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. 2022 Sep 19;9(9):1419.
doi: 10.3390/children9091419.

The CSHQ-DE Questionnaire Uncovers Relevant Sleep Disorders in Children and Adolescents with Long COVID

Sarah Werner  1 , Claus Doerfel  1 , Richard Biedermann  1 , Michael Lorenz  2 , Marius Rasche  2 , Hans Proquitté  1 , Lars Newman  3 , Daniel Vilser  3
Affiliations

The CSHQ-DE Questionnaire Uncovers Relevant Sleep Disorders in Children and Adolescents with Long COVID

Sarah Werner et al. Children (Basel). .

Abstract

Acute SARS-CoV-2 infections in children and adolescents are usually mild. However, they can suffer from ongoing symptoms, generally referred to as long COVID. Sleep disorders are one of the most frequent complaints in long COVID although precise data are missing. We assessed the sleep behavior of children and adolescents who presented at our outpatient clinic between January 2021 and May 2022 with the Children's Sleep Habits Questionnaire (CSHQ-DE). We compared the sleep behavior at three different time points: pre-COVID-19; post-COVID-19 at the initial presentation; and post-COVID-19 at re-presentation. Data from 45 patients were analyzed. Of those, 64% were female and the median age was 10 years (range: 0-18 years). Asymptomatic or mild COVID-19 disease was experienced in 89% of patients; 11% experienced moderate disease. The initial presentation occurred at a median of 20.4 weeks (6 weeks-14 months) after the infection. The CSHQ-DE score increased significantly from pre-COVID-19 (45.82 ± 8.7 points) to post-COVID-19 (49.40 ± 8.3 points; p ≤ 0.01). The score then normalized at re-presentation (46.98 ± 7.8; p = 0.1). The greatest changes were seen in the CSHQ-DE subscale score "daytime sleepiness". Our data showed that children and adolescents with long COVID often suffer from sleep disturbances. For most children and adolescents, these sleep disorders decreased over time without any further medical intervention aside from a basic sleep consultation.

Keywords: SARS-CoV-2; children; coronavirus; long COVID; post-COVID-19 condition; sleep disorders.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Total CSHQ-DE score pre-COVID-19 vs. post-COVID-19 initial and re-presentation. The sleep disturbance score significantly increased between pre-COVID-19 and 1st assessment (45.82 ± 8.7 to 49.40 ± 8.3, respectively), then decreased (46.98 ± 7.8). Univariate ANOVA with multiple measurements, post hoc Bonferroni (** p ≤ 0.01).
Figure 2
Figure 2
Subscale score “Daytime Sleepiness” pre-COVID-19 vs. post-COVID-19 initial and re-presentation: Significant increase from pre- to post-COVID-19 (13 ± 3.0 vs. 14 ± 3.2, respectively) and significant decrease at re-presentation (13 ± 3.2). Univariate ANOVA with multiple measurements and post hoc Bonferroni (*** p ≤ 0.001 and * p = 0.029, respectively).
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