SARS-CoV-2 infection is associated with increased odds of insomnia, RLS and dream enactment behavior

• Published in: Indian journal of psychiatry Vol. 64; no. 4; pp. 354 - 363
• Main Authors: Kumar, Niraj, Goyal, Abhishek, Hussain, Arshad, Saini, Lokesh, Chawla, Omna, Arora, Pankaj, Daga, Ritu, Tikka, Sai, Goyal, Sandeep, Kanchan, Shweta, Desai, Soaham, Ahmed, Sohaib, Das, Sourav, Dubey, Vaibhav, Gupta, Ravi
• Format: Journal Article
• Language: English
• Published: Mysore Wolters Kluwer India Pvt. Ltd 01.07.2022; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow
• Subjects: Anxiety; Coronaviruses; COVID-19; Environmental factors; Epidemics; Hypoxia; Infection; Infections; Insomnia; Mental depression; Olfaction; Original; Pandemics; Questionnaires; Restless legs syndrome; Severe acute respiratory syndrome coronavirus 2; Sleep; Sleep disorders; COVID-19; neurotropism; sleep-disorders
• ISSN: 0019-5545; 1998-3794
• DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_586_21

Background: Literature suggests that the COVID-19 pandemic has resulted in poor sleep quality, especially among the infected population. However, literature regarding the effect of COVID-19 pandemic and SARS-CoV-2 infection on occurrence of insomnia, restless legs syndrome and dream enactment behavior is either scarce or unavailable. Methods: This study was planned to assess the effect of SARS-CoV-2 infection on the occurrence of insomnia, restless legs syndrome (RLS) and dream enactment behavior (DEB). For this cross-sectional study, a questionnaire comprising of items related to demographic details, past medical history, and information related to SARS-CoV-2 infection was distributed through social media. Insomnia was diagnosed using clinical criteria. RLS, DEB, sleep quality, depression and anxiety were assessed using a validated questionnaire. Information regarding the use of hypnotic medications was also gathered. Results: Of the 1596 respondents, 37.2% reported disturbed sleep while insomnia was reported by 22.6% respondents. 27.3% of respondents reported RLS and 17.4% suffered DEB. The odds of insomnia were greater among males (OR = 1.27; 95% CI: 1.03-1.58; P < 0.02) and among those who had SARS-CoV-2 infection (OR = 1.76; 95% CI = 1.42-2.19; P < 0.001). Similarly, SARS-CoV-2 infection was also associated with increased odds of RLS (OR = 2.48; 95% CI = 1.98-3.11; P < 0.001) and DEB (OR = 1.58; 95%CI = 1.21-2.06; P < 0.001). Insomnia, RLS and DEB were more frequent among respondents who required oxygen therapy, those who experienced loss of taste and/or smell, depression and anxiety. Prevalence of insomnia, DEB and RLS was higher than said prevalence among respondents with no history of SARS-CoV-2 infection, but lower than that of those with positive history of SARS-CoV-2 infection. 5.3% of respondents reported taking hypnotic medications before infection, 7% during infection and 5.3% after infection. Conclusion: SARS-CoV-2-infection-related factors in association with environmental factors have increased the prevalence of insomnia, DEB and RLS among subjects having infection. SARS-CoV-2-associated immunological changes, hypoxia and neurotropism may play a role in occurrence of insomnia, DEB and RLS.