Long COVID, the condition where individuals experience lingering symptoms after recovering from COVID-19, has been a subject of study in recent months. While researchers are still trying to understand the condition, studies have shown that people with long COVID may experience a range of symptoms, from fatigue and brain fog to dyspnoea and anxiety. Of these symptoms, sleep disturbances have proven particularly frustrating for patients. The condition can impact the quality and duration of an individual’s sleep, leaving them feeling exhausted and groggy during the day. In this article, we delve deeper into the connection between sleep disturbances, dyspnoea, and anxiety in long COVID, and explore recent research on the topic.
COVID-19 has caused over 6.8 million deaths globally, with many survivors experiencing long-term effects on multiple organ systems. While the controversy remains surrounding the entity of long COVID, it is now established that COVID-19 has long-term effects in a significant number of individuals. Survivors of COVID-19 complain of fatigue, difficulty concentrating, sleep disturbance, anxiety, and dyspnoea. However, the causes of these complaints are unclear, with some studies suggesting a dissociation of objective abnormalities from subjective complaints.
Sleep disorders are prevalent among COVID-19 survivors, with obstructive sleep apnoea affecting up to 1 billion people worldwide, most of which go undiagnosed and untreated. Insomnia affects more than 10% of the adult population. Obstructive sleep apnoea has major neurocognitive and cardiovascular consequences, although the impact of obesity versus obstructive sleep apnoea on dyspnoea and exercise performance is not entirely clear.
A recent multicentre cohort study called CircCOVID comprising over 2000 participants admitted to the UK hospital for COVID-19, found that sleep disturbance, anxiety, and dyspnoea were widespread among COVID-19 survivors compared to the control group. While the COVID-19 cohort had a greater rest time (a surrogate for sleep), they exhibited lower estimated sleep efficiency than the recently hospitalised control group.
However, the study has several potential limitations. Fewer than 50% of the participants with COVID-19 provided follow-up data, raising concerns of participation bias, ascertainment bias, and recall bias. Additionally, the observed abnormalities (in dyspnoea score) were relatively moderate yet statistically significant, making it unclear whether they are clinically significant. Further data are necessary to ascertain the degree of objective versus subjective abnormality in recovered COVID-19 patients.
Researchers must find answers to several questions, including whether functional complaints might represent objective brain abnormalities, and whether anxiety or dyspnoea contributes to low arousal thresholds. Meanwhile, clinicians must determine if therapies such as anticoagulants or previous vaccinations mitigate observed abnormalities during COVID-19 recovery. With more research, scientists will be better positioned to understand the underlying mechanisms that cause long-term COVID-19 effects, and clinicians can tailor post-COVID-19 care to patients’ specific needs.
In conclusion, long COVID is a complex and multifaceted condition that can cause a range of symptoms, including sleep disturbances, dyspnoea, and anxiety. If you are experiencing any of these symptoms, it is important to seek support from your healthcare professional who can provide you with the appropriate treatment and management plan. It is also essential to prioritize self-care strategies, such as maintaining a healthy lifestyle, engaging in relaxation techniques, and seeking emotional support from loved ones or a mental health professional. By taking these steps, you can better manage your symptoms and improve your overall quality of life as you navigate the road to recovery from long COVID.
