Cleveland Clinic Study Finds That 41 Percent Of Individuals With Long COVID Have Moderate To Severe Sleep Disturbances
, or post-acute sequelae of COVID-19 (PASC), is a global public health crisis marked by patients experiencing lingering and debilitating symptoms beyond four weeks after the acute onset of SARS-CoV-2 infection.
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Sleep disturbances are prevalent in 34-50% of Long COVID
cases, but the severity, associated risk factors, and interactions with mood disorders and fatigue are not well understood.
Researchers at the Cleveland Clinic have investigated these aspects, providing insights into the factors associated with sleep disturbance severity in Long COVID patients and the potential implications for targeted interventions.
The study team analyzed data from 962 adult patients with Long COVID, who were evaluated at Cleveland Clinic's reCOVer Clinic between February 2021 and April 2022. The patients completed the Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance and Fatigue questionnaires within 90 days or during their initial clinic visit. Demographics and clinical characteristics were extracted from the COVID-19 Cleveland Clinic Registry.
The analysis revealed that 58% of the patients reported normal to mild sleep disturbances, while 41.3% experienced moderate to severe sleep disturbances. Over two-thirds of patients (67.2%) reported moderate to severe fatigue, with 21.8% experiencing severe fatigue. After adjusting for demographic factors, the study found that Black patients were three times more likely to develop moderate to severe sleep disturbances.
The study identified several risk factors significantly associated with moderate to severe sleep disturbances. These included Black race (OR = 1.84, 95%CI: 1.10-3.08, p = 0.020), hospitalization for COVID-19 (OR = 1.59, 95%CI: 1.10-2.32, p < 0.015), greater anxiety severity (OR = 1.31, 95%CI: 1.18-1.45, p < 0.001), and moderate to severe fatigue (OR = 2.03, 95%CI: 1.33-3.11, p = 0.001). The study found no significant interaction between anxiety severity and moderate to severe fatigue.
In a subset of 48 patients with pre-infection sleep studies available, the study found no association between objective sleep study measures of antecedent sleep apnea and hypoxia with sleep disturbance severity. However, the small sample size, testing indication biases, and limitations of sleep study types may have influenced these findings.
The high prevalence (41.3%) of moderate to severe sleep disturbances in Long COVID patients, as well as the association with Black race, hospitalization for COVID-19, anxiety severity, and moderate to severe fatigue, highlights the importance of identifying sleep disturbances in Long COVID patients.
The study findings underscore the impact of sleep disturbances on patients' quality of life, daytime functioning, and medical health status. Additionally, the persistent disparities throughout the COVID-19 pandemic warrant further investigation into the reasons for the increased vulnerability of Long COVID-related sleep disturbances.
The research conducted by the Cleveland Clinic&a
mp;#39;s reCOVer Clinic sheds light on the prevalence and severity of sleep disturbances in Long COVID patients, as well as the risk factors associated with these disturbances. The study's findings emphasize the importance of identifying sleep disturbances in Long COVID patients due to their impact on patients' quality of life, daytime functioning, and medical health status.
Moreover, the study underscores the need for further research to understand the neurobiological mechanisms or pathways behind the association of sleep disturbances with long COVID, as well as the interplay between mental and sleep disturbances in Long COVID physiologic pathways. Such research can inform risk stratification and contribute to the development of targeted interventions that address the root causes of sleep disturbances in Long COVID patients.
In conclusion, the research conducted by the Cleveland Clinic has provided valuable insights into the prevalence and severity of sleep disturbances in PASC patients and the associated risk factors. The findings of this study not only emphasize the importance of identifying and addressing sleep disturbances in Long COVID patients but also highlight the need for continued research to better understand the underlying mechanisms and develop targeted interventions that reduce disparities and improve patient outcomes.
The study findings were published in the peer reviewed Journal of General Internal Medicine.
It should be noted that sleep disturbances can affect a person’s well-being and is contributing factor to increase risk for strokes, high blood pressure and cardiovascular issues.
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