoms.

“Overall, sleep disturbances were heightened, with 56.5 per cent of our sample reporting clinical levels of insomnia symptoms during the pandemic,” says Dr. Megan Petrov, an assistant professor in the College of Nursing and Health Innovation at Arizona State University, in a statement. “Sleep is an essential part of living, just like air, water and food. Your health and functioning are compromised when the quality of the air you breathe, the water you drink and the food you eat are poor. This is also the case if your sleep is poor quality and insufficient in quantity.”

The findings are published in the journal Sleep Health.

Assessment of the Frequency and Variety of Persistent Symptoms Among Patients With COVID-19A Systematic Review

Authors: Tahmina Nasserie, MPH1Michael Hittle, BS1Steven N. Goodman, MD, MHS, PhD1 JAMA Netw Open. 2021;4(5):e2111417. doi:10.1001/jamanetworkopen.2021.11417 May 26, 2021

Key Points

Question  What are the frequency and variety of persistent symptoms after COVID-19 infection?

Findings  In this systematic review of 45 studies including 9751 participants with COVID-19, the median proportion of individuals who experienced at least 1 persistent symptom was 73%; symptoms occurring most frequently included shortness of breath or dyspnea, fatigue or exhaustion, and sleep disorders or insomnia. However, the studies were highly heterogeneous and needed longer follow-up and more standardized designs.

Meaning  This systematic review found that COVID-19 symptoms commonly persisted beyond the acute phase of infection, with implications for health-associated functioning and quality of life; however, methodological improvements are needed to reliably quantify these risks.Abstract

Importance  Infection with COVID-19 has been associated with long-term symptoms, but the frequency, variety, and severity of these complications are not well understood. Many published commentaries have proposed plans for pandemic control that are primarily based on mortality rates among older individuals without considering long-term morbidity among individuals of all ages. Reliable estimates of such morbidity are important for patient care, prognosis, and development of public health policy.

Objective  To conduct a systematic review of studies examining the frequency and variety of persistent symptoms after COVID-19 infection.

Evidence Review  A search of PubMed and Web of Science was conducted to identify studies published from January 1, 2020, to March 11, 2021, that examined persistent symptoms after COVID-19 infection. Persistent symptoms were defined as those persisting for at least 60 days after diagnosis, symptom onset, or hospitalization or at least 30 days after recovery from the acute illness or hospital discharge. Search terms included COVID-19SARS-CoV-2coronavirus2019-nCoVlong-termafter recoverylong-haulpersistentoutcomesymptomfollow-up, and longitudinal. All English-language articles that presented primary data from cohort studies that reported the prevalence of persistent symptoms among individuals with SARS-CoV-2 infection and that had clearly defined and sufficient follow-up were included. Case reports, case series, and studies that described symptoms only at the time of infection and/or hospitalization were excluded. A structured framework was applied to appraise study quality.

Findings  A total of 1974 records were identified; of those, 1247 article titles and abstracts were screened. After removal of duplicates and exclusions, 92 full-text articles were assessed for eligibility; 47 studies were deemed eligible, and 45 studies reporting 84 clinical signs or symptoms were included in the systematic review. Of 9751 total participants, 5266 (54.0%) were male; 30 of 45 studies reported mean or median ages younger than 60 years. Among 16 studies, most of which comprised participants who were previously hospitalized, the median proportion of individuals experiencing at least 1 persistent symptom was 72.5% (interquartile range [IQR], 55.0%-80.0%). Individual symptoms occurring most frequently included shortness of breath or dyspnea (26 studies; median frequency, 36.0%; IQR, 27.6%-50.0%), fatigue or exhaustion (25 studies; median frequency, 40.0%; IQR, 31.0%-57.0%), and sleep disorders or insomnia (8 studies; median 29.4%, IQR, 24.4%-33.0%). There were wide variations in the design and quality of the studies, which had implications for interpretation and often limited direct comparability and combinability. Major design differences included patient populations, definitions of time zero (ie, the beginning of the follow-up interval), follow-up lengths, and outcome definitions, including definitions of illness severity.

Conclusions and Relevance  This systematic review found that COVID-19 symptoms commonly persisted beyond the acute phase of infection, with implications for health-associated functioning and quality of life. Current studies of symptom persistence are highly heterogeneous, and future studies need longer follow-up, improved quality, and more standardized designs to reliably quantify risks.

For More Information: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780376

New Study Shows Insomnia More Common in COVID-19 Survivors

Updated April 14, 2021

Authors: Written by Elise Chahine

COVID-19 infection may have a large neurological and psychiatric impact on as many as one-third of its survivors.

A study published by Lancet Psychiatry finds that insomnia may be one of the most common neurological and psychiatric outcomes from COVID-19. Researchers evaluated the electronic health records of TriNetX, a global health research network, for approximately 236,000 patients, 10 years of age and older, who tested positive for COVID-19 from January 20, 2020 and were recorded as still alive on December 13, 2020 (see table for baseline characteristics). There was an estimated incidence of 14 neurological and psychiatric outcomes in the 6 months following a confirmed diagnosis of COVID-19, which included (but are not limited to) brain hemorrhage, stroke, muscle disease, dementia, mental health disorders, and insomnia. COVID-19 infection group’s outcomes were compared with flu and other respiratory tract infection groups’ outcomes.

Baseline Characteristics

CharacteristicsAll Patients
Cohort size236,379 (100.0%)
Age range, years26.3-65.7
Sex
  Male104,015 (44.0%)
  Female131,460 (55.6%)
  Other904 (0.4%)
Race
  White135,143 (57.2%)
  Black, African-American44,458 (18.8%)
  Unknown48,085 (20.3%)
Ethnicity
  Hispanic or Latino37,772 (16.0%)
  Not Hispanic or Latino134,075 (56.7%)
  Unknown64,532 (27.3%)

Researchers found that approximately 34% of their COVID patient population experienced at least 1 of the 14 neurological and/or psychiatric outcomes. While 5.4% of all patients in the study experienced insomnia, the number only increased with infection severity and need for hospitalization. With only 5.2% of non-hospitalized patients experiencing insomnia, the number jumps significantly upon hospital-entry to 6% and again to 7.5% and 10% for Intensive-Therapy-Unit–admitted and encephalopathy patients, respectively. It should be noted, this trend—an escalation in incidence with increased infection severity—was seen throughout the patient population despite neurological or psychiatric outcomes experienced.

Researchers speculate that some potential reasons for the neurological attack is viral invasion of the central nervous system, blood clotting disorders, and/or the toll immune response can take on our nervous system. The risks for these particular diagnoses may be small, but spread across a population can prove to have massive repercussions.

This study is further shedding light on the long-term implications COVID-19 will leave in its wake, plus the need for a more robust healthcare system to meet the needs of its population.