The #1 Unexpected Side Effect Doctors Are Now Noticing in Long COVID Patients

We've been grappling with COVID-19 for years. Our knowledge, treatment and protective measures have evolved significantly since those dark days of early 2020. But doctors are still learning more about the virus.

"Early on in the pandemic, we were learning about the acute disease and immediate survival," explainsDr. Uma Darji, MD, a family medicine doctor. "Now, we are learning more about long COVID, which is turning out to be a very complex and ever-evolving condition. Research takes time, and the symptoms of long COVID vary so much from person to person that we are still working to understand all aspects of it."

Research can take time. So, you may have heard of long COVID in the news-sometimes, people with it are referred to as "long haulers." But unless you or a loved one has experienced it, you may not know precisely what it means. The short answer?

"Long COVID refers to chronic symptoms that can persist, recur or newly appear," says Dr. Suraj Saggar, DO, the chief of infectious disease at Holy Name Medical Center. "We have seen a wide variety of symptoms with COVID-19 infection, both with mild and or severe cases of COVID."

Dr. Darji shares that long COVID has some frequently-reported symptoms, including persistent fatigue, brain fog, shortness of breath, joint pain and headaches. There's another one doctors are noticing, too, that often flies under the radar and may surprise you. But if you have long COVID and this symptom, know you're not alone.

Here's the #1 unexpected symptom doctors are seeing in long COVID patients, and what you can do about it.

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The #1 Unexpected Side Effect Doctors Are Now Noticing in Long COVID Patients

"Sleep disruption is a common long COVID symptom," Dr. Darji says. She explains that the COVID virus can affect the brain and nervous system, disrupting sleep regulation.

Dr. Saggar notes that sleep disruption is common among patients with long COVID, affecting 40% to 60% of people.

"People can experience insomnia, which is difficulty falling asleep, staying asleep/waking up throughout the night or getting restful sleep, generally a poor-quality sleep," he says. "As a result, people may experience daytime fatigue and poor concentration."

He compares sleep disruptions with long COVID to having sleep apnea, though you may not wake up gasping for breath.

"This fragmented sleep prevents the body from reaching deep, restorative REM sleep, which is essential for recovery and overall health," Dr. Saggar tells Parade.

Related: There's an ‘Allergy-Like' COVID Symptom Spreading This Season

Why Long COVID Can Cause Sleep Disruptions

TL;DR: We don't know for sure why long COVID affects your sleep.

"The underlying reason for sleep problems in long COVID is not fully understood, but inflammation likely plays a central role by affecting the nervous system," Dr. Saggar says. "Some researchers believe this may involve autonomic dysfunction, where involuntary processes like sleep regulation, heart rate and blood pressure are disrupted."

One recently researched theory is that long COVID affects the hypothalamus, a link between your nervous and endocrine systems.

"Long COVID triggers a drop in energy production, which trips an almond-sized circuit breaker in the brain called the hypothalamus," explains Dr. Jacob Teitelbaum, MD, a board-certified integrative physician and author of You Can Heal From Long COVID. "This circuit breaker controls sleep, so people have trouble both falling and staying asleep. They also have trouble going into the deep stages of sleep that are restorative and needed to eliminate pain."

Related: Doctors Say Older Adults Are Mistaking These Symptoms for Normal Aging-but It Could Be Long COVID

Risks of Poor Sleep With Long COVID

If you have long COVID, you're already at risk for persistent fatigue and brain fog-and sleep disruptions won't help, Dr. Teitelbaum says.

Poor quality sleep is also linked to other health issues. "For a long time, sleep was treated as an afterthought, but we now understand that it's just as important as diet and exercise," Dr. Saggar says. "And it's not only the duration...but also the quality of sleep and the ability to stay asleep long enough to reach deep, restorative REM sleep stages."

He says poor sleep can contribute to:

• Diabetes
• Cardiovascular disease
• Pulmonary hypertension
• Lower cognitive function

"This highlights how critical both sleep duration and sleep quality are for overall health," Dr. Saggar notes.

Related: Doctors Are Seeing a Bizarre New COVID Symptom Right Now

How To Get Better Sleep With Long COVID

We get it. If you or a loved one has sleep disruptions from long COVID, the last thing you want to ruminate about is heart disease. But doctors have good news to share: It's possible to get better sleep, even with long COVID.

"There are several ways to improve sleep through good sleep hygiene," Dr. Saggar says. "You need to get your body ready for sleep. It's not that you just go, go, go, and then you fall asleep. It's a process to get your body to go from wired to shut down."

Here are three steps to better sleep with long COVID.

1. Establish a consistent sleep routine. Dr. Darji advises people to go to bed and wake up at the same time daily-weekends included-to regulate their circadian rhythms. "Many have disrupted internal clocks, and consistency can help retrain the brain and body for better sleep," she says.
2. Avoid getting overstimulated. Dr. Darji says these sources include caffeine in the afternoon and screens within an hour of bedtime. Instead, finish your cup of Joe in the morning, and unplug at least 60 minutes before bedtime to improve sleep quality.
3. Get evaluated for underlying conditions. Dr. Saggar advises people to get assessed for sleep apnea, especially if they snore, have larger neck circumferences or are overweight. "That said, sleep apnea can occur even in people without these risk factors, so evaluation by a sleep specialist can be valuable," he notes.

Long COVID is an under-understood, misunderstood and, frankly, sometimes controversial condition-but it exists. So does support.

"There are a lot of multi-disciplinary long COVID clinics opening, and as we learn more, more targeted treatments are coming around," Dr. Darji says. "This helps as patients can access coordinated care from their primary care doctor and specialists."

She suggests working with a specialist or a primary care doctor you trust who understands that you're dealing with life-altering symptoms.

Up Next:

Related: Doctors Say This Common Habit During COVID Recovery Could Be Making You Sicker

Sources:

• Dr. Uma Darji, MD, a family medicine doctor
• Sleep Disturbances as a Consequence of Long COVID-19: Insights from Actigraphy and Clinimetric Examinations-An Uncontrolled Prospective Observational Pilot Study. Journal of Clinical Medicine.
• Dr. Suraj Saggar, DO, the chief of infectious disease at Holy Name Medical Center
• Dr. Jacob Teitelbaum, MD, a board-certified integrative physician and author of You Can Heal From Long COVID (2025)
• Possible Involvement of Hypothalamic Dysfunction in Long COVID Patients Characterized by Delayed Response to Gonadotropin-Releasing Hormone. International Journal of Molecular Sciences.

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This story was originally published May 7, 2026 at 9:50 AM.