Many individuals with long COVID report being unable to properly rest despite feeling exhausted. Sleep disorders are among the most common - yet often underestimated - symptoms. They can significantly affect daily life, influencing energy levels and concentration through to overall well-being. In this article, you will learn why long COVID may disrupt sleep and what measures can help.
What research has to say
Common sleep problems
The most common complaints include difficulty falling asleep, frequent awakenings during the night, and overall restless sleep. Studies indicate that individuals with long COVID are particularly likely to experience disrupted or non-restorative sleep.
Physiological connections
Researchers believe that multiple mechanisms may be involved, such as alterations in the autonomic nervous system function that regulate the sleep–wake cycle and chronic inflammatory activity in the body. However, the precise relationship between these factors is still not fully understood.
Evidence from studies
Researchers from the Faculty of Medicine at Vajira Hospital in Bangkok, in collaboration with the NIHR Maudsley Biomedical Research Centre in the UK, carried out a meta-analysis - a comprehensive review of multiple studies - on sleep disturbances associated with the long-term effects of SARS-CoV-2 infection. Their evaluation of 29 studies, encompassing 13,935 individuals, indicates that approximately 46% of those affected experience sleep problems (PubMed-Link).
The sleep problems experienced by people with long COVID are often similar to those seen in chronic insomnia. Affected individuals commonly have difficulty falling asleep and staying asleep, frequent night-time awakenings, and non-restorative sleep. However, it remains unclear whether these sleep disorders show the same measurable sleep patterns as classic insomnia, as scientific studies are limited. Although only a few small studies have been conducted so far, they suggest a tendency toward chronic insomnia.
Polysomnographic examinations (specialized sleep measurements) of a group of 17 patients found their sleep parameters closely resembled those of people with typical chronic insomnia, indicating that similar therapeutic approaches might be beneficial. Proven treatments for insomnia could therefore be helpful in supporting those with long COVID (PubMed-Link).
Impact on everyday life
Sleep problems linked to long COVID often affect more than just the night. Those experiencing these issues commonly report daytime exhaustion, low energy levels, reduced concentration, and decreased performance. Poor sleep can also take a toll on mental health, leading to irritability, mood swings, and greater vulnerability to stress. When combined with other long-term symptoms of the virus - such as fatigue, muscle weakness, or “brain fog” - disturbed sleep and lack of rest can greatly increase the overall burden on affected individuals. Recognizing these connections is a crucial step toward developing effective strategies to manage and alleviate symptoms.
Practical approaches and experiences of those affected
Many people with long COVID report common sleep problems, such as difficulty falling asleep or frequent night-time awakenings. So far, few studies have examined the strategies that those affected use to cope. However, well-established approaches from the field of sleep medicine, particularly those used to treat chronic insomnia, can be applied:
- Establish bedtime rituals: Engage in short relaxation exercises, reading, or breathing techniques to signal to your body that it is time to sleep.
- Keep a sleep diary: Track your sleep times, mood, and any factors that affect your ability to fall or stay asleep.
- Practice relaxation before bed: Techniques such as deep breathing or progressive muscle relaxation can help calm the mind.
- Exercise and daylight: Light physical activity during the day and adequate exposure to natural light can help regulate the sleep–wake cycle.
- Seek professional help if needed: If sleep problems persist, consider behavioral therapy, sleep studies, or medical supervision.
These measures can help improve sleep quality over time. Their effectiveness may vary from person to person, and they are not a substitute for medical or therapeutic support. Further information and useful tips are available on the CSS website.
Show
