Sleep disorders, insomnia and sleepiness

Sleep difficulties

Sleep disorders are frequently reported by Long Covid patients and may fluctuate over several months. They may consist of hypersomnia (increased sleep periods or need to sleep), excessive daytime sleepiness, difficulty falling asleep, waking up at night and difficulty going back to sleep. Sleep may also be disturbed by nightmares or strange dreams.  

Breathing-related sleep disorder should be considered as a differential diagnosis. The Insomnia Severity Index (ISI)8 is recommended to assess the level of severity of insomnia. A fatigue assessment is recommended in the event of sleep disorders, along with testing for neurological and psychiatric disorders that can manifest as sleep disorders.  

Sleep disorders can contribute to the onset of depression and anxiety, and the reverse is also true.

Sources:  
Post-Covid recommendations for primary care physicians – Switzerland  
Practical management of post-Covid19 disease, Dr Ioannis Kokkinakis, Dr Mathieu Saubade, Dr Konstantinos Tzartzas, Dr Serge De Vallière, Dr Catherine Duquenne, Pr Gilles Allali, Dr Frédéric Regamey and Pr Bernard Favrat - Rev Med Suisse 2023 

    • Reduced alertness 

    • Shortened attention span 

    • Slower than normal reaction time 

    • Poorer judgement 

    • Reduced awareness of the environment and situation 

    • Reduced decision-making skills 

    • Poorer memory 

    • Reduced concentration

  • Simple actions to begin, that you can do right now   

    • Go to bed at the same time every night and get up from the bed at the same hour in the morning  

    • Avoid stimulants such as caffeine-based beverages (tea, coffee, soda) in the 4-6 hours before sleep, avoid smoking and alcohol with the evening meal  

    • Practice regular physical activity (while considering energy levels and preventing Post-Exertional Symptom Exacerbation) 

    • Eat a light dinner latest 3 hours before sleeping 

    • Prioritize reading instead of working on your computer or using your telephone, no more screen time 1 hour before bed 

    • Lower the lights in the evening to relax your body 

    • Sleeping room temperature around 20 degrees Celsius 

    • Avoid extreme temperatures (cold, hot) in the bedroom  

    • Use the bedroom only for sleeping (do not work or watch TV, etc. in the bedroom), keep the bedroom quiet and dark 

     

    Additional actions to go further 

    • Daily mind fullness meditation before sleeping 

    • Daily resonance breathing (cohérence cardiaque) before sleeping 

    • Weighted blanket 

    • Hypnosis can improve sleep 

    • NSDR (Not Sleep Deep Rest) relaxation technique which mixes deep breathing and body scan meditation 

    • Expose yourself to the sun early in the morning at least 10 min and at the sunset 

    • Think of the positive activities of your day before sleeping

    • Sleep hygiene education  

    • Light therapy prescription 

    • Melatonin prescription 

    • Psychotherapy prescription 

    • Phytotherapy   prescription 

    • Physiotherapy prescription 

     

    Tests: 

    • Epworth sleepiness score, insomnia severity index  

    • Sleep quality and quantity assessment example:  polysomnograph

    • Psychotherapy 

    • Cognitive Behavioural  

    • Physiotherapy for exercise 

    • Mindfulness meditation 

    • Relaxation methods

Find out what has worked for others experiencing your symptoms.

For more in-depth analysis try our 1:1 Free Coaching.