Sleep Disorders in Post-COVID Syndrome: A Psychiatric or Neurological Problem?

The coronavirus pandemic that began in 2019 continues. COVID-19 adversely affects human health not only in the acute, but also in the long-term period of the disease: in a large percentage of cases, health is not fully restored after long periods, requires medical intervention, and is often difficult to correct. Researchers noted during the first wave of the pandemic in 2020 that about 10-20% of patients did not fully recover by three weeks from disease onset and the possible duration of the recovery period remains insufficiently clear, as do the reasons for differences in course during this period. Prolonged recovery after viral infection is not a feature exclusive to COVID-19, which does not facilitate the management of patients with post-COVID syndrome (PCS). The mental health impact of COVID-19 is significant, with at least 30% of recovered patients likely to have symptoms of anxiety and/or depression after the acute phase has passed. Since the onset of COVID-19, there has been an increase in sleep disorders by 42%, with every third COVID-19 survivor reporting sleep complaints. In PCS, this condition is referred to as coronasomnia. The success of therapy for this condition depends on identifying and correcting patients' mental disorders, as anxiety and depression are often accompanied by sleep disorders this results in a bidirectional interaction between mental disorders and sleep quality. This article presents data on the anti-anxiety drugs Noofen and Adaptol, which help to correct the manifestations of PCS with sleep disorders.

[Clinical aspects of the use of imidazopyridine derivatives in the treatment of sleep disorders associated with post-COVID syndrome]. / Klinicheskie aspekty primeneniya preparatov gruppy imidazopiridinov v terapii narushenii sna, assotsiirovannykh s postkovidnym sindromom.

In 2019, a pandemic caused by the SARS-CoV-2 virus began. The fight against COVID-19 required the introduction of a number of restrictive measures, in particular the introduction of quarantine for the population and isolation of the sick, which, along with the direct effect of the virus on the nervous system, led to a significant spread of sleep disorders. In this regard, questions have become relevant about the choice of drugs for the correction of sleep disorders, about which sleeping pills will be safe in conditions of acute illness and during the recovery period after COVID-19. The article discusses the prevalence and therapy of insomnia in patients with acute COVID-19 and in patients with postcovid syndrome. The pharmacological effects and safety of zolpidem, a non-benzodiazepine short-acting hypnotic drug belonging to the class of imidazopyridines, which is used in short courses for both acute and transient insomnia and chronic insomnia, are described. The data on the ability of zolpidem to improve memory after a night's sleep are given. The possibility of its use in acute COVID-19 and postcovid syndrome is being evaluated.

[Sleep disorders in post-COVID syndrome - a problem of psychiatry or neurology?] / Rasstroistva sna pri postkovidnom sindrome ­ problema psikhiatrii ili nevrologii?

The pandemic of coronavirus infection, which has begun in 2019, has not ended to this day. COVID-19 adversely affects human health not only in the acute period of the disease, but also in the long-run: in a large percentage of cases, recovery takes very long, patients require and often have problems returning to their baseline. During the first wave of the pandemic in 2020, researchers noted that about 10-20% of patients didn't fully recover three weeks after the onset of the disease. It is still not clear how long the recovery period can last, and what are the reasons of different time course of the recovery. Long-term recovery after a viral infection is a non-unique feature of COVID-19, which does not facilitate the management of patients with post-COVID syndrome. The impact on mental health after COVID-19 is significant, and at least 30% of those, who have been ill, may have symptoms of anxiety and/or depression after the acute phase of the disease. Since the emergence of the SARS-CoV-2 virus, there has been an increase in somnological disorders by 42%, while every third COVID-19 patient reports altered sleep patterns. In post-COVID-19 syndrome, this condition is referred to as Coronasomnia (COVID-somnia). The success of therapy of this condition depends on reporting and treating mental disorders in patients, as anxiety and depression are often accompanied by sleep disorders, that is, there is a bidirectional influence of mental disorders on the quality of sleep. The article provides data on two anti-anxiety drugs (noofen and adaptol) that help to treat the manifestations of post-COVID syndrome accompanied by sleep disorders.

[COVID-19 and stress-related disorders]. / Kovid-19 i stress-svyazannye rasstroistva.

Since the WHO declared the COVID-19 outbreak a pandemic, the most actual problem has been a change in the lifestyle of the population of Russia and the rest of the world. Fear of illness, self-isolation/quarantine, and decreased quality of life have dramatically increased the level of stress-related disorders in the population. The main mental disorders arising from stress refer to anxiety disorders (post-traumatic stress disorder (PTSD), panic disorder, agoraphobia, social phobia, generalized anxiety disorder), obsessive-compulsive disorder, depressions of varying severity and conversion reactions. The symptoms and early warning signs of stress-related disorders may be chronic or episodic. Stress-related disorders are corrected with psychotropic therapy, which aims to restore the balance of neurotransmitters. Current first choice agents for the treatment of both pathological anxiety and depression are selective serotonin reuptake inhibitors (SSRIs). During the pandemic, the SSRI fluvoxamine is of special interest. Its mechanisms of action are recognized as potentially useful for treating COVID-19 infection. Two studies confirming the efficacy and safety of fluvoxamine in the treatment of coronavirus infection are described.

[Astenic disorders within the framework of post-covid syndrome]. / Astenicheskie rasstroistva v ramkakh postkovidnogo sindroma.

The direct neurotropic and neurotoxic effect of the SARS-CoV-2 virus on the central nervous system, as well as the stressful effect of various factors of the COVID-19 pandemic, contribute to the development of the so-called post-COVID syndrome. The clinical picture of the syndrome includes asthenic, anxiety-asthenic, and depressive manifestations. When prescribing psychopharmacotherapy to patients who have undergone COVID-19, it is recommended to assess the potential benefits and risks in the aspect of using drugs not only with therapeutic antiasthenic and anxiolytic properties, but with minimally expressed undesirable effects and adverse drug interactions.