Post-COVID-19 syndrome with nursing rehabilitation care positions: sleep disorder

Authors:

Bakhtina Irina Sergeevna, PhD in Medical sciences, Director of the Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the Federal Medical and Biological Agency of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +79219074717; e-mail: ibakhtina@yandex.ru; https://orcid.org/0000-0002-4046-0605.

Kalinina Svetlana Alekseevna, PhD in Medical sciences, lecturer, Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the Federal Medical and Biological Agency of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +79668597425; e-mail: kalinina@spbcpo.ru; https://orcid.org/0000-0003-1033-5210.

Garderobova Larisa Vladimirovna, PhD in Medical sciences, Deputy director for scientific and methodological work of the Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the Federal Medical and Biological Agency of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +7911821857; e-mail: lvg@spbcpo.ru; https://orcid.org/0000-0001-5191-8741.

Smirnova Svetlana Sergeevna, lecturer, Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the Federal Medical and Biological Agency of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +7 (905) 266-15-47; e-mail: svet.smirnova.s@mail.ru.

Kolobanova Natalia Gennadievna, lecturer, Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the Federal Medical and Biological Agency of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +7 (921) 398-33-23; e-mail: kolobanova79@gmail.com.

Balandina Irina Nikolaevna, head of practical training, lecturer, Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the Federal Medical and Biological Agency of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +7 (921) 313-45-04; e-mail: irinabalandi@yandex.ru; https://orcid.org/0000-0002-9654-6387.

Gainutdinova Olga Valerievna, head of the Department of the organization of the educational process, Federal State-Financed Educational Institution of Continuing Professional Education “The Saint-Petersburg Center of Postgraduate Medical Education under the Federal Medical and Biological Agency of Russia”, 41 Lunacharskogo Ave., 194291 St. Petersburg, Russian Federation; tel.: +7-911-923-20-04; e-mail: gainutdinova@spbcpo.ru.

Annotation:

Introduction. The urgency of the present study is determined by high prevalence and social significance of mental and somatic consequences of COVID-19. One of the most painful manifestations are sleep disorders.

Aim. To analyze the prevalence of sleep disturbances in survivors of the new coronavirus infection COVID-19 and to define the targets of nursing rehabilitation care according to the domains of the International Classification of Functioning, Disability, and Health (ICF).

Materials and methods. A special questionnaire based on ICF nursing domains was developed for the study; a sociological study was carried out in the period June-September 2022, and questionnaires from 496 respondents who had undergone COVID-19 during the year were administered to the patients; statistical analysis was carried out to evaluate sleep disturbances. The sample of respondents was as follows: women — 83.9 %, men — 16.1 %. 16.3 % of the respondents had no manifestations of post-COVID-19 syndrome; in 37 % of cases the symptoms appeared during the acute illness, in 14 % of cases less than a month later, in 11.8 % of cases within the first three months, in 8 % of cases within 3-6 months, and in 12.9 % of cases within half a year after the illness. The complaints of nervous system disorders were presented by 87.2 %; mental and behavioral disorders — by 85.6 % of respondents.

Results. The most important marker of mental and behavioral disorders were disorders of circadian rhythms of sleep and wakefulness (insomnia and dissomnia). These complaints were made by 66 % of respondents, who noted: insomnia, nightmares, and pathologically vivid dreams. The problem occurred more frequently in respondents aged 19 to 30 years and 50 to 59 years, in men, and who had suffered a severe form of COVID-19 with a stay in the intensive care unit. Sleep was moderately (average 1.8 points) impaired in 65.1 % of respondents, with a higher prevalence (74.1 % vs. 63.5 % for women) and severity (1.9 points vs. 1.7 points for women) among men. Sleep onset was moderately impaired in 56.4 % of respondents (an average of 1.9 points), and sleep maintenance in 64.3 % (an average — 1.7 points). Sleep quality was affected in 66.4 % of women and 70.4 % of men, moderately on average in women (1.8 points) and more than moderately in men (2.1 points).

Discussion. Women with post-COVID-19 syndrome manifestations generally sleep little, fall asleep poorly and wake frequently, and their dreams are of lower quality, that is, with nightmares and no sense of rest after sleep. The average severity of each problem was 1.7 points (closer to moderate), slightly higher on the sleep quality domain. Men sleep less than women, fall asleep more heavily, but wake up less frequently. Sleep quality was also low, but the problem was pronounced moderately, easier to maintain sleep, harder to fall asleep.

Conclusion. Asthenization, chronic pain syndrome, and consequences of hypoxia in patients undergoing COVID-19 contribute to the development of non-psychotic mental disorders, one manifestation of which is disruption of circadian rhythms of sleep and wakefulness. Nurses perform primary monitoring of this function, and they also form the therapeutic environment of the patient during the rehabilitation stages. The professional competencies of nurses as part of a multidisciplinary rehabilitation team must be utilized and focused on patient adaptation and restoration of sleep function. It is necessary to include the theme “Insomnia: prevention and treatment” in additional professional education programs for nursing staff in the specialities “Nursing” and “Rehabilitation Nursing”.

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