Block-Level Deep Sleep Consolidation and Environmental Modifiers in Long COVID with Dysautonomia: A Longitudinal N-of-1 Wearable Study

Background: Sleep architecture fragmentation is common in Long COVID and dysautonomia, yet the relationship between block-level deep sleep consolidation and next-day functional wellbeing has not been characterized longitudinally in this population. We tested the hypothesis that block-level deep sleep architecture predicts next-day wellness better than aggregate stage duration. Methods: A prospective N-of-1 longitudinal study was conducted across 78 nights between January 1 and March 25, 2026 using a consumer wearable (Garmin Index Sleep Monitor). Next-day wellbeing was assessed using the Overall Feeling Score (OFS; 0-10 scale). A five-tier Architecture Group (AG) classification operationalized consolidation quality. A custom predictive model (Pendulum v5.2) quantified consolidation through block-level weighting and contextual penalties. Space weather metrics (Kp index, daily electron fluence, Load Score) were correlated with sleep architecture and OFS across same-day and lagged alignments. A secondary hierarchical regression examined illness as an independent covariate across the full dataset. Results: Architecture Group explained 56.7% of next-day OFS variance (r = 0.753, p < 0.001), compared with 17.0% for total deep sleep duration (r = 0.412) and 4.8% for the Garmin Sleep Score (r = 0.220). Pendulum v5.2 explained 43.0% of variance (r = 0.656). The deep sleep fragmentation phenotype occurred on 25.6% of nights despite adequate total deep sleep. Space weather explained 14.2% of OFS variance through architecture degradation; Load Score at 1-day lag was the strongest space weather predictor (r = -0.328, p = 0.004). A binary illness indicator explained an additional 5.7% of OFS variance beyond architecture and space weather (full-model R{superscript 2} = 55.2%), with a mean illness-night residual of -0.56 (SD = 0.36; 95% CI [-0.72, -0.40]), consistent with immune/viral flares reducing OFS through pathways independent of sleep architecture. Conclusions: Block-level deep sleep consolidation quality is a substantially stronger predictor of next-day wellbeing than total stage duration in Long COVID with dysautonomia. Space weather constitutes a measurable environmental modifier operating through architecture degradation. Immune and viral flares constitute a significant architecture-independent confound consistent with direct neuroinflammatory effects on functional capacity. This framework may be applicable across conditions where sleep architecture fragmentation plays a pathophysiological role.