Relaxed social and work restrictions caused by pandemic lockdown benefited the sleep schedules of patients with central hypersomnias.
A survey measuring the effects of COVID-19-related lockdowns and similar restrictions on patients with narcolepsy type 1 (NT1), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH) found that relaxed social and occupational restrictions to reduce the symptoms of each condition.
The research was published in the Journal of Clinical Sleep Medicine.
Patients with NT1, NT2, and IH have different sleep needs, including frequent naps or longer total sleep time, which often conflict with typical daytime responsibilities such as work or school. Conflict can lead to negative effects if the need for sleep is not met, such as excessive daytime sleepiness or a deterioration in the quality of life. As COVID-19’s lockdown measures eased the daily restrictions that normally impacted sleep needs, investigators questioned what impact this would have on the sleep-wake habits of patients with central hypersomnia.
Participants with either NT1, NT2 or IH observed at a university hospital in France completed an online survey with 78 questions on demographic, clinical and occupational characteristics, and responses from 291 patients were used in the final analysis. The survey focused on changes to the features that occurred during the initial COVID-related lockdown.
The results showed:
- Of 851 respondents, 219 (25.7%) gave a mean (SD) increase of 1.2. on (1.9) hours (P <0.001) in night sleep and a mean decrease of 1.0 (3.4) points (P <0.001) on the Epworth Sleepiness Scale.
- Bedtime and wake up time were delayed by 46.1% and 59.6% of the participants, respectively, and driven by participants with IH.
- Teleworkers reported an average increase in night sleep of 0.9 (1.2) hours (P <0.001) and a mean decrease in sleepiness score of 1.6 (3.1) (P <0.001).
- An improvement in cataplexy was reported in 54.1% of participants with NT1.
- Drowsiness correlated with mental well-being (R = 0.3; P <0.001).
- While 42.5% of participants said they enjoyed lockdown due to factors such as increased sleep time, longer time to spend with hobbies and family, and a freer nap schedule, 13.2% said they disliked lockdown due to isolation and psychological distress.
- About a third of the participants reported decreased fatigue and improved concentration.
- Sleep-related hallucinations decreased in 35.0% of the participants with NT1.
The results of the survey suggest that patients with N1, N2, and IH were more easily able to accommodate their sleep schedule according to the specific needs of their central hypersomnias during lockdown.
Factors such as increased sleep time enabled by COVID-19-related lockouts, circadian delay in patients with IH, and teleworking instead of personal work contributed to reductions in symptoms in patients with N1, N2, and IH, the authors wrote. Although patients were prone to sleep-related factors related to the pandemic, such as stress, anxiety, and extended screen time, for many participants the benefits of a relaxed schedule outweighed the disadvantages.
Patients’ sleep-wake habits could benefit from a sustained decrease in work and social pressures, such as those observed during lockdown, as well as job plans for the affected population, the authors concluded.
Nigam, M., Hippolyte, A., Dodet, P., et al. Sleeping Through a Pandemic: Effects of COVID-19 Restrictions on Narcolepsy and Idiopathic Hypersomnia. J. Clin. Sleep Med. Published online July 27, 2021. doi: 10.5664 / jcsm.9556