ABSTRACT

Given the high prevalence of sleep disorders (e.g. insomnia) among long-COVID-19 patients (LC19Ps), approaches to tackle these disorders should not only depend on sleep specialists, but they should also involve general practitioners (GPs). Indeed, according to the World Health Organization, GPs should be on the front line in the management of LC19Ps. However, in real practice, little data with regard to the management of LC19Ps are available for GPs, which represents an embarrassing situation. Thus, the main aim of this correspondence was to provide GPs with some advice related to the management of sleep disorders in LC19Ps. The pieces advice presented in this correspondence are related to: i) Early and accurate recognition of sleep disorders, ii) General recommendations to manage sleep disorders in LC19Ps (e.g. encouraging vaccination against the virus); and iii) Specific recommendations, such as improving sleep hygiene (patients’ behavior and diet), psychological or behavioral therapies (stimulus control therapy, relaxation, sleep restriction), promising tools (heart coherence, neurofeedback), and pharmacological treatment. The authors of this correspondence deeply believe that given the undesirable side effects associated with the use of hypnotics, the pharmacological approach must only be a “last resort”. The authors believe that an important percentage of pharmacological prescriptions could be avoided if more focus is put on educating GPs to provide LC19Ps with more tools to deal with sleep disorders. The pieces advice presented in this correspondence are indispensable to resume the normal life of LC19Ps and to promote their mental health recovery.

摘要

鉴于睡眠障碍（如失眠）在长期 COVID-19 患者 (LC19P) 中的高发率，解决这些障碍的方法不仅应依赖睡眠专家，还应让全科医生 (GP) 参与进来。事实上，根据世界卫生组织的说法，全科医生应该站在 LC19P 管理的第一线。然而，在实际操作中，全科医生在LC19Ps管理方面的数据却很少，这是一个尴尬的局面。因此，这封信件的主要目的是为全科医生提供一些与 LC19P 睡眠障碍管理相关的建议。本信函中提出的建议与：i)及早准确识别睡眠障碍，ii)管理 LC19P 睡眠障碍的一般建议（例如鼓励接种病毒疫苗）；iii )具体建议，例如改善睡眠卫生（患者的行为和饮食）、心理或行为疗法（刺激控制疗法、放松、睡眠限制）、有前途的工具（心脏连贯性、神经反馈）和药物治疗。这封信件的作者深信，鉴于与使用催眠药相关的不良副作用，药理学方法只能是“最后的手段”。作者认为，如果更多地关注教育 GPs 为 LC19Ps 提供更多处理睡眠障碍的工具，则可以避免很大比例的药理学处方。这封信中提出的建议对于恢复LC19P的正常生活和促进他们的心理健康康复是必不可少的。