Sleep quality and COVID-19 outcomes: the evidence-based lessons in the framework of predictive, preventive and personalised (3P) medicine

Abstract

Sleep quality and duration play a pivotal role in maintaining physical and mental health. In turn, sleep shortage, deprivation and disorders are per evidence the risk factors and facilitators of a broad spectrum of disorders, amongst others including depression, stroke, chronic inflammation, cancers, immune defence insufficiency and individual predisposition to infection diseases with poor outcomes, for example, related to the COVID-19 pandemic. Keeping in mind that COVID-19-related global infection distribution is neither the first nor the last pandemic severely affecting societies around the globe to the costs of human lives accompanied with enormous economic burden, lessons by predictive, preventive and personalised (3P) medical approach are essential to learn and to follow being better prepared to defend against global pandemics. To this end, under extreme conditions such as the current COVID-19 pandemic, the reciprocal interrelationship between the sleep quality and individual outcomes becomes evident, namely, at the levels of disease predisposition, severe versus mild disease progression, development of disease complications, poor outcomes and related mortality for both - population and healthcare givers. The latter is the prominent example clearly demonstrating the causality of severe outcomes, when the long-lasting work overload and shift work rhythm evidently lead to the sleep shortage and/or deprivation that in turn causes immune response insufficiency and strong predisposition to the acute infection with complications. This article highlights and provides an in-depth analysis of the concerted risk factors related to the sleep disturbances under the COVID-19 pandemic followed by the evidence-based recommendations in the framework of predictive, preventive and personalised medical approach.

„Coronasomnia“ – Resilienzförderung durch Insomniebehandlung

“…Aktuelle Daten zeigen, dass die Prävalenz von Insomnie bei COVID-19-Patient*innen zwischen 36 und 88 % liegt [3] und damit signifikant höher ist als die Prävalenz in der Allgemeinbevölkerung von 10-40 % [4].…”

“…Für das medizinische Personal, das auch vor der COVID-19-Pandemie eine Risikogruppe für Schlafstörungen war, empfehlen wir ein breites Präventionsprogramm in allen Krankenhäusern für ein adäquates Schlafmanagement und für die Prävention vonSchlafstörungen [3,25,31].Hierzu können sich die Abteilungen des betrieblichen Gesundheitsmanagements in den medizinischen Einrichtungen an den Empfehlungen des aktuellen Leitfadens zu gesundheitlichen Aspekten und Gestaltung von Nacht-und Schichtarbeit der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF) [32] orientieren.…”

Wrist actigraphic approach in primary, secondary and tertiary care based on the principles of predictive, preventive and personalised (3P) medicine

“…Sleep quality and duration are crucial for maintaining physical and mental health [1,2] as well as for individual outcomes in a spectrum of suboptimal health conditions, external and internal risk factors with health adverse effects [3][4][5][6] as well as pathologies under treatment [7][8][9][10].…”

“…Contextually, individualised sleep quality monitoring is essential to analyse individual sleep patterns, to predict sleep disorders and associated pathologies followed by targeted prevention and treatments tailored to the personalised patient profile [9,[11][12][13][14]. This approach is conform with principles of predictive, preventive and personalised medicine (PPPM/3PM) [15].…”

Targeting phytoprotection in the COVID-19-induced lung damage and associated systemic effects—the evidence-based 3PM proposition to mitigate individual risks

“…Furthermore, they can be highly effective, if being applied to secondary and tertiary care of noncommunicable diseases under pandemic condition. Thus, the stratification of patients evaluating specific health conditions such as sleep quality [9], periodontitis [10], smoking [11], chronic diseases or chronic inflammation [12,13], metabolic disorders or obesity [14], vascular dysfunction [15,16], or cancer [17] would enable effective managemenet of COVID-19-associated complications in primary, secondary, and tertiary care in the context of 3PM. Indeed, flavonoids are abundant compounds found in many plants that are synthesized in a response to microbial attacks and are therefore expected to possess antimicrobial and antiviral capacity [18].…”