Studying the Effect of Long COVID-19 Infection on Sleep Quality Using Wearable Health Devices: Observational Study

Abstract

Background Patients with COVID-19 have increased sleep disturbances and decreased sleep quality during and after the infection. The current published literature focuses mainly on qualitative analyses based on surveys and subjective measurements rather than quantitative data. Objective In this paper, we assessed the long-term effects of COVID-19 through sleep patterns from continuous signals collected via wearable wristbands. Methods Patients with a history of COVID-19 were compared to a control arm of individuals who never had COVID-19. Baseline demographics were collected for each subject. Linear correlations among the mean duration of each sleep phase and the mean daily biometrics were performed. The average duration for each subject’s total sleep time and sleep phases per night was calculated and compared between the 2 groups. Results This study includes 122 patients with COVID-19 and 588 controls (N=710). Total sleep time was positively correlated with respiratory rate (RR) and oxygen saturation (SpO 2 ). Increased awake sleep phase was correlated with increased heart rate, decreased RR, heart rate variability (HRV), and SpO 2 . Increased light sleep time was correlated with increased RR and SpO 2 in the group with COVID-19. Deep sleep duration was correlated with decreased heart rate as well as increased RR and SpO 2 . When comparing different sleep phases, patients with long COVID-19 had decreased light sleep (244, SD 67 vs 258, SD 67; P =.003) and decreased deep sleep time (123, SD 66 vs 128, SD 58; P =.02). Conclusions Regardless of the demographic background and symptom levels, patients with a history of COVID-19 infection demonstrated altered sleep architecture when compared to matched controls. The sleep of patients with COVID-19 was characterized by decreased total sleep and deep sleep.

Characterization of Influenza-Like Illness Burden Using Commercial Wearable Sensor Data and Patient-Reported Outcomes: Mixed Methods Cohort Study

“…Similarly, a study quantifying the population burden of ILI based on changes in activity showed that wearable sensors can be used to estimate the burden of ILI at individual and national levels in terms of the total daily step count [ 12 ]. Other studies have suggested that wearable sensors can potentially capture subtle within-person changes that could signal SARS-CoV-2 infection [ 14 , 15 , 18 , 19 , 21 , 23 ]. A study demonstrated differences in RHR elevations in individuals before and during COVID-19 illness compared with those with non–COVID-19 ILI [ 20 ], although another study cautioned about the potential impact of changes in wearer behavior after receiving a positive COVID-19 test result [ 18 ].…”

“…Another study showed that abnormalities in RHR and sleep duration, measured using wearable sensors, could be leveraged to predict the real-time incidence of ILI [ 13 ]. Recently, wearable sensor data have also been used to assess the physiological signs associated with COVID-19 [ 14 - 23 ].…”

A Review of Neurological Symptoms in Long COVID and Clinical Management

“…69 There is limited evidence at this time on the prevalence of primary sleep disorders in long COVID, but disruption in sleep architecture that may not meet criteria for a specific diagnosis may still have effects and can provide a focus for management strategies. 70 Seizures do not appear to be a frequent finding in long COVID, but electroencephalogram should be performed if concerning symptoms are present. 9 Lumbar puncture and cerebrospinal fluid (CSF) testing are likely not needed in most cases unless there is a concern for an alternative, treatable process.…”

A descriptive study of the clinical impacts on COVID-19 survivors using telemonitoring (The TeleCOVID Study)

“…Sensors and commercial wearable devices have been widely used to monitor vital signs in COVID-19 patients over long periods of time (15)(16)(17)(18)(19). Studies utilizing data from fitbit devices have shown modification in the Resting Heart Rate (RHR) for up to 3 months following symptom onset with substantial intraindividual variability.…”