While researchers have already shown that insomnia was common in patients who have been hospitalized for COVID-19, new findings from a team of scientists in Vietnam found that insomnia was more likely in more than three-quarters of patients who had been diagnosed with a mild infection.
The research, reported in Frontiers in Public Health, was led by Huong T.X. Hoang, PhD, a sleep researcher at Phenikaa University, Vietnam who had received numerous inquiries from friends, relatives and colleagues who experienced sleep disturbances after recovering from COVID-19. “I found that the majority of papers focused on hospitalized patients. The environment of their treatment and quarantine would differ greatly from those with milder symptoms,” Hoang said.
To delve into whether sleep disturbance was common in those who had mild symptoms and didn’t require hospitalization, Hoang and colleagues tapped the Vietnam government’s network of COVID-19 survivors for their study. In total, the investigators recruited 1,056 people older than 18 who had been diagnosed with COVID-19 over the past six months, but had not been hospitalized.
Between June and September of 2022 each person received a survey to learn about sociodemographic characteristics such as sex, age, chronic medical conditions, and the severity and duration of their COVID-19 infections. The investigators also sought to better understand the mental health of the study participants and collected information on symptoms of stress, anxiety, and depression in this cohort. Finally, over a period of two weeks, participants were asked to report how well they slept, for how long, and how long it took for them to fall asleep compared with before they contracted COVID-19.
The collected data showed that among this population, 76.1% reported some level of insomnia after recovery, and that among this group, 22.8% suffered severed insomnia. One third of the participants said that they found it harder to fall asleep, they slept worse, and slept for less time while 50% of patients noted they woke more often during the night. The severity of COVID-19 infection didn’t seem to correlate with the severity of the insomnia experienced, though while those who reported asymptomatic infections scored lower on the insomnia index. The difference for this population, though, was not statistically significant.
The team did find two populations of people in the study who had statistically higher rates of insomnia post infection: those who had a pre-existing chronic condition and those whose scored high on measures of anxiety and depression. The researchers noted that insomnia and mental health are not completely independent of one another—insomnia can worsen mental and physical health and can also be driven by poor physical and mental health.
Interestingly, the investigators reported that the rates of reported insomnia in this study were much higher than rates not only in the general population, but higher than those reported for hospitalized COVID-19 patients. The researchers surmise this could be due to the study group comprising those who are recently recovered from their infection who may have lingering symptoms and that these people may be more stressed and sensitive to changes in their physical health, leading them to perceive their sleep as worse.
“Since this is a cross-sectional study, the relationship of anxiety and depression with insomnia cannot be fully investigated,” noted Hoang. “In addition, collecting data online and a convenience sampling method can cause recall bias and selection bias.”
The researchers suggest that future studies should take a more holistic approach to consider all factors that affect insomnia which will include more in depth analysis of the connection between COVID-19, mental health, and the development of insomnia.
