January 17, 2023
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sauce:
helio interview
Disclosure:
Gurubhagavatula does not report related financial disclosures.
Indira GrubaGabatura, MD, MPH, An associate professor of medicine at Penn Medicine and director of the Sleep Medicine Fellowship, he spoke with Healio about the relationship between COVID-19 and sleep.
Helio: What does current research say about the relationship between COVID-19 and sleep?
GrubaGabatura: There is evidence of a link between COVID-19 infection and sleep disturbances. We’ve seen data suggesting that an underlying sleep disorder may make him more likely to develop COVID-19 or worsen his outcome from a viral illness. Conversely, some evidence suggests that COVID-19 itself can cause or exacerbate sleep disturbances.
Early in the pandemic, social, economic, and occupational stressors were present, which also contributed to the high prevalence of insomnia. This was more commonly experienced among frontline workers, including health care workers. In some groups, increased alcohol and caffeine consumption, increased screen use, reduced physical activity due to gym closures, and late bed and wake times may have contributed to sleep disturbances. There were also changes in health habits, such as
Helio: What is the impact of COVID-19 on patients with sleep disorders?
GrubaGabatura: Sleep is an important modulator of the immune system. Healthy sleep allows a healthy balance between pro- and anti-inflammatory molecules and generates a strong immune response to infections and vaccinations. It may be damaged.
Sleep apnea is a common sleep disorder in the general population. Data show that during the acute phase of infection, patients may not tolerate continuous positive airway pressure, the first-line treatment for sleep apnea. A CPAP consists of a mask that you wear over your face and is connected to a machine that blows a gentle stream of air into your throat to keep your airway open while you sleep. During viral illness, some patients find it difficult to use her CPAP. As a result, symptoms of sleep apnea may recur, causing symptoms such as snoring, fragmented sleep, daytime sleepiness, headaches, and frequent nighttime urination.
The data also show that sleep apnea patients who develop COVID-19 are more likely to get worse, be hospitalized, require a ventilator or require intensive care. is showing. COVID-19 is believed to be an inflammatory disease that affects lung tissue and causes low oxygen levels. Sleep apnea similarly affects tissues by exacerbating inflammation and causing a drop in oxygen during sleep. I have.
Other sleep disorders, such as chronic sleep deprivation, insomnia, and shift work sleep disorders, may also increase the risk of contracting COVID-19 by compromising immune defense systems. Similarly, it may reduce the immune response to vaccination. Data show that one night of sleep deprivation can reduce the immune response to influenza A and hepatitis A vaccinations.
An inverse relationship has also been found. Patients with COVID-19 experience a variety of sleep-related symptoms during their illness, including excessive daytime sleepiness, sleeping longer than usual, or vice versa, persistent insomnia. COVID-related insomnia is common enough to have its own name: “coronasomnia” or “COVID-somnia.”
Even after recovering from acute illness, some patients continue to experience lingering symptoms of COVID-19 that last weeks or months. This is a condition called long-term COVID, chronic COVID, acute post-Covid-19 syndrome (PACS), or long-range COVID-19. 19. About 1 in 5 patients infected with COVID-19 can develop her COVID for a long time, sometimes referred to as a “long-distance traveller.”
Insomnia, daytime fatigue, and “brain fog” are among the most reported symptoms of people with prolonged COVID. Fatigue is reported in up to two-thirds of long-haul transporters. In one series, sleep disturbances were found in nearly 25% of long-term COVID-19 patients, which, along with anxiety and depression (23% to 40% of patients), may themselves contribute to insomnia and daytime fatigue. One of the most common symptoms.
Helio: How common are sleep-related side effects (both with COVID-19 infection and COVID-19 vaccination)?
GrubaGabatura: It is not uncommon for patients infected with COVID-19 to experience long sleep periods and insomnia during the first two days of illness and after vaccination. Cytokines, molecules involved in immunity, can directly interfere with sleep, and some promote sleep. Changes in sleep that occur after vaccination and infection are thought to promote survival from infection. It may be associated with the development of fever.
Helio: how discuss COVID-19 vaccines and boosters When Patience?
GrubaGabatura: There is a lot of misinformation about vaccines and boosters. We know vaccines and boosters work. The latest booster, a bivalent vaccine targeting the original virus and the Omicron variant, has been found to be effective in reducing hospitalization rates by 50%. But only 14% of eligible people received it.
One approach is to talk openly with patients about their concerns about vaccination and what is preventing them from getting vaccinated. Finding time to leave work and go to an immunization center was difficult for some wage earners. to find out how to troubleshoot.
We also encourage patients to make an honest assessment of their risk factors for severe or prolonged COVID-19, their living conditions, and who they are likely to encounter on a regular basis. If you have vulnerable people, such as pregnant women, the elderly, or those with weakened immune systems, talk about the role of vaccination in protecting yourself and loved ones from serious illness. We’ll talk about what it means if you already have risk factors for sleep disorders such as apnea, but also cardiovascular disease, diabetes, asthma, and immunodeficiency.
Many patients have already been infected with COVID-19 multiple times. Some suffer from severe symptoms, and others are more willing to consider vaccination because they don’t want to get sick again. Many people just don’t have accurate information. They believe that if they knew someone who had the vaccine but got sick, the vaccine wouldn’t have worked. Check the fact that it might mitigate. Prevention requires other strategies, such as wearing her properly fitting KN95 or N95 mask in indoor public places and avoiding crowded places.
When discussing vaccines, it is good to remind patients that it is important to maintain healthy sleep habits in the days leading up to vaccination. This is because there is evidence that getting enough good quality sleep beforehand boosts the immune response to vaccines. This means making sure you have enough time to get the sleep you need. If your doctor prescribes treatment for sleep disorders, such as a positive airway pressure device for sleep apnea, be sure to use it before and after vaccination. Limit alcohol, caffeine, and anything that may interfere with sleep for several days before vaccination.
And while some people may be eligible for vaccinations or boosters, benefit from vaccines, and are at increased risk of exposure and serious illness, some, including the disbelief that COVID-19 is irrelevant. Some people are simply unconvinced for the following reasons. in circulation; distrust of vaccine formulations, governments, pharmaceutical companies, or health professionals. Misunderstanding that “just a cold”. Personal preference; or because I believe “natural immunity” is better. Some have expressed concern about losing their jobs due to vaccine-related side effects.
Helio: What advice would you give to people who may be hesitant to get a vaccine or boost? aWorried about sleep-related side effects?
GrubaGabatura: Sleep-related side effects from vaccines or boosters are mostly transient. They may last a day or two and then resolve. If fever, body aches, or injection site pain are interfering with your sleep, over-the-counter medications are available to help relieve symptoms and help you sleep.
Adequate hydration also helps to withstand side effects and improve sleep quality. Limiting alcohol, caffeine, tobacco and recreational drug use before and after vaccination improves sleep quality during vaccination help you to
Most people believe that the side effects are minor and that the protective benefits are worth the temporary inconvenience.
