Evaluation of Sleep Quality in Patients with COVID-19 after Discharge
Abstract
Background and Objective: This study examines sleep quality in patients with coronavirus disease 2019 (COVID-19) after recovery, exploring demographic associations to inform post-discharge management and support.
Materials and Methods: Conducted as a cross-sectional study, sleep quality was assessed in patients with COVID-19 2-4 weeks post-discharge in Iran. A two-part survey was administered via phone, capturing demographics and Pittsburgh Sleep Quality Index (PSQI) scores.
Results: Among 147 patients (109 women and 38 men, mean age: 47.9 years), the average PSQI score was 12.48 ± 7.37, with a mean sleep duration of 6.26 ± 1.69 hours. Poor sleep was notably linked to female gender (P = 0.029), unemployment (P = 0.012), and mental health history (P = 0.021).
Conclusion: Findings underscore the importance of monitoring sleep quality in COVID-19 recovery, with targeted support potentially reducing hospital readmissions.
1. Velavan TP, Meyer CG. The COVID-19 epidemic. Trop Med Int Health 2020; 25: 278-80.
2. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a Report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323: 1239-42.
3. Shah S, Majmudar K, Stein A, et al. Novel Use of Home pulse oximetry monitoring in COVID-19 patients discharged from the emergency department identifies need for hospitalization. Acad Emerg Med 2020; 27: 681-92.
4. Huang C, Huang L, Wang Y, et al. 6-month conse-quences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021; 397: 220-32.
5. Centers from Disease Control and Prevention. Available from: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html
6. Halpin SJ, McIvor C, Whyatt G, et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. J Med Virol 2021; 93: 1013-22.
7. Huang S, Zhuang W, Wang D, et al. Persistent somatic symptom burden and sleep disturbance in patients with covid-19 during hospitalization and after discharge: A prospective cohort study. Med Sci Monit 2021; 27: e930447.
8. Zeitlhofer J, Schmeiser-Rieder A, Tribl G, et al. Sleep and quality of life in the Austrian population. Acta Neurol Scand 2000; 102: 249-57.
9. Altman MT, Knauert MP, Pisani MA. Sleep disturbance after hospitalization and critical illness: A systematic review. Ann Am Thorac Soc 2017; 14: 1457-68.
10. Liu K, Chen Y, Wu D, et al. Effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19. Complement Ther Clin Pract 2020; 39: 101132.
11. Garrigues E, Janvier P, Kherabi Y, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect 2020; 81: e4-e6.
12. Laposky AD, Van CE, Diez-Roux AV. Reducing health disparities: The role of sleep deficiency and sleep disorders. Sleep Med 2016; 18: 3-6.
13. Sonka K, Sos P, Susta M. Past and present in drug treatment of sleep disorders. Neuro Endocrinol Lett 2014; 35: 186-97.
14. Rana M, Riffo AC, Mesa LT, et al. Sleep in children: physiology and update of a literature review. Medicina (B Aires) 2019; 79(Suppl 3): 25-8. [In Spanish].
15. Besedovsky L, Lange T, Haack M. The sleep-immune crosstalk in health and disease. Physiol Rev 2019; 99: 1325-80.
16. Loef B, van Baarle D, van der Beek AJ, et al. Shift work and respiratory infections in health-care workers. Am J Epidemiol 2019; 188: 509-17.
17. Prather AA, Janicki-Deverts D, Hall MH, et al. Behaviorally assessed sleep and susceptibility to the common cold. Sleep 2015; 38: 1353-9.
18. Dehghankar L, Ghorbani A, Yekefallah L, et al. Association of sleep quality with socio-demographic characteristics in elderly referred to health centers in Qazvin, Iran. Sleep Hyp 2018; 20: 227-32.
19. Asif N, Iqbal R, Nazir CF. Human immune system during sleep. Am J Clin Exp Immunol 2017; 6: 92-6.
20. Polese J, Sant'Ana L, Moulaz IR, et al. Pulmonary function evaluation after hospital discharge of patients with severe COVID-19. Clinics (Sao Paulo) 2021; 76: e2848.
21. Namdar P, dehghankar L, Yekefallah L. The effect of hatha yoga on low back pain and sleep quality in nulliparous pregnant women: A clinical trial study. Practising Midwife 2021; 24(7): 1-18.
22. Mollayeva T, Thurairajah P, Burton K, et al. The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis. Sleep Med Rev 2016; 25: 52-73.
23. Hirshkowitz M, Whiton K, Albert SM, et al. Na-tional Sleep Foundation's sleep time duration recommendations: methodology and results summary. Sleep Health 2015; 1: 40-3.
24. Blume C, Schmidt MH, Cajochen C. Effects of the COVID-19 lockdown on human sleep and rest-activity rhythms. Curr Biol 2020; 30: R795-R797.
25. Alimoradi Z, Gozal D, Tsang HWH, et al. Gender-specific estimates of sleep problems during the COVID-19 pandemic: Systematic review and meta-analysis. J Sleep Res 2022; 31: e13432.
26. Trapp GS, Hurworth M, Jacoby P, et al. Energy drink intake is associated with insomnia and decreased daytime functioning in young adult females. Public Health Nutr 2021; 24: 1328-37.
27. Mallampalli MP, Carter CL. Exploring sex and gender differences in sleep health: a Society for Women's Health Research Report. J Womens Health (Larchmt) 2014; 23: 553-62.
28. Franco P, Putois B, Guyon A, et al. Sleep during development: Sex and gender differences. Sleep Med Rev 2020; 51: 101276.
29. Maeda M, Filomeno R, Kawata Y, et al. Association between unemployment and insomnia-related symptoms based on the Comprehensive Survey of Living Conditions: A large cross-sectional Japanese population survey. Ind Health 2019; 57: 701-10.
30. Bagheri Sheykhangafshe F, Hojjat Shamami M. Sleep Quality during coronavirus-2019 pandemic. Int Clin Neurosci J 2021; 8: 105-6.
31. Liu S, Heinzel S, Haucke MN, et al. Increased psy-chological distress, loneliness, and unemployment in the spread of COVID-19 over 6 months in Germany. Medicina (Kaunas) 2021; 57.
32. Gualano MR, Lo MG, Voglino G, et al. Effects of covid-19 lockdown on mental health and sleep disturbances in Italy. Int J Environ Res Public Health 2020; 17.
33. Jiang Z, Zhu P, Wang L, et al. Psychological dis-tress and sleep quality of COVID-19 patients in Wuhan, a lockdown city as the epicenter of COVID-19. J Psychiatr Res 2021; 136: 595-602.
34. Orru G, Bertelloni D, Diolaiuti F, et al. Long-COVID syndrome? A study on the persistence of neurological, psychological and physiological symptoms. Healthcare (Basel) 2021; 9: 5.
2. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a Report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323: 1239-42.
3. Shah S, Majmudar K, Stein A, et al. Novel Use of Home pulse oximetry monitoring in COVID-19 patients discharged from the emergency department identifies need for hospitalization. Acad Emerg Med 2020; 27: 681-92.
4. Huang C, Huang L, Wang Y, et al. 6-month conse-quences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021; 397: 220-32.
5. Centers from Disease Control and Prevention. Available from: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html
6. Halpin SJ, McIvor C, Whyatt G, et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. J Med Virol 2021; 93: 1013-22.
7. Huang S, Zhuang W, Wang D, et al. Persistent somatic symptom burden and sleep disturbance in patients with covid-19 during hospitalization and after discharge: A prospective cohort study. Med Sci Monit 2021; 27: e930447.
8. Zeitlhofer J, Schmeiser-Rieder A, Tribl G, et al. Sleep and quality of life in the Austrian population. Acta Neurol Scand 2000; 102: 249-57.
9. Altman MT, Knauert MP, Pisani MA. Sleep disturbance after hospitalization and critical illness: A systematic review. Ann Am Thorac Soc 2017; 14: 1457-68.
10. Liu K, Chen Y, Wu D, et al. Effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19. Complement Ther Clin Pract 2020; 39: 101132.
11. Garrigues E, Janvier P, Kherabi Y, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect 2020; 81: e4-e6.
12. Laposky AD, Van CE, Diez-Roux AV. Reducing health disparities: The role of sleep deficiency and sleep disorders. Sleep Med 2016; 18: 3-6.
13. Sonka K, Sos P, Susta M. Past and present in drug treatment of sleep disorders. Neuro Endocrinol Lett 2014; 35: 186-97.
14. Rana M, Riffo AC, Mesa LT, et al. Sleep in children: physiology and update of a literature review. Medicina (B Aires) 2019; 79(Suppl 3): 25-8. [In Spanish].
15. Besedovsky L, Lange T, Haack M. The sleep-immune crosstalk in health and disease. Physiol Rev 2019; 99: 1325-80.
16. Loef B, van Baarle D, van der Beek AJ, et al. Shift work and respiratory infections in health-care workers. Am J Epidemiol 2019; 188: 509-17.
17. Prather AA, Janicki-Deverts D, Hall MH, et al. Behaviorally assessed sleep and susceptibility to the common cold. Sleep 2015; 38: 1353-9.
18. Dehghankar L, Ghorbani A, Yekefallah L, et al. Association of sleep quality with socio-demographic characteristics in elderly referred to health centers in Qazvin, Iran. Sleep Hyp 2018; 20: 227-32.
19. Asif N, Iqbal R, Nazir CF. Human immune system during sleep. Am J Clin Exp Immunol 2017; 6: 92-6.
20. Polese J, Sant'Ana L, Moulaz IR, et al. Pulmonary function evaluation after hospital discharge of patients with severe COVID-19. Clinics (Sao Paulo) 2021; 76: e2848.
21. Namdar P, dehghankar L, Yekefallah L. The effect of hatha yoga on low back pain and sleep quality in nulliparous pregnant women: A clinical trial study. Practising Midwife 2021; 24(7): 1-18.
22. Mollayeva T, Thurairajah P, Burton K, et al. The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis. Sleep Med Rev 2016; 25: 52-73.
23. Hirshkowitz M, Whiton K, Albert SM, et al. Na-tional Sleep Foundation's sleep time duration recommendations: methodology and results summary. Sleep Health 2015; 1: 40-3.
24. Blume C, Schmidt MH, Cajochen C. Effects of the COVID-19 lockdown on human sleep and rest-activity rhythms. Curr Biol 2020; 30: R795-R797.
25. Alimoradi Z, Gozal D, Tsang HWH, et al. Gender-specific estimates of sleep problems during the COVID-19 pandemic: Systematic review and meta-analysis. J Sleep Res 2022; 31: e13432.
26. Trapp GS, Hurworth M, Jacoby P, et al. Energy drink intake is associated with insomnia and decreased daytime functioning in young adult females. Public Health Nutr 2021; 24: 1328-37.
27. Mallampalli MP, Carter CL. Exploring sex and gender differences in sleep health: a Society for Women's Health Research Report. J Womens Health (Larchmt) 2014; 23: 553-62.
28. Franco P, Putois B, Guyon A, et al. Sleep during development: Sex and gender differences. Sleep Med Rev 2020; 51: 101276.
29. Maeda M, Filomeno R, Kawata Y, et al. Association between unemployment and insomnia-related symptoms based on the Comprehensive Survey of Living Conditions: A large cross-sectional Japanese population survey. Ind Health 2019; 57: 701-10.
30. Bagheri Sheykhangafshe F, Hojjat Shamami M. Sleep Quality during coronavirus-2019 pandemic. Int Clin Neurosci J 2021; 8: 105-6.
31. Liu S, Heinzel S, Haucke MN, et al. Increased psy-chological distress, loneliness, and unemployment in the spread of COVID-19 over 6 months in Germany. Medicina (Kaunas) 2021; 57.
32. Gualano MR, Lo MG, Voglino G, et al. Effects of covid-19 lockdown on mental health and sleep disturbances in Italy. Int J Environ Res Public Health 2020; 17.
33. Jiang Z, Zhu P, Wang L, et al. Psychological dis-tress and sleep quality of COVID-19 patients in Wuhan, a lockdown city as the epicenter of COVID-19. J Psychiatr Res 2021; 136: 595-602.
34. Orru G, Bertelloni D, Diolaiuti F, et al. Long-COVID syndrome? A study on the persistence of neurological, psychological and physiological symptoms. Healthcare (Basel) 2021; 9: 5.
| Files | ||
| Issue | Vol 8 No 1-2 (2023): Winter- Spring | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jss.v8i1-2.17872 | |
| Keywords | ||
| Sleep quality COVID-19 Patient discharge | ||
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How to Cite
1.
Mohammadi S, Aghakhanbeigi F, Hoseini N, Noorian S, Yekefallah L. Evaluation of Sleep Quality in Patients with COVID-19 after Discharge. J Sleep Sci. 2025;8(1-2):25-30.
