Frange Cristina, de Oliveira Giuliano Paz, Coelho Fernando Morgadinho Santos
Departamento de Neurologia e Neurocirurgia, Universidade Federal de São Paulo, SP São Paulo, Brazil.
Universidade Federal do Delta do Parnaíba, PI Parnaíba, Brazil.
Curr Sleep Med Rep. 2022;8(3):42-49. doi: 10.1007/s40675-022-00226-5. Epub 2022 Jul 25.
Central nervous system (CNS) hypersomnias can be triggered by external factors, such as infection or as a response to vaccination. The 2019 coronavirus disease (COVID-19) pandemic, which was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), led to a worldwide effort to quickly develop a vaccine to contain the pandemic and reduce morbidity and mortality. This narrative review is focused on the literature published in the past 2 years and provides an update on current knowledge in respect of the triggering of CNS hypersomnias by infection per se vaccination, and circadian rhythm alterations caused by social isolation, lockdown, and quarantine.
At present, there is no consensus on the association between hypersomnias and COVID-19 vaccination or infection per se however, the data suggest that there has been an increase in excessive daytime sleepiness due to vaccination, but only for a short duration. Kleine Levin syndrome, hypersomnia, excessive daytime sleepiness, and narcolepsy were aggravated and exacerbated in some case reports in the literature. Both increased and decreased sleep duration and improved and worsened sleep quality were described. In all age groups, delayed sleep time was frequent in studies of patients with hypersomnolence.
The hypothesis that there is a pathophysiological mechanism by which the virus, vaccination, and the effects of quarantine aggravate hypersomnias is discussed in this review.
中枢神经系统(CNS)性睡眠增多症可由外部因素引发,如感染或作为对疫苗接种的反应。由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的2019冠状病毒病(COVID-19)大流行促使全球迅速研发疫苗以控制疫情并降低发病率和死亡率。本叙述性综述聚焦于过去两年发表的文献,提供关于感染本身、疫苗接种引发中枢神经系统性睡眠增多症以及社会隔离、封锁和检疫导致的昼夜节律改变的当前知识更新。
目前,关于睡眠增多症与COVID-19疫苗接种或感染本身之间的关联尚无共识,然而,数据表明接种疫苗后白天过度嗜睡有所增加,但持续时间较短。文献中的一些病例报告显示克莱恩-莱文综合征、睡眠增多症、白天过度嗜睡和发作性睡病病情加重。睡眠时长有增加也有减少,睡眠质量有改善也有恶化的情况均有描述。在所有年龄组中,嗜睡症患者的研究中睡眠延迟很常见。
本综述讨论了病毒、疫苗接种以及隔离影响加重睡眠增多症的病理生理机制假说。