Sleep and COVID-19: considerations about immunity, pathophysiology, and treatment.
Sleep and COVID-19: considerations about immunity, pathophysiology, and treatment.
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DOI：
10.5935/1984-0063.20200062
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发表时间：
2020-07
期刊：
影响因子：
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通讯作者：
Tufik S
中科院分区：
文献类型：
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作者：
Mello MT;Silva A;Guerreiro RC;da-Silva FR;Esteves AM;Poyares D;Piovezan R;Treptow E;Starling M;Rosa DS;Pires GN;Andersen ML;Tufik S
2019冠状病毒病（COVID-19）大流行引起的恐惧和不确定性，对生存的威胁是日常生活的主要问题之一;然而，精神卫生保健也必须被视为优先事项。在社会隔离期间，也称为自我隔离，限制流动性和社会接触，关注财务资源和供应品的可用性，害怕感染，对自我隔离的持续时间提出疑问，导致焦虑，抑郁，压力，失眠和睡眠质量和数量减少，这可能对一般人群的健康构成更大的风险。睡眠障碍正日益成为现代社会的主要健康问题，并且受到电子设备的视网膜刺激以及延长和/或夜班工作的影响，这可能会加剧病毒感染期间的全身和肺部炎症。睡眠障碍可诱发促炎状态，在COVID-19大流行期间有害。许多用于治疗COVID-19的药物与用于治疗睡眠障碍的药物之间可能存在的相互作用尚不清楚，主要是由于缺乏治疗这些患者的标准方案。睡眠不足或不规则的睡眠-觉醒周期可能损害健康、免疫系统，诱导促炎症状态，并可能导致对病毒感染的易感性增加，涉及炎症和氧化/抗氧化失衡。从这个意义上说，阻塞性睡眠呼吸暂停与公认的COVID-19风险合并症有关，并被认为是COVID-19的风险因素。在COVID-19大流行期间，医疗保健不能停止，远程医疗已成为提供服务的替代方法。当面对面的访问是强制性的，或在睡眠中心恢复活动的社区传播最小的地方，睡眠中心设施必须做好在COVID-19大流行期间接收患者的适当准备，并遵守所有相关的安全规则。在这项工作中，我们聚集了一群研究人员，他们是时间生物学、睡眠、睡眠障碍和免疫系统方面的专家。因此，我们进行了一项叙述性综述，以探讨COVID-19与睡眠之间的关系，以及其免疫学方面和可用于减轻大流行期间影响每个人的健康有害影响的策略。
The fear and uncertainty caused by the coronavirus disease 2019 (COVID-19) pandemic, threats to survival are one of the main problems of everyday life; however, mental health care must also be considered a priority. During social isolation also called self-quarantine, the restricted mobility and social contact, concern about financial resources and availability of supplies, fear of infection, questions about the duration of self-quarantine, cause anxiety, depression, stress, insomnia and reduced the quality and quantity of sleep, that may present a greater risk to the health of the general population. Sleep disorders are increasingly becoming a major health issue in modern society, and are influenced by retinal stimulation by electronic devices, as well extended and/or night shift-work, which may aggravate the systemic and lung inflammation during viral infections. Sleep disorders can induce pro-inflammatory states and be harmful during the COVID-19 pandemic. The possible interactions between many drugs used to treat COVID-19, and those used to treat sleep disorders are unknown, mostly due to the lack of a standard protocol to treat these patients. Insufficient sleep or irregular sleep-wake cycles may impair health, immune system, induce pro-inflammation state, and may lead to increased vulnerability to viral infections, involving inflammatory and oxidative/antioxidant imbalance. In this sense, obstructive sleep apnea has been associated with recognized COVID-19 risk comorbidities and considered a risk factor for COVID-19. During the COVID-19 pandemic, health care cannot stop, and telemedicine has presented itself as an alternative method of delivering services. When a face-to-face visit is mandatory, or in locations with minimal community transmission where sleep centers have resumed activities, it is important that the sleep center facilities are properly prepared to receive the patients during the COVID-19 pandemic, and follow all relevant safety rules. In this work we gathered a group of researchers, specialists in aspects related to chronobiology, sleep, sleep disorders, and the immune system. Thus, we conducted a narrative review in order to address the relationship between COVID-19 and sleep, as well as its immunological aspects and strategies that may be applied in order to mitigate the harmful effects on health that affects everyone during the pandemic.