Lack of quality sleep, regardless of Long COVID status, takes a toll on the mind and body. Not only can it lead to daytime tiredness, but sleep loss impairs alertness, cognition, and motivation to participate in day-to-day activities. Racking up quality sleep has been a problem for many Long COVID patients. Other Long COVID symptoms – such as depression and anxiety – are associated with sleep disturbances on their own, potentially causing or compounding these sleep troubles.
Though lesser known than the Long COVID symptoms of brain fog and fatigue, sleep disturbances are common. A study of 1,142 COVID-19 patients across four Spanish hospitals found that 34.5% of participants reported poor sleep quality seven months after hospitalization. In a survey from the Patient-Led Research Collaborative, out of 3,762 respondents with Long COVID, nearly 80% reported a sleep symptom (however, depending on the sleep symptom, 14%–34% of respondents said their sleep issue arose before they had COVID-19). Insomnia proved the most common complaint, reported by 60% of respondents.
Other sleep symptoms are getting in the way of quality shuteye too. In the Patient-Led Research Collaborative survey, people also reported experiencing night sweats, waking up feeling breathless, restless legs, sleep apnea, vivid dreams, nightmares, and lucid dreams since their COVID-19 diagnosis.
Scientists still don’t know what’s behind these Long COVID sleep disruptions. The issues may arise from stress and mental health problems. In the study of Long COVID patients previously hospitalized for COVID-19 in Spain, the researchers also saw that sleep quality was associated with anxiety and depressive symptoms. Chronic inflammation during Long COVID is another potential culprit, as research has shown a two-way link between inflammatory diseases and sleep disturbances.
Investigators are beginning to test some of these ideas. The International COVID Sleep Study (ICOSS) aims to learn about the associations between COVID-19 and sleep, and how issues with sleep or circadian rhythms may predispose some people to develop Long COVID. Participants from 16 countries across Europe, the Americas, and Asia will complete online surveys about their sleep health, socioeconomic circumstances, and well-being before and during the pandemic, and answer questions about SARS-CoV-2 infections and any subsequent sleep issues.
The National Heart Lung and Blood Institute of the National Institutes of Health is sponsoring the RECOVER study of Long COVID which could answer questions about mechanisms driving sleep disturbances. Researchers will be studying participants’ sleep quality through surveys, sleep studies, and clinical visits, along with assessing a host of other symptoms associated with Long COVID.
For Long COVID patients who have trouble logging quality sleep, the solutions may depend on what researchers learn from studies like ICOSS and RECOVER. But in general, when struggling to fall and stay asleep, experts recommend following a relaxing bedtime routine, reducing screen time before bed, and waking at the same time each day. Sleep disorders, such as insomnia, may require more intervention, like sleep studies to diagnose the issue and cognitive behavioral therapy or medication to treat it.