3.3  Self-reported sleep quality
Patients in the poor-sleep group had lower RCSQ scores in the first week (median, 40.0 [IQR, 30.0–50.0] vs 75.0 [IQR, 70.0–82.0], P < 0.0001), second week (median, 45.0 [IQR, 40.0–50.0] vs 80.0 [IQR, 75.5–86.0], P < 0.0001) and third week (median, 45.0 [IQR, 40.0–50.5] vs 80.0 [IQR, 75.0–88.0], P < 0.0001) than those in the good-sleep group (Table 2 ). The PSQI scores were higher in patients in the poor-sleep group than those in the good-sleep group (median, 12.0 [IQR, 11.0–14.0] vs 5.0 [IQR, 4.0–6.0], P < 0.0001). Among the etiological causes of poor-sleep during hospitalization, these included environmental factors, psychosocial factors, discomfort caused by the illness, and chronic insomnia for 85.3%, 60.0%, 56.0%, and 32.0% of patients, respectively (Table 2).
Table 2 Sleep quality assessment in patients with COVID-19.
Median (IQR) P value
Good sleep (n = 60) Poor sleep (n = 75)
RCSQ scores in the first week, median (IQR)
All ages 75.0 (70.0–82.0) 40.0 (30.0–50.0) < 0.0001
 < 50 years 76.0 (71.0–84.0) 44.5 (40.0–47.5) < 0.0001
 50–70 years 75.0 (70.0–80.5) 40.0 (30.0–50.0) < 0.0001
 ≥ 70 years 78.5 (72.0–80.0) 45.0 (32.5–50.0) < 0.0001
RCSQ scores in the second week, median (IQR)
All ages 80.0 (75.5–86.0) 45.0 (40.0–50.0) < 0.0001
 < 50 years 86.0 (76.0–87.0) 46.0 (42.5–50.0) < 0.0001
 50–70 years 80.0 (75.0–85.0) 45.0 (40.0–50.0) < 0.0001
 ≥ 70 years 78.5 (76.0–82.0) 44.0 (35.0–50.0) < 0.0001
RCSQ scores in the third week, median (IQR)
 All ages 80.0 (75.0–88.0) 45.0 (40.0–50.5) < 0.0001
 < 50 years 80.0 (75.0–89.0) 51.5 (45.0–60.0) 0.0002
 50–70 years 81.0 (75.0–89.0) 45.0 (40.0–55.0) < 0.0001
 ≥ 70 years 80.0 (75.0–82.0) 45.0 (40.0–50.0) < 0.0001
PSQI scores, median (IQR)
All ages 5.0 (4.0–6.0) 12.0 (11.0–14.0) < 0.0001
 < 50 years 6.0 (4.0–6.0) 12.0 (10.5–15.0) < 0.0001
 50–70 years 5.0 (4.5–6.0) 12.0 (11.0–13.0) < 0.0001
 ≥ 70 years 5.0 (4.0–7.0) 13.0 (12.0–15.0) < 0.0001
Factors affecting sleep quality
 Environmental factor, n (%) – 61 (85.3) –
 Psychosocial factor, n (%)a – 45 (60.0) –
 Discomfort caused by the illness, n (%) – 42 (56.0) –
 Chronic insomnia, n (%) – 24 (32.0) –
Values are median (IQR [range]) unless stated otherwise. aPsychological factors include fear, anxiety, helplessness and depression. Abbreviations: IQR, interquartile range; n, number; PSQI, Pittsburgh Sleep Quality Index; RCSQ, Richards Campbell sleep questionnaire. P values indicate differences between the good-sleep and the poor-sleep patients. P < 0.05 was considered statistically significant.