Hospitalized COVID-19 Patients Were Five Times More Likely to Suffer From Total Sleep Deprivation Compared to Non-COVID-19 Patients; an Observational Comparative Study

Ende, Eva S. van den; Veldhuizen, Kim D. I. van; Toussaint, Belle; Merten, Hanneke; Ven, Peter M. van de; Kok, Natasja A.; Nanayakkara, Prabath W.B.

doi:10.3389/fnins.2021.680932

Cited by 12 publications

(16 citation statements)

References 57 publications

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“…Among patients hospitalized for COVID-19, a recent observational comparative study assessing quality and quantity of sleep, confirmed that hospitalized COVID-19 patients were five times more likely to suffer from total sleep deprivation compared to non-covid patients [ 97 ]. It is still not clear if sleep disturbances can be promoted by the hospitalization in itself [ 98 ] or by an effect of symptoms such as anxiety or dyspnea [ 99 ] or if the penetration of the virus in the CNS (cerebrospinal fluid) may have an influence on them [ 100 ].…”

Section: Sleep Deprivation Immune System and Viral Infectionsmentioning

confidence: 99%

Sleep Deprivation, Immune Suppression and SARS-CoV-2 Infection

Ragnoli

Pochetti

Pignatti

et al. 2022

IJERPH

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Sleep health and its adaptation to individual and environmental factors are crucial to promote physical and mental well-being across animal species. In recent years, increasing evidence has been reported regarding the relationship between sleep and the immune system and how sleep disturbances may perturb the delicate balance with severe repercussions on health outcomes. For instance, experimental sleep deprivation studies in vivo have reported several major detrimental effects on immune health, including induced failure of host defense in rats and increased risk for metabolic syndrome (MetS) and immune suppression in humans. In addition, two novel risk factors for dysregulated metabolic physiology have recently been identified: sleep disruption and circadian misalignment. In light of these recent findings about the interplay between sleep and the immune system, in this review, we focus on the relationship between sleep deprivation and immunity against viruses, with a special interest in SARS-CoV-2 infection.

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Section: Sleep Deprivation Immune System and Viral Infectionsmentioning

confidence: 99%

Sleep Deprivation, Immune Suppression and SARS-CoV-2 Infection

Ragnoli

Pochetti

Pignatti

et al. 2022

IJERPH

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“…The authors surveyed COVID-19 patients during their hospital stay and discovered that COVID-19 patients reported a complete lack of sleep five times more often than other hospital patients, but the average total sleep time differed between the groups by only 15 min. However, the authors pointed out a different distribution of sleep time among the two groups, namely, in COVID-19 patients, it was often 0 h of sleep or more than 13 h of sleep, while in the COVID-19 negative group, in most cases, this time oscillated around the average of 6 h [ 138 ].…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, among patients with MDD or BD, sleep deprivation is associated with a subsequent improvement in mood or the development of a (hypomanic) episode [ 128 , 129 , 130 , 131 ]. In relation to COVID-19, sleep disturbances and insomnia are reported by patients and described by the authors of the studies relatively often [ 3 , 137 , 138 ]. This is quite a unique feature of COVID-19 and is strongly associated with the development of mania and should therefore be taken into account in the overall assessment of the risk of developing BD after COVID-19.…”

Section: Resultsmentioning

confidence: 99%

“…Sleep disorders, on the other hand, are one of the more common complications of COVID-19 reported by patients. Their influence on the development of BD symptoms may include the activation of the HPA axis and the induction of the secretion of neurotransmitters such as DA, GABA and GLU [ 3 , 135 , 136 , 137 , 138 ]. Disturbances in neurotransmission are widely described in BD.…”

Section: Discussionmentioning

confidence: 99%

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Is SARS-CoV-2 a Risk Factor of Bipolar Disorder?—A Narrative Review

Lorkiewicz

Waszkiewicz

2022

JCM

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For 2.5 years we have been facing the coronavirus disease (COVID-19) and its health, social and economic effects. One of its known consequences is the development of neuropsychiatric diseases such as anxiety and depression. However, reports of manic episodes related to COVID-19 have emerged. Mania is an integral part of the debilitating illness—bipolar disorder (BD). Due to its devastating effects, it is therefore important to establish whether SARS-CoV-2 infection is a causative agent of this severe mental disorder. In this narrative review, we discuss the similarities between the disorders caused by SARS-CoV-2 and those found in patients with BD, and we also try to answer the question of whether SARS-CoV-2 infection may be a risk factor for the development of this affective disorder. Our observation shows that disorders in COVID-19 showing the greatest similarity to those in BD are cytokine disorders, tryptophan metabolism, sleep disorders and structural changes in the central nervous system (CNS). These changes, especially intensified in severe infections, may be a trigger for the development of BD in particularly vulnerable people, e.g., with family history, or cause an acute episode in patients with a pre-existing BD.

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“…The possibility of improvement was to be expected, because many studies show final wake times in hospitalized patients of even before 6:00 am , with the main cause for these early awakenings being hospital staff. 50 , 51 , 52 …”

Section: Discussionmentioning

confidence: 99%

Evaluation of Nonpharmacologic Interventions and Sleep Outcomes in Hospitalized Medical and Surgical Patients

et al. 2022

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ImportanceInadequate sleep negatively affects patients' physical health, mental well-being, and recovery. Nonpharmacologic interventions are recommended as first-choice treatment. However, studies evaluating the interventions are often of poor quality and show equivocal results.ObjectiveTo assess whether the implementation of nonpharmacologic interventions is associated with improved inpatient night sleep.Design, Setting, and ParticipantsIn a nonrandomized controlled trial, patients were recruited on the acute medical unit and medical and surgical wards of a Dutch academic hospital. All adults who spent exactly 1 full night in the hospital were recruited between September 1, 2019, and May 31, 2020 (control group), received usual care. Patients recruited between September 1, 2020, and May 31, 2021, served as the intervention group. The intervention group received earplugs, an eye mask, and aromatherapy. Nurses received sleep-hygiene training, and in the acute medical unit, the morning medication and vital sign measurement rounds were postponed from the night shift to the day shift. All interventions were developed in collaboration with patients, nurses, and physicians.Main Outcomes and MeasuresSleep was measured using actigraphy and the Dutch-Flemish Patient-Reported Outcomes Measurement Information System sleep disturbance item bank. Other outcomes included patient-reported sleep disturbing factors and the use of sleep-enhancing tools.ResultsA total of 374 patients were included (222 control, 152 intervention; median age, 65 [IQR, 52-74] years). Of these, 331 were included in the analysis (195 [59%] men). Most patients (138 [77%] control, 127 [84%] intervention) were in the acute medical unit. The total sleep time was 40 minutes longer in the intervention group (control: median, 6 hours and 5 minutes [IQR, 4 hours and 55 minutes to 7 hours and 4 minutes]; intervention: 6 hours and 45 minutes [IQR, 5 hours and 47 minutes to 7 hours and 39 minutes]; P < .001). This was mainly due to a 30-minute delay in final wake time (median clock-time: control, 6:30 am [IQR, 6:00 am to 7:22 am]; intervention, 7:00 am [IQR, 6:30-7:30 am]; P < .001). Sleep quality did not differ significantly between groups. For both groups, the main sleep-disturbing factors were noises, pain, toilet visits, and being awakened by hospital staff. Sleep masks (23 of 147 [16%]) and earplugs (17 of 147 [12%]) were used most. Nightly vital sign checks decreased significantly (control: 54%; intervention: 11%; P < .001).Conclusions and RelevanceThe findings of this study suggest that sleep of hospitalized patients may be significantly improved with nonpharmacologic interventions. Postponement of morning vital sign checks and medication administration rounds from the night to the day shift may be a useful way to achieve this.Trial RegistrationNetherlands Trial Registry Identifier: NL7995

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Hospitalized COVID-19 Patients Were Five Times More Likely to Suffer From Total Sleep Deprivation Compared to Non-COVID-19 Patients; an Observational Comparative Study

Cited by 12 publications

References 57 publications

Sleep Deprivation, Immune Suppression and SARS-CoV-2 Infection

Sleep Deprivation, Immune Suppression and SARS-CoV-2 Infection

Is SARS-CoV-2 a Risk Factor of Bipolar Disorder?—A Narrative Review

Evaluation of Nonpharmacologic Interventions and Sleep Outcomes in Hospitalized Medical and Surgical Patients

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