SLEEP QUALITY IN COVID 19 PATIENTS AND ITS ASSOCIATION WITH SEVERITY OF COVID

Main Article Content

Dr Shilpa Gupta
Dr Sushant Meshram
Dr. Alina Alexander

Keywords

COVID 19, High-resolution computed tomography (HRCT), Pittsburgh Sleep Quality Index (PSQI) questionnaire, Sleep Hygiene Index (SHI)

Abstract

Introduction: Bad sleep quality is associated with deregulated immune response; therefore an individual is prone to develop various viral infections.


 Aim: of the study was to assess quality of sleep in COVID 19 patients and its association with severity of disease.


Methods: this was a prospective questionnaire based study. One hundred and twenty three subjects with microbiologically confirmed COVID 19 were administered Pittsburgh Sleep Quality Index (PSQI) questionnaire. Disease severity was assessed with HRCT thorax. Demographic data and co morbidities were noted. Correlation between quality of sleep parameters and disease severity determined.


Results: Analysed data of 123 subjects. Mean age was 51.69 ± 13.17 years. Male: Female ratio was 2.1:1. Co-morbidities were found in 41%; among which Diabetes mellitus, Hypertension, combined DM and HTN, CAD, Hypothyroidism and Airway diseases were 39%, 37%, 22%, 23%, 14% and 10% respectively. Out of 118 patients with HRCT, based on CT Severity Index, subjects with mild, moderate and severe disease were 46% (54), 37% (44) and 17% (20) respectively. Based on global PSQI, 51% (62) had bad quality of sleep. Good or bad quality of sleep doesn’t have association with age and gender. Bad subjective sleep quality was reported in 21% subjects and it’s not related to disease severity grades. Insomnia (Sleep latency of >30 min) reported in 22% of the subjects and it’s correlated with severe COVID disease (P value: 0.095; <0.10).


Conclusion: In this study we observed severe COVID is associated with bad quality and reduced sleep duration. Global PSQI can be used as a screening instrument to predict severity of COVID 19.Validation of global PSQI as a screening instrument for development of severe COVID 19 is recommended.

Abstract 26 | pdf Downloads 15

References

1. Cardinali DP, García AP, Cano P, Esquifino AI. Melatonin role in experimental arthritis. Curr Drug Targets Immune Endocr Metabol Disord 2004; 4: 1-10.
2. Ime ri L, Opp MR. How (and why) the immune system makes us sleep. Nat Rev Neurosci 2009; 10: 199-210
3. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet 2020; 395 : 507-13.
4. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395 : 497-506.
5. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323 : 1061-9.
6. Anant Mohan, Pawan Tiwari , Sushma Bhatnagar , Ankit Patel et al, Clinico-demographic profile & hospital outcomes of COVID-19 patients admitted at a tertiary care centre in north India. Indian J Med Res 152, July & August 2020, pp 61-69 DOI: 10.4103/ijmr.IJMR_1788_20.
7. Shiv Lal Soni , Kamal Kajal , L.N. Yaddanapudi , Pankaj Malhotra et.al. Demographic & clinical profile of patients with COVID-19 at a tertiary care hospital in north India. Indian J Med Res 153, January & February 2021, pp 115-125 DOI: 10.4103/ijmr.IJMR_2311_20.
8. Panda, et al.: Sleep related disorders in India; Neurology India | Jan-Feb 2012 | Vol 60 | Issue 1
9. Cermakian N et.al,Crosstalk between the circadian clock circuitry and the immune system.Chronobiol Int 30: 870–888, 2013. doi:10.3109/07420528. 2013.782315.
10. Ruiz FS et.al, Sleep influences the immune response and the rejection process alters sleep pattern: evidence from a skin allograft model in mice. Brain Behav Immun 61: 274–288, 2017. doi:10.1016/j.bbi. 2016.12.027.
11. De Lorenzo BH et.al, Sleep-deprivation reduces NK cell number and function mediated by -adrenergic signalling. Psychoneuroendocrinology 57: 134–143, 2015. doi:10.1016/j.psyneuen.2015.04.006
12. Irwin M et.al. Partial sleep deprivation reduces natural killer cell activity in humans. Psychosom Med 56: 493–498, 1994. doi:10.1097/00006842- 199411000-00004. 254.
13. Irwin M et.al, Partial night sleep deprivation reduces natural killer and cellular immune responses in humans. FASEB J 10: 643–653, 1996. doi:10.1096/fasebj.10.5.8621064
14. Ruiz FS et.al, Immune alterations after selective rapid eye movement or total sleep deprivation in healthy male volunteers. Innate Immun 18: 44– 54, 2012. doi:10.1177/1753425910385962.
15. Reis ES et.al, Sleep and circadian rhythm regulate circulating complement factors and immunoregulatory properties of C5a. Brain Behav Immun 25: 1416–1426, 2011. doi:10.1016/j.bbi. 2011.04.011.
16. Sauvet F et.al, Effect of acute sleep deprivation on vascular function in healthy subjects. J Appl Physiol (1985) 108: 68–75, 2010. doi:10.1152/ japplphysiol.00851.2009.