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Pajėdienė E, Urbonavičiūtė V, Ramanauskaitė V, Strazdauskas L, Stefani A. Sex Differences in Insomnia and Circadian Rhythm Disorders: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:474. [PMID: 38541200 PMCID: PMC10971860 DOI: 10.3390/medicina60030474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/04/2024] [Accepted: 03/08/2024] [Indexed: 07/23/2024]
Abstract
Insomnia and circadian rhythm disorders are increasingly common in modern society and lead to significant challenges for people's health and well-being. Some studies suggests that men and women differ in neurohormonal secretion, biological processes, and brain morphology. Thus, such differences may affect the etiology, manifestation, and course of sleep disorders, including insomnia and circadian rhythm. This systematic review aims to synthesize the existing literature on sex differences in insomnia and circadian rhythm disorders. PubMed, MEDLINE, Epistemonikos, and Cochrane databases were searched for articles published from inception until 5 September 2023, not older than five years. We performed a systematic search using MESH and non-MESH queries: (sex differences) or (male and female differences) or (men and women differences) or (men and women) AND (insomnia) or (sleep wake disorder*) or (sleep wake rhythm disorder*) or (circadian rhythm disorder*) or (sleep cycle disruption) or (sleep cycle disorder*). Out off 2833 articles screened, 11 studies were included. The prevalence of insomnia is higher among women, and their sleep is more regular and stable compared to men. Studies evaluating the impact of the stressful situation associated with the lockdown on women's and men's insomnia present discordant results concerning sex differences. Women's circadian rhythm was found to be more stable and less fragmented than men's. However, the progression of peak activity time with age was more pronounced in men. The current literature suggests that risk factors for insomnia and circadian rhythm disorders affect men and women differently. These include cerebrovascular and cardiometabolic factors, shift work, and infections. The long-term effects of insomnia seem to be more relevant for the male sex, shortening lifespan more than in women. By summarizing and analyzing existing studies, we highlight the need for further research to improve understanding of the interaction between sex and sleep.
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Affiliation(s)
- Evelina Pajėdienė
- Department of Neurology, Lithuanian University of Health Sciences, Eivenių g. 2, 50161 Kaunas, Lithuania
| | - Viltė Urbonavičiūtė
- Faculty of Medicine, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307 Kaunas, Lithuania; (V.R.); (L.S.)
| | - Vita Ramanauskaitė
- Faculty of Medicine, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307 Kaunas, Lithuania; (V.R.); (L.S.)
| | - Lukas Strazdauskas
- Faculty of Medicine, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307 Kaunas, Lithuania; (V.R.); (L.S.)
| | - Ambra Stefani
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
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Badinlou F, Rahimian F, Hedman-Lagerlöf M, Lundgren T, Abzhandadze T, Jansson-Fröjmark M. Trajectories of mental health outcomes following COVID-19 infection: a prospective longitudinal study. BMC Public Health 2024; 24:452. [PMID: 38350959 PMCID: PMC10863235 DOI: 10.1186/s12889-024-17997-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/05/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has triggered a global mental health crisis. Yet, we know little about the lasting effects of COVID-19 infection on mental health. This prospective longitudinal study aimed to investigate the trajectories of mental health changes in individuals infected with COVID-19 and to identify potential predictors that may influence these changes. METHODS A web-survey that targeted individuals that had been infected with COVID-19 was used at three time-points: T0 (baseline), T1 (six months), and T2 (twelve months). The survey included demographics, questions related to COVID-19 status, previous psychiatric diagnosis, post-COVID impairments, fatigue, and standardized measures of depression, anxiety, insomnia. Linear mixed models were used to examine changes in depression, anxiety, and insomnia over time and identify factors that impacted trajectories of mental health outcomes. RESULTS A total of 236 individuals completed assessments and was included in the longitudinal sample. The participants' age ranged between 19 and 81 years old (M = 48.71, SD = 10.74). The results revealed notable changes in mental health outcomes over time. The trajectory of depression showed significant improvement over time while the trends in anxiety and insomnia did not exhibit significant changes over time. Younger participants and individuals who experienced severe COVID-19 infection in the acute phase were identified as high-risk groups with worst mental ill-health. The main predictors of the changes in the mental health outcomes were fatigue and post-COVID impairments. CONCLUSIONS The findings of our study suggest that mental health outcomes following COVID-19 infection exhibit a dynamic pattern over time. The study provides valuable insights into the mental health trajectory following COVID-19 infection, emphasizing the need for ongoing assessment, support, and interventions tailored to the evolving mental health needs of this population.
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Affiliation(s)
- Farzaneh Badinlou
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, and Stockholm Health Care Services, Region of Stockholm, Stockholm, Sweden.
- Medical Unit, Medical Psychology, Women's Health and Allied Health Professional Theme, Karolinska University Hospital, Stockholm, Sweden.
| | - Fatemeh Rahimian
- RISE Research Institutes of Sweden, Department of Computer Science, Stockholm, Sweden
| | - Maria Hedman-Lagerlöf
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, and Stockholm Health Care Services, Region of Stockholm, Stockholm, Sweden
| | - Tobias Lundgren
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, and Stockholm Health Care Services, Region of Stockholm, Stockholm, Sweden
| | - Tamar Abzhandadze
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Markus Jansson-Fröjmark
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, and Stockholm Health Care Services, Region of Stockholm, Stockholm, Sweden
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Seighali N, Abdollahi A, Shafiee A, Amini MJ, Teymouri Athar MM, Safari O, Faghfouri P, Eskandari A, Rostaii O, Salehi AH, Soltani H, Hosseini M, Abhari FS, Maghsoudi MR, Jahanbakhshi B, Bakhtiyari M. The global prevalence of depression, anxiety, and sleep disorder among patients coping with Post COVID-19 syndrome (long COVID): a systematic review and meta-analysis. BMC Psychiatry 2024; 24:105. [PMID: 38321404 PMCID: PMC10848453 DOI: 10.1186/s12888-023-05481-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/25/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Post COVID-19 syndrome, also known as "Long COVID," is a complex and multifaceted condition that affects individuals who have recovered from SARS-CoV-2 infection. This systematic review and meta-analysis aim to comprehensively assess the global prevalence of depression, anxiety, and sleep disorder in individuals coping with Post COVID-19 syndrome. METHODS A rigorous search of electronic databases was conducted to identify original studies until 24 January 2023. The inclusion criteria comprised studies employing previously validated assessment tools for depression, anxiety, and sleep disorders, reporting prevalence rates, and encompassing patients of all age groups and geographical regions for subgroup analysis Random effects model was utilized for the meta-analysis. Meta-regression analysis was done. RESULTS The pooled prevalence of depression and anxiety among patients coping with Post COVID-19 syndrome was estimated to be 23% (95% CI: 20%-26%; I2 = 99.9%) based on data from 143 studies with 7,782,124 participants and 132 studies with 9,320,687 participants, respectively. The pooled prevalence of sleep disorder among these patients, derived from 27 studies with 15,362 participants, was estimated to be 45% (95% CI: 37%-53%; I2 = 98.7%). Subgroup analyses based on geographical regions and assessment scales revealed significant variations in prevalence rates. Meta-regression analysis showed significant correlations between the prevalence and total sample size of studies, the age of participants, and the percentage of male participants. Publication bias was assessed using Doi plot visualization and the Peters test, revealing a potential source of publication bias for depression (p = 0.0085) and sleep disorder (p = 0.02). However, no evidence of publication bias was found for anxiety (p = 0.11). CONCLUSION This systematic review and meta-analysis demonstrate a considerable burden of mental health issues, including depression, anxiety, and sleep disorders, among individuals recovering from COVID-19. The findings emphasize the need for comprehensive mental health support and tailored interventions for patients experiencing persistent symptoms after COVID-19 recovery.
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Affiliation(s)
- Niloofar Seighali
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Abolfazl Abdollahi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Arman Shafiee
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
| | - Mohammad Javad Amini
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Omid Safari
- Department of Community Medicine, School of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Parsa Faghfouri
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Alireza Eskandari
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Omid Rostaii
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Amir Hossein Salehi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hedieh Soltani
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahsa Hosseini
- Student research committee, Arak University of Medical Sciences, Arak, Iran
| | - Faeze Soltani Abhari
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Reza Maghsoudi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Bahar Jahanbakhshi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahmood Bakhtiyari
- Department of Community Medicine, School of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran.
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Chinvararak C, Chalder T. Prevalence of sleep disturbances in patients with long COVID assessed by standardised questionnaires and diagnostic criteria: A systematic review and meta-analysis. J Psychosom Res 2023; 175:111535. [PMID: 37898059 DOI: 10.1016/j.jpsychores.2023.111535] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVE We aimed to study the prevalence of sleep disturbances in patients with long COVID-19. METHODS We conducted a systematic review and meta-analysis of the pooled prevalence of sleep disturbances in patients post COVID-19. We systematically searched relevant studies from three databases, including Medline, Embase and Scopus. Original articles were included based on specific criteria: peer-reviewed, observational studies involving adults (18 or older) with confirmed post COVID-19 status through PCR testing and focused on sleep in the context of post COVID-19. Exclusion criteria included non-English articles, studies with insufficient data, and narrative/systematic reviews. The search was performed from 31st July 2023 to 15th August 2023. We identified 35 eligible papers; however, we excluded 6 studies which did not describe the sleep assessment. We used a random-effects meta-analysis model to estimate the pooled prevalence of sleep disturbances. RESULTS 29 studies involved 13,935 long COVID-19 patients; approximately 39% of participants were male aged 18 to 97 years. The overall pooled prevalence of sleep disturbance was 46% (95% CI: 38-54%). Subgroup analyses revealed that the pooled prevalence of poor sleep quality was 56% (95% CI: 47-65%). The pooled prevalence of insomnia was 38% (95% CI: 28-48%). Finally, the pooled prevalence of excessive daytime sleepiness was 14% (95% CI: 0-29%). CONCLUSION Sleep disturbances are common in long COVID-19 patients. The healthcare sector should recognise these sleep issues and provide an early, effective treatment to prevent long-term sequelae of sleep problems.
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Affiliation(s)
- Chotiman Chinvararak
- Department of Psychiatry, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand; Department of Psychological Medicine, Division of Academic Psychiatry, King's College London, United Kingdom
| | - Trudie Chalder
- Department of Psychological Medicine, Division of Academic Psychiatry, King's College London, United Kingdom; Persistent Physical Symptoms Research and Treatment Unit and Neuropsychiatry Outpatients South London and Maudsley Hospital NHS Trust, United Kingdom.
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Munteanu I, Marc M, Gheorghevici C, Diaconu GA, Feraru N, Sion D, Nemes RM, Mahler B. Sleep Quality Aspects in Post-COVID-19 Patients. J Pers Med 2023; 13:1125. [PMID: 37511738 PMCID: PMC10381792 DOI: 10.3390/jpm13071125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/07/2023] [Accepted: 07/09/2023] [Indexed: 07/30/2023] Open
Abstract
In this observational cohort study, sleep quality in post-COVID-19 patients was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. This study aimed to examine aspects of sleep quality in patients who have undergone SARS-CoV-2 infection and if there is a pattern of progression or regression over time (6 months). We also observed and analyzed the results in order to identify any possible links between the severity of COVID-19 and sleep quality as measured by the PSQI questionnaire. The study group consisted of 65 adult patients with confirmed SARS-CoV-2 infection who were referred to a pulmonologist for evaluation. Sleep quality was impacted at a high rate in post-COVID-19 patients, quantified by a PSQI score ≥5. Out of 65 patients, 51% of them had scores greater than or equal to 5. Sleep was subjectively reported as unsatisfactory predominantly in mild and moderate COVID-19 patients. According to the PSQI score and a 6-month follow-up, many patients presented persistency in poor sleep quality. Investigation and individualized treatment of sleep disorders in post-COVID-19 patients should be part of the routine pneumological control, as improvement in sleep quality has an impact not only on the health but also on the psychological state of patients. Educating patients about the importance of sleep and sleep quality impairment should be a primary concern.
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Affiliation(s)
- Ioana Munteanu
- Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
| | - Monica Marc
- Department of Pneumology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | | | | | - Nicolae Feraru
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
| | - Dragos Sion
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
| | - Roxana Maria Nemes
- Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
| | - Beatrice Mahler
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
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Dillon GA, Joyner MJ, Baker SE. Closing the window on COVID-19 case-control studies. Am J Physiol Heart Circ Physiol 2023; 324:H364-H365. [PMID: 36735404 PMCID: PMC9942877 DOI: 10.1152/ajpheart.00048.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 02/01/2023] [Indexed: 02/04/2023]
Affiliation(s)
- Gabrielle A Dillon
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Sarah E Baker
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States
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