. Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Chile.
. Laboratorio de Inmunología Traslacional, Departamento de Bioquímica Clínica e Inmunología, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile.
J Bras Pneumol. 2022 Apr 29;48(3):e20210398. doi: 10.36416/1806-3756/e20210398. eCollection 2022.
To describe the prevalence and severity of sleep disorders and circadian alterations in COVID-19 patients four months after the acute phase of the disease.
This was a cross-sectional observational prospective study of patients with mild COVID-19, moderate COVID-19 (requiring hospitalization but no mechanical ventilation), or severe COVID-19 (with ARDS) four months after the acute phase of the disease. All patients underwent a home sleep apnea test and seven-day wrist actigraphy, as well as completing questionnaires to assess sleep quality and mental health. Differences among the three groups of patients were evaluated by ANOVA and the chi-square test.
A total of 60 patients were included in the study. Of those, 17 were in the mild COVID-19 group, 18 were in the moderate COVID-19 group, and 25 were in the severe COVID-19 group. Sleep quality, as assessed by satisfaction, alertness, timing, efficiency, and duration scale scores, was found to be impaired in all three groups, which also had a high prevalence of unhealthy sleep, as assessed by the Pittsburgh Sleep Quality Index. The prevalence of insomnia was increased in all three groups, as assessed by the Insomnia Severity Index. The home sleep apnea test showed that the overall prevalence of obstructive sleep apnea was 60%, and seven-day wrist actigraphy showed that total sleep time was < 7 h in all three groups. Changes in quality of life and in the circadian rest-activity pattern were observed in all three groups.
Sleep-related symptoms, changes in the circadian rest-activity pattern, and impaired mental health appear to be common in COVID-19 patients four months after the acute phase of the disease, severe COVID-19 being associated with a higher prevalence of obstructive sleep apnea.
描述 COVID-19 患者在疾病急性阶段后四个月时睡眠障碍和昼夜节律改变的流行率和严重程度。
这是一项针对 COVID-19 轻症患者、中症患者（需要住院但无需机械通气）和重症患者（ARDS）的横断面前瞻性观察性研究，患者在疾病急性阶段后四个月时接受家庭睡眠呼吸暂停测试和七天腕动描记术，同时完成评估睡眠质量和心理健康的问卷。通过方差分析和卡方检验评估三组患者间的差异。
共有 60 例患者纳入研究，其中 17 例为轻症 COVID-19 组，18 例为中症 COVID-19 组，25 例为重症 COVID-19 组。三组患者的睡眠质量均受损，满意度、警觉性、时间、效率和持续时间评分评估结果均显示睡眠质量较差，匹兹堡睡眠质量指数评估结果也显示三组患者均存在较高比例的不健康睡眠。所有三组患者的失眠症患病率均增加，失眠严重程度指数评估结果显示三组患者的失眠症严重程度均较高。家庭睡眠呼吸暂停测试显示三组患者总体阻塞性睡眠呼吸暂停患病率为 60%，七天腕动描记术显示三组患者的总睡眠时间均<7 小时。所有三组患者的生活质量和昼夜节律活动模式均发生改变。
COVID-19 患者在疾病急性阶段后四个月时，睡眠相关症状、昼夜节律活动模式改变和心理健康受损似乎较为常见，且重症 COVID-19 患者的阻塞性睡眠呼吸暂停患病率更高。
