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.
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 language | English |
|---|---|
| Journal | The Lancet Respiratory Medicine |
| Early online date | 15 Apr 2023 |
| DOIs | |
| Publication status | Published - 15 Apr 2023 |