Volume 30, Issue 7 (10-2023)                   RJMS 2023, 30(7): 1-10 | Back to browse issues page

Research code: 20526
Ethics code: IR.IUMS.FMD.REC.1400.171


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Rahmanifar F, Aloosh O, Kooranifar S, Afshar H, Ramim T, Ziaie S et al . A Questionnaire Study on the Quality and Quantity of Sleep in Patients with Covid-19 Admitted to Rasoul Akram Hospital in Tehran. RJMS 2023; 30 (7) :1-10
URL: http://rjms.iums.ac.ir/article-1-7971-en.html
Department of Internal Medicine, School of Medicine, Hazrat- e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran , drfrahmanifar123@gmail.com
Abstract:   (307 Views)
Background & Aims: The prevalence of infectious diseases is associated with sleep disturbance and psychological distress, i.e. traumatic stress, depression and anxiety. Effective factors include physical illness, mental health history, environmental stress, social isolation and separation from family and friends, and other measures to control the spread of the disease. As with previous infectious diseases, available evidence suggests that the novel coronavirus disease has had a significant impact on public mental health, causing fear, mental health problems and sleep disturbances in various populations, including the general public, healthcare personnel and patients. infected with SARS-CoV-2. Sleep disorder and other neuropsychiatric symptoms are especially common in patients with Covid-19. For example, symptoms of post-traumatic stress disorder (PTSD) were reported in more than 96% of patients recovering from hospitalization, while levels of depression (29%) were also lower among newly recovered patients compared to patients. Quarantine (9.8%) was higher. In addition, some patients infected with SARS-CoV-2 may exhibit prolonged, relapsing, or persistent symptoms for more than four weeks after infection, even after initial remission of symptoms. These clinical consequences are categorized as "post-covid syndrome" or "post-acute covid" or "long-term covid". This condition can occur even in patients with mild or asymptomatic infections. It is difficult to distinguish post-Covid symptoms from those that occur for other reasons because patients experience social isolation due to decreased activity and adverse psychological effects. In addition, post-Covid-19 syndrome may overlap with multi-organ complications and may include adverse effects of treatment or hospitalization, for example post-treatment care syndrome (PICS), severe weakness, PTSD, fatigue, difficulty concentrating, persistent respiratory symptoms, loss of smell or taste, severe post-exercise weakness, depression, anxiety, and sleep disturbances are commonly reported in "post-Covid syndrome." Mental health problems, including major depression, anxiety, and stress, are associated with more sleep problems (eg, difficulty initiating and maintaining sleep) during the COVID-19 pandemic (8). There is much less research on positive factors that may counteract sleep problems due to Covid-19 (eg, well-being, self-care, problem-focused coping). It is expected that patients with covid-19 have the highest frequency of sleep disorder (approximately 75%), because the main symptoms of the disease include cough, fever, and difficulty breathing, all of which are associated with sleep problems (10). More sleep problems among patients with Covid-19 may also be due to physical pain and side effects of drugs prescribed to treat the virus. The International Classification of Sleep Disorders defines insomnia as "a recurrent problem in the initiation, duration, consistency, or quality of sleep that occurs despite adequate opportunity and appropriate conditions for sleep and results in some type of activity disturbance during It's day." Patients with insomnia usually have difficulty falling asleep, staying asleep, or persistent periods of unwanted awakening during normal sleep periods. Various studies have identified cognitive and physiological risk factors for insomnia. The instrument used to estimate sleep problems in most studies is the Pittsburgh Sleep Quality Index. The average PSQI has been investigated for different populations (13). Apart from PSQI, a wide range of other valid scales are used to evaluate sleep disorders, such as the Athens Insomnia Scale and the Insomnia Severity Index (ISI. The PSQI and the Athens Insomnia Scale assess sleep symptoms over the past month, while the ISI assesses sleep symptoms over the past 2 weeks. On the other hand, PSQI assesses a very wide range of sleep disorders, such as nightmares and snoring, which could indicate a higher prevalence of sleep disorders compared to others. Currently, few studies have been conducted to investigate the prevalence of sleep disorders in patients with Covid-19 in the Iranian population. Therefore, the present study was conducted with the aim of determining the prevalence of sleep disorders in patients with covid-19.
Methods: A cross-sectional, descriptive-analytical study was conducted in patients admitted to Hazrat Rasool Akram (PBUH) Hospital with the diagnosis of Covid-19. Inclusion criteria include age 18-65 years, diagnosis of covid-19 disease with positive PCR test and clinical symptoms listed in the file, not being hospitalized in ICU, not using a ventilator, oxygen saturation more than 93% in room air, not being pregnant or breastfeeding. Being a patient, not having a history of using drugs effective in sleep disorders. Sampling was done in a non-probability and easy way and all the patients who met the conditions to enter the study were selected. Sampling continued until the number of considered samples was completed. The study was conducted in Tehran, Hazrat Rasool Akram (PBUH) Hospital during a period of one and a half years (from April 1400 to October 1401). After the approval of the ethics committee of Iran University of Medical Sciences and obtaining the code of ethics (IR.IUMS.FMD.REC.1400.171), the study was conducted in hospitalized patients diagnosed with the disease of COVID-19. The diagnosis of the disease was confirmed according to the clinical record and the positive PCR test. After obtaining consent to participate in the study, the patients were interviewed and in addition to the demographic status, the sleep status of the patients was checked. The Pittsburgh Sleep Quality and Quantity Questionnaire (PSQI) was used to check the sleep status of the patients participating in the study (8). The Pittsburgh Sleep Quality and Quantity Questionnaire (PSQI) examine people's attitudes about sleep quality in the last 4 weeks. The reliability of this questionnaire was calculated using Cronbach's alpha coefficient of 83%. The content validity of the sleep quality questionnaire has also been confirmed (8). This questionnaire originally has 9 items, but since question 5 contains 10 sub-items, the whole questionnaire has 19 items, which are scored on a 4-point Likert scale from 0 to 3. Scores range from zero to 21. Higher scores indicate more sleep disturbance. This questionnaire has 7 subscales: Subjective sleep quality, sleep latency, Sleep duration, Habitual sleep efficiency, and Sleep disturbances, Use of sleeping medication, Daytime dysfunction. After completing the checklists, their information was entered into spss26 software. In the descriptive analysis, central indices such as mean and dispersion indices such as standard deviation (SD) were used. Independent t test or man-whitney test was used to compare quantitative variables and chi-square test or fisher exact test was used to compare qualitative variables. A significance level of less than 0.05 was considered.
Results: A total of 94 patients with an average age of 45.49 ± 10.29 years (20-64 years) participated in the study. Out of 94 patients, 38 (40.43%) were women and 56 (59.57%) were men. The average sleep quality and quantity score of the patients was 9.3 ± 2.75 (4-16). There were no significant disorders between men and women in the reduction of sleep time and in each of the PSQI items and measures in terms of sleep quality between men and women.
Conclusion: Finally, the findings of the study showed that the average quality and quantity of sleep based on the PSQI criteria in patients with covid-19 is in favor of the high prevalence of sleep disorders. It is necessary to use preventive or even therapeutic measures in most of these patients.
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Type of Study: Research | Subject: Internal Medicine

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