Management of long-COVID-19 patients with sleep disorders: practical advice to general practitioners

Figures & data

Figure 1. Behavioral recommendations to improve sleep of patients with long-Coronavirus disease 2019.

Box 1. Hypnotics recommended for the treatment of chronic insomnia in adults×.

Hypnotic	Family	Dose (mg)	Indication	Side effects
Benzodiazepines	.Triazolam	.0.25	.Sleep onset insomnia	.Speech disorder
	.Temazepam	.15Ψ	.Sleep onset insomnia .Sleep maintenance insomnia	.Headache .Blurred vision .Depression .Confusion
Benzodiazepine receptor agonists	.Eszopiclone	.2–3#	.Sleep onset insomnia .Sleep maintenance insomnia	.Dizziness .Dry mouth .Headache .Somnolence .Unpleasant taste
	.Zaleplon	.10#	.Sleep onset insomnia	.Headache .Asthenia .Neurasthenia .Pain .Fatigue .Somnolence
	.Zolpidem	10#	.Sleep onset insomnia .Sleep maintenance insomnia	.Amnesia .Dizziness .Daytime somnolence
Orexin receptor antagonist	.Suvorexant	10–20	.Sleep maintenance insomnia	.Daytime somnolence
Heterocyclics	.Doxepin	3–6	.Sleep maintenance insomnia	.Daytime somnolence .Dizziness .Dry mouth .Constipation
Melatonin agonists	.Ramelteon	8	.Sleep onset insomnia	.Daytime somnolence .Dizziness .Fatigue .Nausea

*Box 1 is inspired from the American academy of sleep medicine clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults [15].

ΨWith the dose of 30 mg: daytime impairment, drowsiness, lethargy and vertigo.

#Reduce to half in the elderly.

Note: duration of treatment as brief as possible (<4 weeks).