The effects of sleep disturbance on dyspnoea and impaired lung function following COVID-19 hospitalisation in the UK: a prospective multi-centre cohort study

Callum Jackson, Peter Cunningham, Andrew Hazel, Bashar Al-Sheklly, Neil Hanley, Karen Piper Hanley, Alexander Horsley, Martin K. Rutter, John Blaikley, et al., PHOSP-COVID Study Collaborative Group

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Sleep disturbance is common following hospitalisation both for COVID-19 and other causes. The clinical associations are poorly understood despite sleep disturbance contributing to morbidity in other scenarios. Therefore, we investigated the prevalence and nature of sleep disturbance after COVID-19 hospitalisation and whether this was associated with dyspnoea.

Methods
Sleep parameters were assessed in a prospective multi-centre cohort of patients (n=2,468) hospitalised for COVID-19 in the United Kingdom using both subjective (n=638) and device-based (n=729) measures. Results were compared to a matched UK Biobank cohort. Multivariable linear regression was used to define associations.

Findings
The majority (62% (396/638)) of participants reported poor sleep quality. A comparable proportion (53% (338/638)) felt their sleep quality had deteriorated for at least 1-year following hospitalisation. Compared to a non-hospitalised matched cohort, both sleep regularity (44·5 vs 56·5) and sleep efficiency (85·4% vs 89·0%) were lower as opposed to sleep period duration which was longer (8·25h vs 7·17h). Overall sleep quality (effect estimate 3·9, 95%CI (2·8–5·1)), deterioration in sleep quality following hospitalisation (effect estimate 3·0, 95%CI (1·8–4·3)), and sleep regularity (effect estimate 4·4, 95%CI (2·1–6·7)) were associated with dyspnoea and impaired lung function (FEV1 and FVC). Depending on the sleep metric, anxiety mediated 18–39% of the effect of sleep disturbance on dyspnoea and muscle weakness mediated 27-41% of this effect.

Interpretation
Sleep disturbance is associated with dyspnoea, anxiety, and muscle weakness following COVID-19 hospitalisation. Targeting sleep disturbance may be beneficial in treating the post-COVID-19 condition.
Original languageEnglish
JournalThe Lancet Respiratory Medicine
Early online date15 Apr 2023
DOIs
Publication statusPublished - 15 Apr 2023

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