Sleep Disorders after COVID-19 Infection at Yale New Haven Sleep Center

Glenda Bowen, MD 1,2

and Meir Kryger, MD 1,2

Department of Pulmonary, Critical Care, and Sleep Medicine , Yale School of Medicine 1 2

BACKGROUND RESULTS RESULTS CONCLUSIONS

The prevalence of sleep disorders among all
populations during the COVID-19 pandemic has
risen. Patients who were previously infected with
COVID-19 appeared to be the most affected
group. The primary objective of this research is to
80
The most frequent sleep related symptoms were • The most prevalent sleep disorders among
70 68
snoring and fatigue. A significant number of this population were obstructive sleep apnea
60 patients (21%) developed memory loss and and insomnia.
50 cognitive impairment. Some patients developed
insomnia rooted in a fear of falling asleep. (Table3) • More than half of patients were African

Number of Cases
40 38 37
catalog the clinical features of these patients in 31 American or Hispanic, which mimics what we
30
order to better understand the impact of COVID-
26 Symptom N=100 have seen at a national level with minorities
19 on sleep.
20
12
Snoring 83 being unequally affected by the pandemic.
10
4 4 4 5
3
Fatigue 63
METHODS 0
Insomnia Sleep
0
Parasomnia
1 1
Hypersomnia
2 1
Restless Legs
1 2
PLMS Excessive daytime sleepiness 48
• Hypertension and obesity, which are
We conducted a retrospective review of the
Disordered
Breathing
Sd.
associated with severe COVID-19 disease,
Difficulty staying asleep 36
medical record of 100 patients seen in our clinic Female Male Total
were prevalent in this cohort.
Dyspnea 31
from March 2020 to February 2021 who had Figure 1. Sleep disorders in patients after COVID 19 infection. Difficulty falling asleep 30 • Snoring, fatigue and excessive daytime
previously tested positive for COVID-19. These
Most patients are women (58%), African American (47%) Cognitive Impairment 21 sleepiness were the most common sleep
included new and established patients. We
with a BMI >30 (77%). A third of patients were hospitalized Headache 21 related complaints.
collected demographic information, symptoms,
for COVID infection and 10% required ICU admission.
comorbidities and polysomnographic data.  Nightmares 8
Table 1 • Patients presenting with fatigue, or cognitive
Fear of falling asleep 8
The most common sleep disorders in this cohort were impairment after COVID 19 infection should
RESULTS
sleep disordered breathing (68%) and insomnia (38%). Table 3. Sleep symptoms reported by subjects. be screened for sleep disorders.
DEMOGRAPHIC DATA
VARIABLE N=100 Figure 1
Male 42 Cognitive Impairment 20
32
• Understanding the prevalence of sleep
Female 58 Hypertension and anxiety were the most common disorders and characteristics of our
6
Age comorbid conditions in patients with insomnia and OSA. ILD 5
population after COVID-19 infection can help
18-25 6
26-45 36 Figure 2 Asthma 33
34 create screening tools and optimize care for
46-65 46
>65 12 COPD 8
11 these patients in our community.
Sleep disorder
Race
Asian/Pacific Islander 22 Diagnosis Total Patients diagnosis after COVID DM2 27
26
Black/African American 47 infection
12
REFERENCES
Hispanic 15 CHF 8
White 35 SLEEP DISORDERED 68 29
Other 1 8 1.- Jarami H, Bahammam, A, Bragazzi NL, Saif Z, Faris M, Vitiello, M.
BREATHING CAD 3 Sleep problems during the COVID-19 pandemic by population: a
BMI 59 systematic review and meta-analysis. J Clin Sleep Med. 2020 Oct
18-25 9 Hypertension 61
INSOMNIA 38 13 27.doi: 10.5664/jcsm.8930.
26-29 14
30-34 23 Anxiety 42
PARASOMNIA 4 0 63
35-39 26 2.- Maas MB, Kim M, Malkani RG, Abbott SM, Zee PC. Obstructive
>40 28 Depression 29
sleep apnea and risk of COVID-19 infection. Hosp Respir Fail Sleep
HYPERSOMNIA 2 1 39
Disease Severity 0 10 20 30 40 50 60 70 Breath. 2020;29:1–3
Ambulatory 67 RLS 5 1
% of patients in each group OSA Inosmnia
Hospitalized 33 3.- Lin L., Wang J., Ouyang X. The immediate impact of the 2019 novel
Supplemental Oxygen 24 PLMD 4 1
ICU Admission 10 Figure 2. Comorbidities among patients with obstructive sleep coronavirus (COVID-19) outbreak on subjective sleep status. Sleep
Mechanical Ventilation 7 apnea and insomnia. Labels correspond to percent of patients with Med. 2020
Table 2. Patients diagnosed with a sleep disorder following COVD insomnia or OSA.
4.- https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html
Table 1. Demographic Characteristics, total sample=100 infection.