PERSISTENT sleep disturbance and fatigue showed little improvement after UK pandemic lockdown restrictions ended, researchers found.
Persistent Sleep Disturbance Remained After Restrictions
Researchers conducted a prospective longitudinal study involving 2,390 participants from the UK COVID-19 Symptom Study Biobank. Participants completed validated assessments of sleep quality, insomnia symptoms, daytime sleepiness, obstructive sleep apnea indicators, restless legs syndrome symptoms, fatigue, anxiety, and depression.
Questionnaires were administered in October 2021, while lockdown restrictions remained in place, and again in March 2022, after all UK lockdown measures had ended. The assessments were scheduled near the autumn and spring equinoxes to provide comparable daylight exposure.
Despite the major change in social restrictions, sleep and fatigue scores showed no clinically or statistically meaningful improvement. Mean Pittsburgh Sleep Quality Index scores remained above the threshold indicating clinically significant sleep disturbance at both assessments.
Restless legs syndrome symptoms were also common, increasing from an estimated 29.8% at baseline to 32.6% at follow-up. Among participants with paired data, more individuals developed new symptoms than experienced symptom resolution.
Findings Were Independent of COVID-19 Status
Persistent sleep disturbance was not independently associated with baseline SARS-CoV-2 infection, infection acquired during follow-up, or post-COVID-19 syndrome. Participants’ initial sleep and fatigue scores were consistently the strongest predictors of their later results.
A new SARS-CoV-2 infection between assessments was associated with a small increase in STOP-Bang scores compared with remaining uninfected or experiencing reinfection. However, the difference was substantially below the change considered clinically meaningful.
Receiving a COVID-19 booster vaccination was associated with slightly lower daytime sleepiness scores. It was also associated with greater odds of restless legs syndrome symptoms, although baseline symptoms remained a much stronger predictor of symptoms at follow-up.
Routine Sleep Assessment May Support Fatigue Care
The researchers concluded that pandemic-related sleep disruption may persist without active intervention. Routine sleep assessment may therefore be appropriate for people presenting with persistent fatigue, including those with long COVID and coexisting sleep disturbance.
The observational study cannot establish causation and lacked prepandemic sleep data. Generalizability was also limited because participants were predominantly White, middle-aged women, and all outcomes were self-reported.
Reference
Toson B et al. Persistent sleep disturbance following pandemic lockdowns: longitudinal findings from the UK COVID-19 Symptom Study Biobank. J Sleep Res. 2026;DOI:10.1111/jsr.70344.
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