Sleep disorders after COVID-19 in patients with primary headaches

Objective. To analyze the incidence of new-onset sleep disorders after novel coronavirus infection (COVID-19) in patients with primary headaches. Material and methods. A prospective case-control study was conducted from May 2022 to July 2024 using a semi-structured interview with 212 patients with primary headaches and complaints of sleep problems with a history of COVID-19 (main group, n=135 patients, 98% women, mean age 46.3 years) and without COVID-19 (control group, n=77, 54% women, mean age 45.7 years). COVID-19 was confirmed by a PCR test. Patients of both groups were included in the study in parallel according to the inclusion and exclusion criteria. The period from the onset of COVID-19 to the interview was ≥12 months in 57.7% of the patients, from 6 to 12 months in 20.1% of the patients, and up to 6 months in 22.2% of the patients. Most patients (87%) had mild symptoms of COVID-19. Results. Pre-existing sleep disorders (before the COVID-19 pandemic, before 2020) in patients with primary headaches were found in 56.3% of patients with a history of COVID-19 and 59.7% of patients without COVID-19. In 39 (28.8%) patients out of 135 patients with COVID-19, sleep disorders debuted for the first time at the onset of COVID-19 and persisted at the time of the interview (not less than 6 months): 25 patients (18.5%) had chronic insomnia, 5 patients (3.7%) restless legs syndrome, 7 people (5.2%) hypersomnia, 2 (1.5%) obstructive sleep apnea syndrome. In all these patients, sleep disturbances were not associated with anxiety, depression, other diseases, or medications, but were associated in close temporal relationship with COVID-19. Conclusion. Our study showed that a third of patients with primary headache disorders have new-onset sleep disorders associated with COVID-19 which persisted for a long time after recovery.