The year 2020 will be remembered for a cataclysmic event- the coronavirus disease 19 (
COVID 19) pandemic, caused by severe acute respiratory syndrome coronavirus 2.

COVID 19 is a serious disease that can significantly affect the daily lives of recovered
patients and their families in terms of mental health problems such as post- traumatic
stress, depression, anxiety, and insomnia, as well as the negative impact COVID 19 has on
patients quality of life. Since the patients are not immune to future infection, it may
lead to a more negative impact on patient's quality of life. Health related quality of
life is an important measure that is used for assessing the impact of diseases,
disorders, or disabilities on the physical, mental, and social domains of patients
health. The assessment of health related quality of life (HRQol) helps healthcare
providers identify the factors affecting quality of life (QoL) and recognize the aspects
of COVID 19 management that needs to be enhanced for improving the QoL of patients. COVID
19 infection causes systemic inflammation leading to a surge on inflammatory mediators in
the body that are known to influence sleep and vice versa.

Systemic infection related increase in the inflammatory mediators are known to increase
the amount of non rapid eye movement (NREM) sleep and duration of sleep, perhaps in an
attempt to save energy and counter the infection. However, different infections have
varying effects on sleep. That could be one reason that COVID 19 infection has led to
insomnia and worsening of sleep quality rather than increment in sleep. Not only the
sleep quality has been affected during the COVID 19 pandemic, but pandemic could have led
to emergence of sleep disorders as well.

It has been persuasively argued as to why elderly persons are more susceptible to
contract severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection. Several
factors have been discussed that worsens sleep among the elderly, including aging of the
circadian network.

Considering high prevalence of these disorders, optimal management of these disorders is
important during pandemic not only to reduce the risk of contracting SARS-COV-2
infection, but also to reduce adverse health consequences related to same.

This is an important area for research as the relationship appears bidirectional,
improvement in sleep may be used to reduce impact of COVID 19 and vice versa.