COVID-19 enfeksiyonu takibinde uyku bozuklukları: Tek Merkez Deneyimi

Year 2022, , 325 - 333, 31.12.2022

Selahattin Ayas , Anıl Uçan

https://doi.org/10.36516/jocass.1162315

Abstract

Giriş: Bu çalışma, COVID-19 enfeksiyonu sonrası uyku ile ilişkili bozuklukları ve olası nedenlerini araştırmayı amaçlamaktadır.
Gereç ve Yöntemler: Uyku Bozuklukları Ünitemize son 3 ayda başvuran, COVID-19 enfeksiyonu öyküsü olan, 18 yaş üstü hastaların verileri anamnez, laboratuvar, görüntüleme ve polisomnografi incelemelerinden geriye dönük olarak elde edildi. Hastaların Pittsburgh uyku kalite indeksi (PUKI), Epworth uykululuk skalası ve Beck anksiyete envanteri (BAE) testleri verileri çalışmaya dahil edildi.
Bulgular: COVID-19 enfeksiyonu sonrası tüm hastaların Uyku Bozuklukları Ünitemize başvuru nedeni uykusuzluk şikayetleriydi. Hastaların %64'ünde uyku ile ilişkili başka bir bozukluk saptanmıştır (Obstrüktif Uyku Apne Sendromu (OUAS) %52 ile en sık görülenidir). Kronik kardiyorespiratuar, serebral, endokrin-metabolik hastalık öyküsü, uykusuzluk şikayeti ve buna eşlik eden uyku ile ilişkili bozuklukları olan hastalarda anlamlı olarak daha yüksekti (%68'e karşı %0, p=0,001). Ayrıca, bu hastalarda hastaneye yatış öyküsü anlamlı olmasa da daha yüksekti (%50'ye karşı %11, p=0,088). Tüm hastalar için medyan BAE değeri ve ortalama PUKI değeri yüksekti (sırasıyla 13 ve 11,6) ancak aralarında bir korelasyon bulunamadı (p=0,336).
Sonuç: COVID-19 enfeksiyonu sonrası en sık uyku ile ilgili başvuru nedeni uykusuzluk şikayetleri olup, kronik kardiyorespiratuar, serebral, endokrin-metabolik hastalık öyküsü ve/veya COVID-19 enfeksiyonu nedeniyle hastaneye yatış öyküsü mevcutsa OUAS başta olmak üzere eşlik eden başka ilişkili bozukluklar araştırılmalıdır. Ayrıca uykusuzluk şikayetlerinin bir nedeni olarak anksiyete bozukluğunun şiddeti uyku kalitesinde bozulma ile korele değildir.

Keywords

Uykusuzluk, COVID-19, komorbidite, polisomnografi

Sleep disorders in the follow-up of COVID-19 infection: A Single Center Experience

Abstract

Introduction: This study aims to investigate sleep-related disorders and their possible causes after COVID-19 infection.
Material and Methods: The data of patients over the age of 18 with a history of COVID-19 infection who applied to our Sleep Disorders Unit in the last 3 months were obtained retrospectively from anamnesis, laboratory, imaging, and polysomnography examinations. The data of Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale and Beck anxiety inventory (BAI) tests of patients were included in the study.
Results: After COVID-19 infection, in all patients, reason for admitting to our Sleep Disorders Unit was complaints of insomnia. Another sleep-related disorder was determined in 64% of the patients (Obstructive Sleep Apnea Syndrome (OSAS) is the most common with 52%). The history of the chronic cardiorespiratory, cerebral, endocrine-metabolic disease was significantly higher in patients having complaints of insomnia and another accompanying sleep-related disorders (68% vs 0%, p=0.001). Also, the history of hospitalization in these patients was higher, although not significant(50% vs 11%, p=0.088). For all patients, the median BAI value and the mean PSQI value were high (13 and 11.6, respectively), but no correlation was found between them (p=0.336).
Conclusions: The most common reason for sleep-related admission after COVID-19 infection is complaints of insomnia and if there is a history of chronic cardiorespiratory, cerebral, endocrine-metabolic disease and/or hospitalization because of COVID-19 infection, another accompanying sleep-related disorders, especially OSAS, should investigate. Also, the severity of anxiety disorder as a cause of insomnia complaints is not correlated with the deterioration in sleep quality.

Keywords

Insomnia, COVID-19, comorbidity, polysomnography

References

• 1. Rogers JP, Chesney E, Oliver D, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. The lancet Psychiatry. 2020;7(7):611-627.
• 2. Kay-Stacey M, Attarian H. Advances in the management of chronic insomnia. BMJ. 2016;354.
• 3. Kokou-Kpolou CK, Megalakaki O, Laimou D, et al. Insomnia during COVID-19 pandemic and lockdown: Prevalence, severity, and associated risk factors in French population. Psychiatry Res. 2020;290.
• 4. Morin CM, Carrier J. The acute effects of the COVID-19 pandemic on insomnia and psychological symptoms. Sleep Med. 2021;77:346-347.
• 5. Voitsidis P, Gliatas I, Bairachtari V, et al. Insomnia during the COVID-19 pandemic in a Greek population. Psychiatry Res. 2020;289:113076.
• 6. Cukrowicz K, Otamendi A, Pinto J, Dreaming RB-, 2006 undefined. The impact of insomnia and sleep disturbances on depression and suicidality. psycnet.apa.org. Published online 2006.
• 7. Mazza MG, De Lorenzo R, Conte C, et al. Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain Behav Immun. 2020;89:594-600.
• 8. Griffin SC, Williams AB, Mladen SN, et al. Reciprocal Effects Between Loneliness and Sleep Disturbance in Older Americans. J Aging Health. 2020;32(9):1156-1164.
• 9. Fang H, Tu S, Sheng J, et al. Depression in sleep disturbance: A review on a bidirectional relationship, mechanisms and treatment. J Cell Mol Med. 2019;23(4):2324-2332.
• 10. Ibarra-Coronado EG, Pantaleón-Martínez AM, Velazquéz-Moctezuma J, et al. The Bidirectional Relationship between Sleep and Immunity against Infections. J Immunol Res. 2015;2015.
• 11. Irwin MR, Opp MR. Sleep Health: Reciprocal Regulation of Sleep and Innate Immunity. Neuropsychopharmacology. 2017;42(1):129-155.
• 12. Buysse DJ, Reynolds CF, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.
• 13. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540-545.
• 14. Beck AT, Epstein N, Brown G, et al. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893-897.
• 15. Academy of Sleep Medicine A. The AASM Manual for the Scoring of Sleep and Associated Events Summary of Updates in Version 2.6. Published online 2020.
• 16. Perez MN, Salas RME. Insomnia. Continuum (Minneap Minn). 2020;26(4):1003-1015.
• 17. Medicine AA of S. International Classification of Sleep Disorders. 3rd ed. Published online 2014.
• 18. Kessler RC, Aguilar-Gaxiola S, Alonso J, et al. Trauma and PTSD in the WHO World Mental Health Surveys. Eur J Psychotraumatol. 2017;8(sup5).
• 19. Liu H, Petukhova M V., Sampson NA, et al. Association of DSM-IV Posttraumatic Stress Disorder With Traumatic Experience Type and History in the World Health Organization World Mental Health Surveys. JAMA psychiatry. 2017;74(3):270-281.
• 20. Organization WH. Depression and other common mental disorders: global health estimates. Published online 2017. Accessed December 13, 2021. https://apps.who.int/iris/bitstream/handle/10665/254610/W?sequence=1
• 21. Ohayon MM, Sagales T. Prevalence of insomnia and sleep characteristics in the general population of Spain. Sleep Med. 2010;11(10):1010-1018.
• 22. Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc. 2008;5(2):136-143.
• 23. Buysse DJ. Insomnia. JAMA. 2013;309(7):706-716.
• 24. Rosa RR, Bonnet MH. Reported chronic insomnia is independent of poor sleep as measured by electroencephalography. Psychosom Med. 2000;62(4):474-482.
• 25. Lichstein KL, Durrence HH, Taylor DJ, et al. Quantitative criteria for insomnia. Behav Res Ther. 2003;41(4):427-445.
• 26. DE F, DB K. Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? JAMA. 1989;262(11):1479-1484.
• 27. Seow LSE, Subramaniam M, Abdin E, et al. Sleep disturbance among people with major depressive disorders (MDD) in Singapore. J Ment Health. 2016;25(6):492-499.
• 28. Korkmaz S, Kazgan A, Çekiç S, et al. The anxiety levels, quality of sleep and life and problem-solving skills in healthcare workers employed in COVID-19 services. J Clin Neurosci. 2020;80:131-136.