Association of Sleep Quality With Fatigue in Post-COVID-19 Patients in an Indian Population

<bold>Objective: </bold>The aims of the study are to assess the quality of sleep in recently recovered COVID-19 and long-COVID cases and to determine its associations with fatigue and pain. <bold>Methods: </bold>Post-COVID-19 cases ( n = 201) and controls ( n = 206) were assessed using the Pittsburgh Sleep Quality Index questionnaire for sleep quality, Fatigue Severity Scale for fatigue, and Numeric Pain Rating Scale for pain in this observational study. <bold>Results: </bold>Global Pittsburgh Sleep Quality Index score was higher ( P <= 0.001) among cases (5.7 +/- 5.1; 95% confidence interval, 5.0-6.4) than controls (2.1 +/- 2.0; 95% confidence interval, 1.8-2.4). Normal sleep latency was observed in 56 (27.9%) patients and 164 (79.6%) controls ( P < 0.001). Fatigue Severity Scale score was higher ( P <= 0.001) among cases (16.8 +/- 10.2; 95% confidence interval, 15.4, 18.2) against controls (10.9 +/- 4.1; 95% confidence interval, 10.3-11.4). The Fatigue Severity Scale scores in mild, moderate, and severe COVID-19 were 14.3 +/- 8.1, 22.1 +/- 10.8, and 22.8 +/- 13, respectively ( P < 0.001) and higher in the older (20.7 +/- 12.1) and middle-aged (19.6 +/- 10.3) than in younger (13.9 +/- 8.3) ( P <= 0.001) cases. The global Pittsburgh Sleep Quality Index score was positively correlated with the Fatigue Severity Scale ( r = 0.755, P < 0.001) and Numeric Pain Rating Scale scores ( r = 0.657, P < 0.001). Numeric Pain Rating Scale score correlated with Fatigue Severity Scale score ( r = 0.710, P < 0.001). Fatigue Severity Scale and global Pittsburgh Sleep Quality Index scores were higher in the long-COVID group ( P < 0.001). <bold>Conclusions: </bold>Significantly poor sleep quality was observed in post-COVID-19 individuals including long COVID being positively associated with fatigue and pain.