Objective Sleep–Wake Findings in Patients with Post-COVID-19 Syndrome, Fatigue and Excessive Daytime Sleepiness

Sleep–wake disturbances are common in post-COVID-19 syndrome but lack extensive objective characterization. This study evaluated sleep–wake patterns in 31 patients with post-COVID-19 syndrome referred for fatigue and excessive daytime sleepiness (EDS). Assessments included questionnaires (the fatigue severity scale, the Epworth sleepiness scale, and the Beck Depression Index-II), video polysomnography (V-PSG), the multiple sleep latency test (MSLT, n = 15), and actigraphy (n = 29). Patients (70% female, mean age 45 years) had mostly mild acute SARS-CoV-2 infections and were assessed a median of 31 weeks post-infection. Fatigue (fatigue severity scale, median 6.33), sleepiness (the Epworth sleepiness scale, median 15), and depression (Beck depression inventory-II, median 20) scores were elevated. V-PSG showed moderate sleep apnea in 35.5%, increased arousal index in 77.4%, and median sleep stage percentages of NREM1 (12%), NREM2 (37%), NREM3 (19%), and REM (15.8%). MSLT revealed only 13.3% with sleep latencies under 8 min and no sleep-onset REM periods. Actigraphy indicated increased inactivity index in 96.6%, with high variability in time in bed. These findings highlight a polysomnographic and actigraphic profile of increased arousal and clinophilia, alongside moderate sleep apnea and limited objective sleepiness on MSLT. Addressing these multifactorial sleep disturbances is crucial in managing post-COVID-19 syndrome.