Search

This protocol paper describes the development of an international collaboration to survey several thousand adults from different countries around the world about their sleep during the coronavirus disease 2019 (COVID-19) pandemic. It is based on the development of a harmonised survey with 50 questions (106 different items) on sleep habits and sleep symptoms that permit comparability of information. The harmonised questionnaire may be used in anonymous cross-sectional surveys, and the instruments within the questionnaire may also be used in prospective studies and clinical studies. The aim was to develop a questionnaire to sample a variety of sleep-wake disorders and other symptoms likely to be caused by prolonged social confinement or by having had COVID-19. The questionnaire was designed to be: (a) simple and, (b) free to use, for research purposes, (c) multilingual, and (d) comprehensive. It can be completed in <30 min. By the end of June 2020, the survey questionnaire had been administered in Austria, Canada, China, Finland, France, Germany, Hong Kong, Italy, Japan, Norway, Poland, Sweden, UK and USA. Research questions to be addressed by the pooled data derived from the participating sites focus on describing the nature and rates of various sleep and circadian rhythms symptoms, as well as their psychological and medical correlates, that arise at various points during the COVID-19 pandemic., (© 2020 European Sleep Research Society.)

Summary: Recent investigations show that many people affected by SARS‐CoV2 (COVID‐19) report persistent symptoms 2–3 months from the onset of the infection. Here, we report the Italian findings from the second International COVID‐19 Sleep Study survey, aiming to investigate sleep and dream alterations in participants with post‐acute symptoms, and identify the best determinants of these alterations among patients with long‐COVID. Data from 383 participants who have had COVID‐19 were collected through a web‐survey (May–November 2021). Descriptive analyses were performed to outline the sociodemographic characteristics of long‐COVID (N = 270, with at least two long‐lasting symptoms) and short‐COVID (N = 113, with none or one long‐lasting symptom) participants. They were then compared concerning sleep and dream measures. We performed multiple linear regressions considering as dependent variables sleep and dream parameters discriminating the long‐COVID group. Age, gender, work status, financial burden, COVID‐19 severity and the level of care were significantly different between long‐COVID and short‐COVID subjects. The long‐COVID group showed greater sleep alterations (sleep quality, daytime sleepiness, sleep inertia, naps, insomnia, sleep apnea, nightmares) compared with the short‐COVID group. We also found that the number of long‐COVID symptoms, psychological factors and age were the best explanatory variables of sleep and oneiric alterations. Our findings highlight that sleep alterations are part of the clinical presentation of the long‐COVID syndrome. Moreover, psychological status and the number of post‐acute symptoms should be considered as state‐like variables modulating the sleep problems in long‐COVID individuals. Finally, according to previous investigations, oneiric alterations are confirmed as a reliable mental health index. [ABSTRACT FROM AUTHOR]

Summary: Many people report suffering from post‐acute sequelae of COVID‐19 or "long‐COVID", but there are still open questions on what actually constitutes long‐COVID and how prevalent it is. The current definition of post‐acute sequelae of COVID‐19 is based on voting using the Delphi‐method by the WHO post‐COVID‐19 working group. It emphasizes long‐lasting fatigue, shortness of breath and cognitive dysfunction as the core symptoms of post‐acute sequelae of COVID‐19. In this international survey study consisting of 13,628 subjects aged 18–99 years from 16 countries of Asia, Europe, North America and South America (May–Dec 2021), we show that post‐acute sequelae of COVID‐19 symptoms were more prevalent amongst the more severe COVID‐19 cases, i.e. those requiring hospitalisation for COVID‐19. We also found that long‐lasting sleep symptoms are at the core of post‐acute sequelae of COVID‐19 and associate with the COVID‐19 severity when COVID‐19 cases are compared with COVID‐negative cases. Specifically, fatigue (61.3%), insomnia symptoms (49.6%) and excessive daytime sleepiness (35.8%) were highly prevalent amongst respondents reporting long‐lasting symptoms after hospitalisation for COVID‐19. Understanding the importance of sleep‐related symptoms in post‐acute sequelae of COVID‐19 has a clinical relevance when diagnosing and treating long‐COVID. [ABSTRACT FROM AUTHOR]

About 80% of posttraumatic stress disorder (PTSD) patients suffer from nightmares or dysphoric dreams that cause major distress and impact nighttime or daytime functioning. Lucid dreaming (LD) is a learnable and effective strategy to cope with nightmares and has positive effects on other sleep variables. In LDs, the dreamer is aware of the dreaming state and able to control the dream content. The aim of this study is to evaluate the effectiveness of lucid dreaming therapy (LDT) in patients suffering from PTSD. We suggest that learning a technique that enables the affected subjects to regulate the occurrence and content of nightmares autonomously increases the chance of coping with the complex symptoms of PTSD and can reduce suffering. Sleep quality (PSQI, Pittsburgh Sleep Quality Index), daytime sleepiness (ESS, Epworth Sleepiness Scale), quality of life (MQLI, Multicultural Quality of Life Index), psychological distress (SCL-90-R, Symptom Checklist 90-Revised), distress caused by traumatic events (IE-S, Impact of Events Scale), anxiety (SAS, Self-Rating Anxiety Scale), depression (SDS, Self-Rating Depression Scale), and nightmare severity were assessed in a self-rating questionnaire before and after the intervention. LDT had no effect on the investigated sleep variables. No correlation between reduction of nightmare severity and changes in PTSD-profile (IE-S) was found. Nevertheless, levels of anxiety and depression decreased significantly in the course of therapy. LDT could provide an alternate or complementary treatment option for nightmares in PTSD, specifically for symptoms of anxiety and depression. [ABSTRACT FROM AUTHOR]

In the current global home confinement situation due to the COVID‐19 outbreak, most individuals are exposed to an unprecedented stressful situation of unknown duration. This may not only increase daytime stress, anxiety and depression levels, but also disrupt sleep. Importantly, because of the fundamental role that sleep plays in emotion regulation, sleep disturbance can have direct consequences upon next day emotional functioning. In this paper, we summarize what is known about the stress−sleep link and confinement as well as effective insomnia treatment. We discuss those effects of the current home confinement situation that can disrupt sleep but also those that could benefit sleep quality. We suggest adaptions of cognitive behavioural therapy elements that are feasible to implement for those facing changed work schedules and requirements, those with health anxiety and those handling childcare and home‐schooling, whilst also recognizing the general limitations imposed on physical exercise and social interaction. Managing sleep problems as best as possible during home confinement can limit stress and possibly prevent disruptions of social relationships. [ABSTRACT FROM AUTHOR]

Sleep coaching by Holzinger & Klösch™ is a new, Gestalt therapy-based holistic approach to non-pharmacological treatment of non-restorative sleep. It includes psychotherapeutic aspects which enable participants to improve their sleep quality by developing their own coping strategies as a daily routine. Dream work and relaxation techniques are also part of the programme. The aim of this study was to measure the effectiveness of a two-day sleep coaching seminar on sleep quality, daytime sleepiness, and work and life quality in shift workers employed in an Austrian railway company (Österreichische Bundesbahnen, ÖBB). Thirty shift workers (28 male; mean age=24±45.90, age range 24–56 years) answered the same survey before and six months after the seminar (baseline and follow-up) containing items of the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS), their chronotype, personality factors, and burnout risk factors. The baseline findings in this group were compared with those of non-completers (who did not take the follow-up survey) (N=154) to see if the two groups differed significantly enough to create a bias among completers (who took the follow-up survey as well). Groups differed significantly in burnout levels as well as sleep duration, but not in the distribution of critical PSQI and ESS values. The two-day sleep coaching seminar resulted in a significant improvement in total PSQI score and subjective sleep quality and in a significant reduction in diurnal fatigue, sleep latency, and daytime sleepiness. Nevertheless, more research with a larger sample and a longitudinal design is needed to establish the long-term effects of sleep coaching. [ABSTRACT FROM AUTHOR]

The main goal of the present study was to explore electrophysiological differences between lucid and nonlucid dreams in REM sleep. Seven men and four women experienced in lucid dreaming underwent polysomnographic recordings in the sleep laboratory on two consecutive nights. EEG signals were subjected to spectral analysis to obtain five different frequency bands between 1 and 20 Hz. Lucidity was determined by both subjective dream reports and eye-movement signals made by the subjects in response to light stimuli indicating a REM period. The main discrimination factor between lucid and nonlucid dreaming was found in the beta-1 frequency band (13–19 Hz), which in lucid dreaming was increased in both parietal regions. The ratio of frontal to parietal beta-1 activity was 1 to 1.16 in nonlucid and 1 to 1.77 in lucid dreaming. A tendency towards the greatest increase was observed in the left parietal lobe (P3), an area of the brain considered to be related to semantic understanding and self-awareness. [ABSTRACT FROM AUTHOR]