Sleep disturbances following recovery from COVID-19: a comparative cross-sectional study in Egypt

Background: Sequelae from COVID-19 are increasingly being reported, but sleep disturbances after recovery from the disease have had little attention. Aims: This study aimed to identify and compare sleep disturbances and associated correlates among adults who have recovered from COVID-19 with those who have never been infected with the disease. Methods: The sample included 85 adults who have recovered from COVID-19 and 85 adults who have never been infected (matched on age, sex, education and socioeconomic level). Individuals were recruited from Zagazig University Hospitals, Egypt from 1 September to 29 November 2020. Participants were interviewed using a sociodemographic and clinical checklist, the Pittsburgh Sleep Quality Index and the Hospital Anxiety Depression Scale. Results: Most (77%) of the recovered cases had experienced sleep disturbances, compared with 46% of controls. Individuals who had recovered from COVID-19 were more likely to have poor subjective sleep quality (odds ratio (OR) 1.5, 95% confidence interval (CI): 1.1–2.1), prolonged sleep latency (OR 1.8, 95% CI: 1.3–2.6), shorter sleep duration (OR 1.6, 95% CI: 1.1–2.2), reduced sleep efficiency (OR 3.8, 95% CI: 2.0–7.1), frequent daytime dysfunction (OR 1.9, 95% CI: 1.2–3.1) and poor global Pittsburgh Sleep Quality Index score (OR 3.0, 95% CI: 1.5–6.0). Depressive (P = 0.002) and anxiety (P = 0.003) symptoms were associated with a poor global Pittsburgh Sleep Quality Index score among recovered female participants (P = 0,034) who had low-to-medium education level (P = 0.004). Conclusions: Further studies (e.g. population-based longitudinal studies) are needed on sleep disturbances as a potential sequelae of COVID-19, because it can impair mental and physical well-being.

Night noise guidelines for Europe

The WHO Regional Office for Europe set up a working group of experts to provide scientific advice to the Member States for the development of future legislation and policy action in the area of assessment and control of night noise exposure. The working group reviewed available scientific evidence on the health effects of night noise, and derived health-based guideline values. In December 2006, the working group and stakeholders from industry, government and nongovernmental organizations reviewed and reached general agreement on the guideline values and key texts for the final document of the Night noise guidelines for Europe. Considering the scientific evidence on the thresholds of night noise exposure indicated by Lnight,outside as defined in the Environmental Noise Directive (2002/49/EC), an Lnight, outside of40 dB should be the target of the night noise guideline (NNG) to protect the public, including the most vulnerable groups such as children, the chronically ill and the elderly. Lnight,outside value of55 dB is recommended as an interim target for the countries where the NNG cannot be achieved in the short term for various reasons, and where policy-makers choose to adopt a stepwise approach. These guidelines are applicable to the Member States of the European Region, and may be considered as an extension to, as well as an update of, the previous WHO Guidelines for community noise (1999).