Cleveland Clinic researchers have found that moderate to severe sleep disturbances are prevalent among those with long COVID, affecting 41% of patients, while Black patients are even more likely to be affected.

The retrospective analysis, published in the Journal of General Internal Medicine, identified risk factors for moderate to severe sleep disturbances, including race, hospitalization for COVID-19, greater anxiety severity, and fatigue. After adjusting for demographics, Black patients were three times more likely to be affected. 

“Sleep difficulties and fatigue are widely reported by people with long COVID, but little is known about the severity and factors associated with these symptoms,” says Cinthya Pena Orbea, MD, assistant professor of medicine at Cleveland Clinic’s Sleep Disorders Center and lead author of the study, in a press release. “We leveraged data from Cleveland Clinic’s reCOVer Clinic for people with long COVID to better understand these associations.”

The team analyzed data collected from 962 adult patients with long COVID—known clinically as post-acute sequelae of COVID-19 (PASC)—in Cleveland Clinic’s reCOVer Clinic between February 2021 and April 2022. The patients had recovered from COVID-19 and completed the sleep disturbance and fatigue questionnaires of the Patient-Reported Outcomes Measurement Information System.

More than two-thirds of patients (67.2%) reported moderate to severe fatigue, while 21.8% reported severe fatigue. More than half of the patients (58%) reported normal to mild disturbances, while 41.3% indicated moderate to severe sleep disturbances.

“Our findings not only emphasize the importance of identification of sleep disturbance in long COVID considering its impact on patients’ quality of life, daytime functioning, and medical health status, but they also draw the attention to the persistent inequities seen throughout the COVID-19 pandemic,” says Pena Orbea in a press release.

Reena Mehra, MD, director of Sleep Disorders Research at Cleveland Clinic and senior author of this investigation, says in a press release, “There is an unmet need to understand the neurobiological mechanisms or pathways behind the association of sleep disturbances with long COVID and, per our findings, investigate the reasons for the increased vulnerability of PASC-related sleep disturbance in the Black population so that we can develop race-specific interventions to overcome disparities.”

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