Sleep and Circadian Health of Critical COVID-19 Survivors 3 Months After Hospital Discharge,Critical Care Medicine

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Sleep and Circadian Health of Critical COVID-19 Survivors 3 Months After Hospital Discharge
Critical Care Medicine ( IF 8.8 ) Pub Date : 2022-06-01 , DOI: 10.1097/ccm.0000000000005476
Iván D Benítez _{1,

2} , Anna Moncusí-Moix _{1,

2} , Rafaela Vaca ₁ , Clara Gort-Paniello _{1,

2} , Olga Minguez ₁ , Sally Santisteve ₁ , Paola Carmona ₁ , Gerard Torres _{1,

2} , Juliane Fagotti ₃ , Gonzalo Labarca _{4,

5} , Antoni Torres _{2,

6} , Jessica González _{1,

2} , David de Gonzalo-Calvo ₁ , Ferran Barbé _{1,

2} , Adriano D S Targa _{1,

2}

Affiliation

OBJECTIVES:

To evaluate the sleep and circadian rest-activity pattern of critical COVID-19 survivors 3 months after hospital discharge.

DESIGN:

Observational, prospective study.

SETTING:

Single-center study.

PATIENTS:

One hundred seventy-two consecutive COVID-19 survivors admitted to the ICU with acute respiratory distress syndrome.

INTERVENTIONS:

Seven days of actigraphy for sleep and circadian rest-activity pattern assessment; validated questionnaires; respiratory tests at the 3-month follow-up.

MEASUREMENTS AND MAIN RESULTS:

The cohort included 172 patients, mostly males (67.4%) with a median (25th–75th percentile) age of 61.0 years (52.8–67.0 yr). The median number of days at the ICU was 11.0 (6.00–24.0), and 51.7% of the patients received invasive mechanical ventilation (IMV). According to the Pittsburgh Sleep Quality Index (PSQI), 60.5% presented poor sleep quality 3 months after hospital discharge, which was further confirmed by actigraphy. Female sex was associated with an increased score in the PSQI (p < 0.05) and IMV during ICU stay was able to predict a higher fragmentation of the rest-activity rhythm at the 3-month follow-up (p < 0.001). Furthermore, compromised mental health measured by the Hospital Anxiety and Depression Scale was associated with poor sleep quality (p < 0.001).

CONCLUSIONS:

Our findings highlight the importance of considering sleep and circadian health after hospital discharge. Within this context, IMV during the ICU stay could aid in predicting an increased fragmentation of the rest-activity rhythm at the 3-month follow-up. Furthermore, compromised mental health could be a marker for sleep disruption at the post-COVID period.

中文翻译：

出院后 3 个月内危重 COVID-19 幸存者的睡眠和昼夜健康状况

目标：

评估危重 COVID-19 幸存者出院 3 个月后的睡眠和昼夜休息活动模式。

设计：

观察性、前瞻性研究。

环境：

单中心研究。

患者：

连续 172 名 COVID-19 幸存者因急性呼吸窘迫综合征入住 ICU。

干预措施：

为期 7 天的体动记录仪，用于评估睡眠和昼夜节律休息活动模式；经过验证的问卷；3个月随访时进行呼吸检查。

测量和主要结果：

该队列包括 172 名患者，其中大多数为男性 (67.4%)，中位年龄（25-75%）为 61.0 岁（52.8-67.0 岁）。入住 ICU 的中位天数为 11.0 天 (6.00-24.0)，51.7% 的患者接受有创机械通气 (IMV)。根据匹兹堡睡眠质量指数（PSQI），60.5%的人在出院后3个月表现出睡眠质量较差，并通过体动记录仪进一步证实。女性与 PSQI 评分增加相关 ( p < 0.05)，ICU 住院期间的 IMV 能够预测 3 个月随访时休息活动节律的更高碎片化 ( p < 0.001)。此外，根据医院焦虑和抑郁量表测量的心理健康状况不佳与睡眠质量差相关（p < 0.001）。