Many people with COVID-19 seem able to move on with their lives with relative ease after a few uncomfortable days, or maybe a couple weeks.
But sleep issues in the months following COVID-19 may be a bigger issue than has been reported in earlier long COVID research.
For a study published on February 4, 2024, in Frontiers of Public Health, scientists in Vietnam surveyed more than 1,000 people who had recovered from COVID-19 that did not require hospitalization; none had a prior history of insomnia or psychiatric conditions.
Just over 76 percent reported experiencing insomnia within six months after their initial infection, the researchers found. Of those patients, nearly 23 percent said their insomnia was severe.
“The results of the current study confirm the high prevalence of insomnia in COVID-19 survivors with none or mild symptoms who did not require hospitalization,” wrote Huong Thi Xuan Hoang, an investigator at the school of nursing at Phenikaa University in Hanoi, Vietnam, and her study coauthors.
Hoang and her research team noted that among the study participants, those with depression or anxiety were more than 3 times as likely to have insomnia. They also observed a “statistically higher rate of insomnia” in the nearly 12 percent of study subjects who had preexisting chronic conditions, such as cardiovascular disease, diabetes, and cancer.
A Range of Sleep Issues Can Occur After COVID-19
For the analysis, 1,056 adults (average age 33 and just over two-thirds were female) completed a survey between June and September 2022 asking how well they slept, how long they slept, and how easy it was to fall asleep in the last two weeks compared with before contracting COVID-19.
The survey also measured symptoms of anxiety, depression, and stress, and captured patient characteristics, including age, sex, chronic conditions, and severity of COVID illness.
Half the participants said they woke more often in the night post-infection, while one-third said they found it harder to fall asleep, slept worse, and slept for less time.
Hoang and her collaborators highlighted that the severity of infection did not seem to correspond with the severity of sleep disruption.
They also recognized certain limitations in the study; for instance, it was based on data reported by participants (versus data from researchers’ direct observations). They also point out that the research didn’t prove that COVID-19 causes insomnia, but simply that there is an association.
Don’t Sleep on Your Sleep Problems, Experts Say
If you’re having trouble with insomnia in the wake of COVID-19, don’t ignore it, experts say: Get help.
“The whole point [of the study] is that COVID, even if it’s mild, may be linked with insomnia,” says Abhinav Singh, MD, medical director of the Indiana Sleep Center in Greenwood and clinical assistant professor at Marian University College of Medicine in Indianapolis. “People who have had COVID need to be aware of this and seek help early for their insomnia. Don’t let this problem germinate. Don’t sleep on your sleep problems. Seek action early and get back to sleeping well.”
Dr. Singh, who was not involved in the study, confirms that addressing sleep problems may be especially pressing for those with mental-health issues such as depression and anxiety, who can be more prone to insomnia. Prior research has demonstrated that optimal sleep is connected with high levels of well-being.
For Better Sleep, Try These Strategies
In cases of mild insomnia, Hoang and her study co-authors wrote in their paper, better sleep may result from “simple actions,” such as taking a warm shower before bedtime, shutting your phone down at least one hour before going to bed, doing 30 minutes of exercise per day (but not close to bedtime), and avoiding caffeine after 4 p.m.
Over-the-counter sleep aids may help, but if insomnia persists, a person should see a doctor or sleep therapist.
For those seeking help from a medical professional, Singh calls cognitive behavioral therapy (CBT) the “gold standard” of insomnia treatment. CBT focuses on identifying thoughts, feelings, and behaviors that are contributing to symptoms of insomnia.
“Sleep is life,” Singh says. “Your body needs sleep to survive. If you’ve lost it, that means something has come in the way and we have to find what it is and remove it.”
