ABSTRACT
Introduction: The COVID-19 pandemic has rocked our society to its core. Insomnia is the most common sleep disorder in later life and impacts approximately 20%-50% of older adults >65 years, therefore, especially vulnerable to mental health problems, including fear, anxiety and depression. Objective(s): To analyse the changes in older patients with chronic insomnia produced by the covid-19 pandemic. Method(s): Consecutives individuals aged >=65 years of the sleep unit were included, 50 patients before a COVID-19 pandemic (BeCOVID) and 50 patients posterior a COVID-19 pandemic (POSTCOVID). Clinical history specific for sleep disorders;scores on sleep-questionnaires: Epworth Sleepiness Scale (ESS) >=8 sleepiness mild, moderate or severe;Insomnia Severity Index (ISI)>=15 clinical insomnia moderate or severe;psychological tests Beck depression inventory (BDI-II), no-mild <=19, moderate-severe (20-63);the state-trait anxiety inventory (STAI) considered positive above 50th percentile. Result(s): A total of 8 patients BeCOVID and 25 POSTCOVID with chronic insomnia, the most prevalent sleep disorders in older adults produced by COVID-19 (p = < 0,001), age (72.5 +/- 0.8 and 71 +/- 0.9) years old. Intake of benzodiazepine hypnotic drugs in (63/40%), nonbenzodiazepine hypnotic drugs (13/12%) and antidepressants (25/32%) of the patients. Chronic diseases (hypertension 75/76%;mellitus diabetes 38/18%, dyslipidaemia 56/25%;glaucoma 38/8%), psychiatric disease previous 0/8%. Other sleep disorders, obstructive sleep apnoea 63/72%, rest leg syndrome 32/25%, periodic leg movement (PLM) disorders 63/16%, REM sleep behaviours disorders 0/4% and circadian rhythms disorders 2/2%. When comparing polysomnography no significant difference were observed in sleep architecture parameters such as sleep latency, REM sleep latency, efficiency, total sleep time, proportion of sleep stages (N1, N2, N3 y REM), wake after sleep onset, arousals index, PLM index or apnoea-hypopnea index (AHI) or changes of phases number were observed. Sleeps questionnaires show moderate or severe clinical insomnia in 50/76%, depression mild 20/32%, moderate 20/16% severe 0/8%, anxiety state 60/40% and trait 60/64%. Conclusion(s): Immediate interventions are essential in order to enhance psychological resilience.COVID-19 pandemic was associated an increase of chronic insomnia and generalized anxiety disorder in older patients.