Pre-hospital, in-hospital and post-hospital factors associated with sleep quality among COVID-19 survivors 6 months after hospital discharge: Cross-sectional survey in five cities in China

Background Understanding factors associated with post-discharge sleep quality among COVID-19 survivors is important for intervention development. 

Aims This study investigated sleep quality and its correlates among COVID-19 patients 6 months after their most recent hospital discharge. 

Method Healthcare providers at hospitals located in five different Chinese cities contacted adult COVID-19 patients discharged between 1 February and 30 March 2020. A total of 199 eligible patients provided verbal informed consent and completed the interview. Using score on the single-item Sleep Quality Scale as the dependent variable, multiple linear regression models were fitted. 

Results Among all participants, 10.1% reported terrible or poor sleep quality, and 26.6% reported fair sleep quality, 26.1% reported worse sleep quality when comparing their current status with the time before COVID-19, and 33.7% were bothered by a sleeping disorder in the past 2 weeks. After adjusting for significant background characteristics, factors associated with sleep quality included witnessing the suffering (adjusted B =-1.15, 95% CI =-1.70,-0.33) or death (adjusted B =-1.55, 95% CI =-2.62,-0.49) of other COVID-19 patients during hospital stay, depressive symptoms (adjusted B =-0.26, 95% CI =-0.31,-0.20), anxiety symptoms (adjusted B =-0.25, 95% CI =-0.33,-0.17), post-traumatic stress disorders (adjusted B =-0.16, 95% CI =-0.22,-0.10) and social support (adjusted B = 0.07, 95% CI = 0.04, 0.10). 

Conclusions COVID-19 survivors reported poor sleep quality. Interventions and support services to improve sleep quality should be provided to COVID-19 survivors during their hospital stay and after hospital discharge. Copyright © 2021 The Author(s).