Análise da qualidade do sono, capacidade funcional e modulação autonômica cardíaca de idosas diabéticas na síndrome Pós-Covid 19

Abstract

Introduction: during the covid-19 pandemic diabetic individuals were at increased risk for hospitalization, presentation of severe cases of the disease, and high mortality. However, after the acute phase of the disease, remaining symptoms may continue, in the so-called post-covid 19 syndrome, especially if the population is elderly, one of the groups most susceptible to sequelae of covid-19. Post-covid 19 sequelae have emerged as an important health problem for this population, leading to changes in sleep quality, modification of functional capacity levels, and dysfunctions in the autonomic nervous system. Objective: to analyze the quality of sleep,

functional capacity, and cardiac autonomic modulation of elderly diabetic women in the post- covid 19 syndrome. Methodology: 41 elderly women, aged 60-75 years, diagnosed with Type

2 Diabetes Mellitus and who had covid-19 were included, divided into three groups: 14 in the Diabetes without covid-19 group (GD), 15 in the Diabetes with covid-19 group (GD+C), 12 in the Diabetes with covid-19 group who had Pulmonary Compromise (GD+P). Sleep quality was assessed using the Pittsburgh questionnaire, anamnesis, capillary blood glucose, blood pressure collection, anthropometry, adipometry, resting electrocardiogram for 10 minutes to analyze heart rate variability (HRV), 6-minute walk test, stand up and sit test, and time up and go (TUG). Data were analyzed by 1-way ANOVA, followed by Tukey-Kramer Multiple Comparisons Test, significance for p ≤ 0.05. Results: there was no significant difference in age, blood glucose, blood pressure, and body composition between the groups. Analysis of sleep quality was significant for the following indices: sleep duration (p = 0.02), sleep efficiency (p = 0.004), sleep disturbances (p = 0.0002), and daytime sleepiness (p = 0.03). In the TUG there was a positive correlation between GD+C and GD+P compared to GD. Further, there was a reduction in autonomic indices between GD+C vs. GD: Var RR (ms2), SDNN (ms), SD1 (ms), TINN (ms), HF-log (ms2), LF-log (ms2); and between GD+P vs. GD: Var RR (ms2), SDNN (ms), RMSSD (ms), SD1 (ms), SD2 (ms), and HF-log (ms2). Conclusion: it is suggestive that elderly diabetic women who had covid-19, with and without pulmonary impairment, have impaired sleep quality, reduced levels of functional capacity, and interference on HRV with decreased parasympathetic autonomic modulation.