Underestimated sleep breathing disorders in a cohort of patients admitted to post-COVID-19 follow-up program: A single center experience

Abstract

Background and aimsHypersomnolence is a risk factor of ischemic stroke (IS), as well as one of its complications. We analyzed literature sources to study existing methods and neurotransmitters for diagnosing hypersomnolence in acute IS, and to assess the possibility and necessity of their use in this group of patients. MethodsWe reviewed 64 publications taken out from the databases PubMed, Embase, Frontiers, ResearchGate. ResultsCurrently, for the clinical and instrumental assessment of hypersomnolence disorders, questionnaires (ESS, SSS, PSQI), sleep diary, MSLT, PSG, actigraphy are used. Each method has its own pros and cons. They all complement each other, making it possible to compose the most complete picture. The main criteria for choosing a methodthe ability to perform a specific study in a hospital, and the patient's ability to postpone the study / fill out questionnaires. GABA, adenosine, glutamate, norepinephrine, serotonin, acetylcholine were mentioned as laboratory biomarkers. In the context of our search for hypersomnia biomarkers in IS, glutamate, GABA, and acetylcholine seem to be the most promising. The influence of most neurotransmitters on the regulation of sleep and wakefulness has been studied only experimentally. The gradual accumulation of deeper knowledge about the neurochemistry of the sleep-wake cycle will lead to the development of new laboratory tests, as well as new treatments for patients with post-stroke hypersomnolence. ConclusionsTo determine the optimal diagnostic algorithm for hypersomnolence in patients in the acute period of stroke, it is necessary to study with the rational use of the considered methods.

Undiagnosed obstructive sleep apnea syndrome as a treatable cause of new‐onset sleepiness in some post‐COVID patients

“…There are very few data regarding OSAS in post‐COVID patients. To date, a few abstracts have reported rates of between 44% and 75% for newly diagnosed OSAS in pneumological patients with post‐COVID syndrome [16–18]. The percentage of OSAS cases among these patients is higher than that in our cohort.…”

Prevalence of sleep pattern impairment post Covid-19

“…According to our report, 83.64% of the applicants presented sleeping troubles, that is, insomnia below the threshold and at least moderate sleepiness. This is linked to the research done by (Angeli et al, 2021), where it was found that 68.1% of the study contestants had sleep disorders. A study did in Peru (Arteaga Poma, 2021) also showed that 91% of the participants presented insufficient sleep quality.…”

“…According to (Lima et al, 2020) it is expected that in the planet more than 30% of children and teenagers get sleep disorders and around 40% of teenagers have few hours of rest and are tired after waking up. This can cause the presence of various pathologies such as insomnia or drowsiness, which severely affect individuals sleep quality (Angeli et al, 2021). People contaminated with COVID-19 have registered great struggle in initiating or staying slept.…”