Department of Neurology, Philipps-University Marburg, Marburg, Germany.
Center for Mind, Brain and Behavior, CMBB, Philipps-University Marburg, Marburg, Germany.
Eur J Neurol. 2024 Mar;31(3):e16159. doi: 10.1111/ene.16159. Epub 2023 Nov 21.
Infection with COVID-19 can lead to persistent sequelae, such as fatigue, daytime sleepiness or disturbed sleep, that can remain for more than 12 weeks and that are summarized as post-COVID syndrome. The causes remain unclear. The present study investigated the presence of sleep disorders in patients with post-COVID syndrome using polysomnography.
Thirty-four patients with post-COVID syndrome and new-onset fatigue and sleepiness after a SARS-CoV2 infection underwent polysomnography in accordance with American Association of Sleep Medicine (AASM) standards as part of their clinical workup. Analysis was performed visually based on AASM criteria (scoring manual version 2.6, 2020).
Polysomnography revealed a sleep efficiency of <80% in 50% of patients and a mean respiratory disturbance index (RDI) of 9.9 ± 15.4/h. Excluding central apneas, 12 patients (35%) had an RDI of ≥5/h, pointing to obstructive sleep apnea syndrome (OSAS; AASM 2014). Patients with a high RDI were significantly older (p = 0.01) and showed a trend towards a higher body mass index (p = 0.08) than patients with a normal RDI but had no other risk factors for OSAS. Six patients agreed to long-term treatment of their OSAS and all reported discontinuation of daytime symptoms.
Post-COVID symptoms such as daytime sleepiness, fatigue and memory and concentration problems may in part be a result of reduced sleep efficiency and sleep apnea in a relevant percentage of patients. This possibly treatable cause of the symptoms should be kept in mind in patients presenting with post-COVID syndrome.
COVID-19 感染可导致持续性后遗症，如疲劳、日间嗜睡或睡眠障碍，这些症状可持续 12 周以上，统称为新冠后综合征。其病因仍不清楚。本研究通过多导睡眠图（PSG）调查新冠后综合征患者是否存在睡眠障碍。
34 例 COVID-19 感染后新发疲劳和日间嗜睡的新冠后综合征患者根据美国睡眠医学学会（AASM）标准进行 PSG，作为其临床评估的一部分。分析根据 AASM 标准（评分手册版本 2.6，2020）进行视觉分析。
PSG 显示 50%的患者睡眠效率<80%，平均呼吸紊乱指数（RDI）为 9.9±15.4/h。排除中枢性呼吸暂停后，12 例（35%）患者 RDI≥5/h，提示阻塞性睡眠呼吸暂停低通气综合征（OSAS；AASM 2014）。RDI 较高的患者明显年龄较大（p=0.01），且体重指数（BMI）呈升高趋势（p=0.08），但无 OSAS 的其他危险因素。6 例患者同意对 OSAS 进行长期治疗，所有患者均报告日间症状消失。
新冠后综合征的日间嗜睡、疲劳、记忆力和注意力问题等症状部分可能是由于相当一部分患者睡眠效率降低和睡眠呼吸暂停所致。对于出现新冠后综合征的患者，应考虑到这些可能是症状的潜在可治疗原因。
