Long COVID & Sleep Addressing Persistent Fatigue, Insomnia, and Breathing Disruptions

Introduction

While most people recover from COVID-19 within weeks, many continue to experience symptoms months later—a condition known as Long COVID or Post-Acute Sequelae of SARS-CoV-2 infection (PASC). Among the most common and frustrating lingering effects are sleep disturbances and respiratory issues.

Common Post-COVID Sleep Issues

  • Insomnia and fragmented sleep
  • Restless legs or new onset of periodic limb movement disorder
  • Nightmares and vivid dreams related to nervous system changes
  • Daytime hypersomnia (excessive sleepiness) despite adequate hours in bed

Respiratory After-Effects

  • Persistent cough or shortness of breath
  • Lung inflammation or scarring (post-viral fibrosis)
  • Decreased exercise tolerance

Possible Mechanisms

  • Chronic low-grade inflammation
  • Dysautonomia (imbalances in the autonomic nervous system)
  • Direct effects on the brain regions controlling sleep
  • Hormonal disruption of the hypothalamic–pituitary–adrenal axis

Evaluation at Lung & Sleep Specialists

  • Pulmonary function testing and imaging (CT, X-ray)
  • Overnight polysomnography or home sleep testing
  • Oxygen saturation and CO₂ monitoring
  • Full review of prior COVID illness, vaccines, and current medications

Treatment Pathways

  1. Sleep Hygiene & Circadian Support: Regular bedtime, limited blue light, melatonin if indicated.
  2. Pulmonary Rehabilitation: Breathing exercises, graded activity, and oxygen therapy if needed.
  3. Medication Management: Address inflammation, treat new or worsened sleep apnea, optimize existing medications.
  4. Integrative Support: Anti-inflammatory diet, gentle exercise like yoga or tai chi, stress-reduction practices.

Self-Care Tips

  • Pace physical activity (“energy budgeting”) to avoid crashes.
  • Maintain a Mediterranean-style diet rich in antioxidants.
  • Use relaxation techniques such as diaphragmatic breathing or mindfulness.

If lingering fatigue, cough, or insomnia continue more than 8–12 weeks after COVID, schedule a comprehensive evaluation with Lung & Sleep Specialists to design a personalized recovery plan.

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