Sleep Disturbance Linked to Breathlessness in COVID-19 Patients

Poor sleep patterns in COVID-19 patients were likely to be a cause of dyspnea, revealed a large UK study. The University of Manchester and Leicester led the research, which was presented at the European Congress of Clinical Microbiology and Infectious Diseases (Copenhagen, 15-18 April) and published in The Lancet Respiratory Medicine.

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Sleep Quality Linked to Breathlessness in COVID-19 Patients

The researchers discovered that 62% of patients admitted to the hospital for COVID-19 had sleep disruption, which was likely to last at least a year, highlighting for the first time the link between two post-COVID condition symptoms: breathlessness and sleep disruption. Patients who were hospitalised with COVID-19 slept for more than an hour longer on average, but their sleep patterns were less regular (19% reduction on the sleep regularity scale) than matched patients who were admitted for any reason.

Researchers discovered that participants with sleep disturbances were more likely to experience anxiety and physical weakness, both of which are common post-COVID-19 disease symptoms.

Statistical analysis revealed that sleep disruption was likely to be the direct cause of breathlessness, but that impaired muscular function and increased anxiety, both known causes of breathlessness, could partially moderate the relationship between sleep disruption and breathlessness.

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Addressing Sleep Disturbances in COVID Patients May Ease Dyspnea

The study's authors suggest that addressing sleep disruption in these patients by reducing anxiety and enhancing muscle strength may ease dyspnea, but more research is needed. The researchers analysed substantial data from hospitals that participated in the PHOSP-COVID study between March 2020 and October 2021.

Sleep quality was examined using subjective measures that 638 patients self-reported to researchers. It was also objectively quantified in 729 more patients who wore equipment comparable to smartwatches that measured night-time activity levels.

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Link Between Sleep and COVID-19 Post-Conditions

Both metrics consistently demonstrated a higher prevalence of sleep disturbance in COVID-19 patients compared to matched controls from the UK Biobank who had been hospitalized for any reason.

The effect of COVID-19 hospitalization on sleep was independent of critical care hospitalization.

One of the authors Dr John Blaikley, a clinical scientist from The University of Manchester and a respiratory doctor said, “This study has discovered that sleep disturbance could be an important driver of post-COVID-19 breathlessness – or dyspnea - because of its associations with reduced muscle function and anxiety. “If this is the case, then interventions targeting poor sleep quality might be used to manage symptoms and convalescence following COVID-19 hospitalisation, potentially improving patient outcomes.”

First author and mathematician Mr. Callum Jackson from The University of Manchester said, “Understanding the causes of breathlessness is complex since it can arise from conditions that affect the respiratory, neurological, cardiovascular, and mental health systems.

“These same systems are also affected by sleep disturbance, another symptom that has been frequently reported after COVID-19. “Our findings suggest that sleep disturbance is a common problem after hospitalisation for COVID-19 and is associated with breathlessness. “We also show this is likely to persist for at least 12 months as subjective sleep quality did not change between 5 and 12-month follow-up visits.”

Professor Chris Brightling from the University of Leicester said: “The strengths of our study include its size, multicentre nature, and the use of different complementary assessment measures to evaluate sleep disturbance. Consistent clinical associations were also observed across each evaluation method.”

“Future research should now assess whether interventions targeting sleep disturbance can improve not only sleep quality but also breathlessness through reducing anxiety and improving muscle strength.”

Source-Medindia