Good Sleep (COVID Update)

Not everything has a silver lining, but, for me, COVID has had one. I was discouraged that I was still testing positive at Day 16, but I slept around the clock again on Wednesday night...11:00 p.m. to 11:00 a.m.

It's been nostalgic to revisit, in very early old age, the way I used to be able to sleep when I was younger. I'm not into having COVID, but I've enjoyed being able to sleep. I suffer from a form of insomnia called EMA—early morning awakening. I often pop awake at 4:15 or 5:30 or some ungodly early morning hour and, more than half the time, can't get back to sleep. Well, on Thursday morning I got dragged out of sleep at 5:45, looked at the internet for a while on my tablet, conked out again, and enjoyed basically a whole second night's sleep. I haven't slept that late in years.

The oximeter
If you get COVID, a handy device to have around is something called a "fingertip pulse oximeter," or just "oximeter" for short. It's that little clip that goes on your fingertip that measures your pulse and the oxygen saturation, or the percentage of oxygen, in your blood. A normal, healthy adult or child with functioning lungs has a blood oxygen level of between 95 and 100%. My impression from various things I read about COVID early on was that people who are otherwise asymptomatic can have a condition called "happy" (also called "silent") hypoxia, which means you have low blood oxygen levels but you're not aware of it. Fingertip pulse oximeters were widely recommended during the early days of COVID as a way to detect happy hypoxia. However, in poking around on the web, I came across a study at Penn Medicine that indicated that automated text messaging—regularly asking people with COVID whether they felt short of breath—was just as effective in terms of outcomes as patient self-measuring with an oximeter.

However, I don't get automated text messages from my doctor's office asking me about shortness of breath. In fact I've yet to see a sign from them that they're interested in how I'm doing. So I've been using the oximeter. There are a zillion pulse oximeters on Amazon; this is the one I happen to have, not that that matters. I just slip it on my finger a few times a day to check. Mainly reassurance, I guess.

After I encountered that Penn Medicine study, though, I figured I might need to know a little more, from an expert. So I reached out to John Hansen-Flaschen MD, a TOP reader who is also a highly distinguished pulmonologist (as well as, of course, a photographer). Here's what John told me:

Early on, when COVID infection was frequently life threatening, some people were found to have a low blood oxygen level before they developed severe shortness of breath. Other chest infections did not typically do this. Also, there was no quick COVID testing then. So, at that time, we encouraged people to buy a finger pulse oximeter and to test themselves at the first hint of any new respiratory symptoms.

Current omicron strains do not behave this way, so we no longer recommend pulse oximetry for early detection. Instead, when someone is known to have acute symptomatic COVID, a pulse oximeter can be useful in deciding when to go to an emergency room and when to be admitted to a hospital. A drop in oxygen % saturation of greater than 4 mmHg to below 92% is a reason to go to an ED for further evaluation. Below 85–88% may be a reason to admit someone.

So I guess I'm doing the right thing keeping an eye on it. John also told me that I'm at risk for long COVID, mentioning that "our clinic is overrun with people who have this distressing condition." Yikes. But then, I guess we've all known all along that COVID is inherently a "yikes" kind of thing to start with. I'm keeping my fingers crossed that I won't have that.

Finally, I called my doctor's office, and was told by a nurse that people who've had COVID can continue testing positive for up to 30 days even if they've recovered. She told me to stop testing myself, sort of implying that all I'm doing is driving myself crazy. So, okay.

Anyway, I am feeling a lot better—the penultimate remaining symptom, a cough, seems to be almost gone. The ultimate remaining symptom seems to be...good sleep. Not sure if I want that to go away. But I guess I'll know I'm really better when it does.

Good health to you and your family! In all ways, and always.

Mike

Book o' the Week

Migrant Mother, by Sarah Meister. "Each volume in the One on One series is a sustained meditation on a single work from the collection of MoMA." Forty-two pages with many illustrations. An engaging guided tour of the history and lore of "American photography's Mona Lisa."

This book link is a portal to Amazon. You're very kind use our links, as they help support the site.

B&H Photo

Original contents copyright 2020 by Michael C. Johnston and/or the bylined author. All Rights Reserved. Links in this post may be to our affiliates; sales through affiliate links may benefit this site. As an Amazon Associate I earn from qualifying purchases.

(To see all the comments, click on the "Comments" link below.)
Featured Comments from:

Tom Burke: "Very glad to hear you're getting better, Mike. Like you, the cough has been the last thing to disappear for me.

"You mentioned above that you're still testing positive. Is that PCR tests, or lateral flow test? It's well known that PCR tests can continue to pick up non-infectious viral proteins anything u to 90 days after infection.

"I think I mentioned in an earlier comment that I had found a reference to a study that looked at when people stopped being infectious. I've dug out the references. First, the summary from the Imperial College site; and this is the link to the study report in the Lancet Respiratory Medicine journal.

"The message seems to be that the study found that less than a quarter of cases were shedding virus before the onset of symptoms; and that lateral flow testing was a poor indicator of the onset of infectiousness, but was very good at spotting the moment when you cease to be infectious. In my case I tested negative on two days in succession at the end of my illness (10 days after symptom onset) so I was OK to go out. Four days after that, however, a PCR test (in connection with a survey I'm enrolled in) came back with a positive result. I decided that the latter result was an example of the problem with PCR test results after you've been ill."

Comments

[darlene]

Glad you are feeling better, Mike.

I woke up Tuesday morning around 4:30 feeling like a mack truck hit me. Vomiting for hours had deep chills, my nose hurt like hell and my head felt like it was splitting and muscle aches first felt deep into my calves as I tried to walk. Could not contain the vomiting and knew my blood pressure was taking a toll. As soon as I could get word to my doc, she then video conferenced me and diagnosed me with the new COVID strand. Ordered me to the hospital, worked on stopping the constant vomiting, and got fixed up with meds to take home, even an inhaler even though I am not having breathing problems. For the next 24 hours, my fever broke and I was drenched with sweat while sleeping in winter pajamas and a blanket as the Florida sun shined through my windows. What a nasty couple of days, but now I am on day 4 and I am slowly getting back to my routine. Still on headache meds and have muscle aches, but I am definitely getting back to health thank goodness!

Be careful out there everyone. I am not used to being sick and have taken very good care of myself and choose to not hang around where groups of people may be, except for grocery shopping, post office drop-offs, and library pick-ups. I have had the flu before, but nothing has ever hit me as this did. The night before there was no symptom my body was about to take a beating.

[That sounds scary, Darlene, and I'm glad it didn't last any longer for you. You were sicker than I was. I gather it hits everybody somewhat differently. I sincerely hope your recovery continues and that there are no lingering effects. Godspeed! --Mike]

[Peter Komar]

Mike, I recall you and I got COVID around the same time and this variant is definitely a strange beast. My wife and I still have lingering but not troublesome effects. We were also both told to stop getting tested, we will still be positive for a while, hang in there and that’s all we can do. Sounds like you are on the mend just not as quickly as we would all like. Rest and good long hours of sleep is what we all need. I hope you make a full recovery soon, best regards.

[Dan Khong]

Mike

Hope you get stronger soon and test negative.

Your body might be telling you to sleep earlier and get up earlier. It's one of our biorhythms that is not fixed in stone.

I wake up typically at 4.30am (was later when I was younger), so I now sleep by 9pm.

Go with the flow - don't force it.

Dan K.

[Timothy Auger]

Mike, good luck with your recovery. I had Covid in February - dry cough followed by raging sore throat. It was more than 12 days before the second pink stripe disappeared, so you're not unique. As an occasional asthmatic I was concerned about breathing - I was able to breathe easily, but it felt as if half my lung capacity had disappeared. Lots of puffing and blowing. More than 6 months on, and things have gradually gone back to normal. So give yourself time, and try to stop worrying.

[Bob Johnston]

Best wishes for a speedy recovery. I was lucky, I didn't get long covid. I can sympathise with EMA. It plagues me. Unfortunately covid didn't cure it for me.

[Dave]

"She told me to stop testing myself, sort of implying that all I'm doing is driving myself crazy."

Good advice. I wouldn't doubt that the disease would hang around longer if all seems "doom and gloom".

The vaccines aren't really vaccines, in that they don't prevent the coronavirus as polio vaccines prevent polio.

I'm lucky not to have gotten the bug, unlike the others in our small office. I joke that the coronavirus can't stand the cigarette smoke. (Only half a pack a day, so not a fiend about it. But yes, it would be better to quit. Someday.)

Do as much as you feel like doing. We'll understand. (I didn't think I'd see anything new on your site until Monday. Now I've got two other posts to read!)

I hope you're rid of the virus without long effects. I am not a doctor, but the extra sleep may be (partially) a method to build up the immune system. The body has had many years of evolution to find ways to survive. Bonne chance!

[Be sure to quit before you turn 40. There's a big shelf in the actuarial tables between people who quit before 40 and after 40. After 40, it's still beneficial to quit, but your statistical outcomes get worse. --Mike]