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https://www.sciencedirect.com/science/article/abs/pii/S0022399923003793
Journal of Psychosomatic Research
Available online 14 October 2023, 111522
Nynke L. Rauwerda, Tanja A. Kuut, Annemarie M.J. Braamse, Irene Csorba, Pythia Nieuwkerk, Annemieke van Straten, Hans Knoop,
Insomnia and sleep characteristics in post COVID-19 fatigue: A cross-sectional case-controlled study
Author links
a
Amsterdam UMC location University of Amsterdam, Department of Medical Psychology, Meibergdreef 9, Amsterdam, the Netherlands
b
Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands
c
Department of Medical Psychology, Hospital Gelderse Vallei, Ede, the Netherlands
d
Amsterdam Institute for Infection and Immunity, and Amsterdam Public Health, Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
e
Department of Clinical Psychology & Amsterdam Public Health Research Institute, VU University, Amsterdam, the Netherlands
Received 25 August 2022, Revised 7 October 2023, Accepted 11 October 2023, Available online 14 October 2023.
https://doi.org/10.1016/j.jpsychores.2023.111522Get rights and content
Abstract
Objective
Following COVID-19 many patients report persistent fatigue and insomnia. Given the overlapping features, insomnia can be underdiagnosed in post-COVID-19 fatigue patients. This study aimed to determine insomnia severity, prevalence of clinical insomnia and sleep characteristics of post-COVID-19 fatigue patients. Data of post-COVID-19 fatigue patients were compared with those of patients with chronic fatigue syndrome (ME/CFS), a condition resembling post-COVID-19 fatigue.
Methods
In this cross-sectional case-controlled study, insomnia severity, assessed with the Insomnia Severity Index (ISI), and prevalence of clinical insomnia (ISI score ≥ 10), were determined in patients with post-COVID-19 fatigue (n = 114) and compared with ME/CFS (n = 59) using ANCOVA and logistic regression, respectively. Linear regression analyses were used to evaluate whether mood, concentration problems, pain, fatigue (assessed with questionnaires) and diagnosis were associated with insomnia. Sleep characteristics were determined with a sleep diary and accelerometer in post-COVID-19 fatigue and compared with ME/CFS using ANCOVA.
Results
In patients with post-COVID-19 fatigue mean (SD) insomnia severity was 11.46 (5.7) and 64% reported clinical insomnia. Insomnia severity was significantly associated with depressive symptoms (ß = 0.49, p = 0.006) and age (ß = 0.08, p = 0.04). The mean (SD) subjective sleep duration was 7.4 (1.0) hours with a sleep efficiency of 82 (11)%. Several subjective sleep characteristics of the post-COVID-19 fatigue patients differed from ME/CFS patients; only sleep duration, being significantly shorter in post-COVID-19 fatigue patients (p = 0.003), seemed clinically relevant (d = 0.58).
Conclusion
Insomnia severity and prevalence of clinical insomnia are high in patients with post-COVID-19 fatigue. Insomnia should be assessed and if present treated with insomnia focused therapy.
Journal of Psychosomatic Research
Available online 14 October 2023, 111522
Nynke L. Rauwerda, Tanja A. Kuut, Annemarie M.J. Braamse, Irene Csorba, Pythia Nieuwkerk, Annemieke van Straten, Hans Knoop,
Insomnia and sleep characteristics in post COVID-19 fatigue: A cross-sectional case-controlled study
Author links
a
Amsterdam UMC location University of Amsterdam, Department of Medical Psychology, Meibergdreef 9, Amsterdam, the Netherlands
b
Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands
c
Department of Medical Psychology, Hospital Gelderse Vallei, Ede, the Netherlands
d
Amsterdam Institute for Infection and Immunity, and Amsterdam Public Health, Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
e
Department of Clinical Psychology & Amsterdam Public Health Research Institute, VU University, Amsterdam, the Netherlands
Received 25 August 2022, Revised 7 October 2023, Accepted 11 October 2023, Available online 14 October 2023.
https://doi.org/10.1016/j.jpsychores.2023.111522Get rights and content
Abstract
Objective
Following COVID-19 many patients report persistent fatigue and insomnia. Given the overlapping features, insomnia can be underdiagnosed in post-COVID-19 fatigue patients. This study aimed to determine insomnia severity, prevalence of clinical insomnia and sleep characteristics of post-COVID-19 fatigue patients. Data of post-COVID-19 fatigue patients were compared with those of patients with chronic fatigue syndrome (ME/CFS), a condition resembling post-COVID-19 fatigue.
Methods
In this cross-sectional case-controlled study, insomnia severity, assessed with the Insomnia Severity Index (ISI), and prevalence of clinical insomnia (ISI score ≥ 10), were determined in patients with post-COVID-19 fatigue (n = 114) and compared with ME/CFS (n = 59) using ANCOVA and logistic regression, respectively. Linear regression analyses were used to evaluate whether mood, concentration problems, pain, fatigue (assessed with questionnaires) and diagnosis were associated with insomnia. Sleep characteristics were determined with a sleep diary and accelerometer in post-COVID-19 fatigue and compared with ME/CFS using ANCOVA.
Results
In patients with post-COVID-19 fatigue mean (SD) insomnia severity was 11.46 (5.7) and 64% reported clinical insomnia. Insomnia severity was significantly associated with depressive symptoms (ß = 0.49, p = 0.006) and age (ß = 0.08, p = 0.04). The mean (SD) subjective sleep duration was 7.4 (1.0) hours with a sleep efficiency of 82 (11)%. Several subjective sleep characteristics of the post-COVID-19 fatigue patients differed from ME/CFS patients; only sleep duration, being significantly shorter in post-COVID-19 fatigue patients (p = 0.003), seemed clinically relevant (d = 0.58).
Conclusion
Insomnia severity and prevalence of clinical insomnia are high in patients with post-COVID-19 fatigue. Insomnia should be assessed and if present treated with insomnia focused therapy.