A significant UK study has discovered that the disturbed sleep patterns in patients hospitalized with COVID-19 were prone to be a driver of breathlessness.

The study of patients in 38 institutions across the UK was led by the University of Manchester and Leicester, presented on the European Congress of Clinical Microbiology & Infectious Diseases (Copenhagen, 15-18 April), and published in The Lancet Respiratory Medicine.

Study: Effects of sleep disturbance on dyspnoea and impaired lung function following hospital admission because of COVID-19 within the UK: a prospective multicentre cohort study. Image Credit / Ground Picture / Shutterstock

The team discovered that 62% of participants who had been admitted to hospital for COVID-19 had sleep disruption, which was prone to persist for a minimum of 12 months and highlighted for the primary time the association between two post-COVID condition symptoms: breathlessness and sleep disruption.

On average, participants who had been hospitalized with COVID-19 slept for over an hour longer, but their sleep patterns were less regular (19% decrease on the sleep regularity scale) than matched participants who were hospitalized because of any cause.

The study researchers also found that participants with sleep disturbance were more prone to have anxiety and muscle weakness, common post-COVID-19 condition symptoms.

Statistical evaluation identified that sleep disruption was prone to drive breathlessness directly but that reduced muscle function and increased anxiety, each recognized causes of breathlessness, could partially mediate the association between sleep disturbance and breathlessness.

The study authors speculate that targeting sleep disruption by reducing anxiety and improving muscle strength in these patients could alleviate breathlessness, but further investigation is required.

The study used extensive data from the hospitals participating within the PHOSP-COVID study between March 2020 and October 2021.

PHOSP-COVID is a consortium from across the UK researching long-term health outcomes for patients hospitalized with COVID-19.

The study was funded by the UK Research and Innovation and others.

Sleep quality was assessed using subjective measures self-reported by 638 patients to researchers.

It was also measured objectively in one other 729 patients who wore devices much like smartwatches that measured night-time activity levels.

Each measures consistently revealed a better prevalence of sleep disturbance in people hospitalised with COVID-19 compared with matched controls from the UK Biobank who had been hospitalized for any cause.

The impact on sleep from hospitalization because of COVID-19 was no matter critical care admission.

Certainly one of the authors Dr. John Blaikley, a clinical scientist from The University of Manchester and respiratory doctor, said: “This study has discovered that sleep disturbance could possibly be a crucial driver of post-COVID-19 breathlessness – or dyspnoea – due to its associations with reduced muscle function and anxiety.

“If that is so, then interventions targeting poor sleep quality is perhaps used to administer symptoms and convalescence following COVID-19 hospitalisation, potentially improving patient outcomes.”

First writer and mathematician Mr. Callum Jackson from The University of Manchester said: “Understanding the causes of breathlessness is complex since it will probably arise from conditions that affect the respiratory, neurological, cardiovascular, and mental health systems.

“These same systems are also affected by sleep disturbance, one other symptom continuously reported after COVID-19.

“Our findings suggest that sleep disturbance is a typical problem after hospitalization for COVID-19 and is related to breathlessness.

“We also show that is prone to persist for a minimum of 12 months as subjective sleep quality didn’t change between 5 and 12 month follow-up visits.”

Professor Chris Brightling from the University of Leicester said: “The strengths of our study include its size, multicentre nature, and using different complementary assessment measures to judge sleep disturbance. Consistent clinical associations were also observed across each evaluation method.”

“Future research should now assess whether interventions targeting sleep disturbance can improve not only sleep quality but additionally breathlessness through reducing anxiety and improving muscle strength.”