Obstructive sleep apnea may increase risk of severe COVID-19: study

TORONTO — A new study has found that people with a high risk of obstructive sleep apnea (OSA) had increased odds of having COVID-19 and were twice as likely to be hospitalized with the disease or treated for it in an intensive care unit (ICU).

The findings, published in Sleep and Breathing, a Nature journal, conducted questionnaires from May to August 2020 with more than 26,000 people across 14 countries and regions like Austria, Brazil, Canada, Hong Kong, France, Germany, Japan and the U.S.

Researchers used the STOP screening questionnaire – a recognized diagnostic tool for sleep apnea – and asked questions about COVID-19, hospitalization and ICU treatment.

The voluntary and anonymous questionnaire was administered online in several languages for participants 18 years or older. Researchers believe it is the first study of its kind to examine the association between the high risk of obstructive sleep apnea, comorbidities and severe COVID-19.

Researchers determined that “patients with OSA have a significantly increased risk of severe COVID-19, as well as hospitalization and mortality” as the condition is thought to increase the severity of the disease and risk through “proinflammatory pathways.”

The inflammation caused by sleep apnea “may enhance” the evolution of the COVID-19 disease, and researchers observed a “significant” association between a high risk of OSA and increased COVID-19 hospitalization and ICU treatment, the study states.

Researchers noted that many people at high risk of OSA may be undiagnosed and therefore won’t have received treatment which could feed into poorer outcomes, compared to those who have received a diagnosis and treatment like a continuous positive airway pressure (CPAP) machine.

“CPAP therapy decreases the underlying proinflammatory conditions which may help manage COVID-19 symptoms by reducing upper airway and systemic oxidative stress,” researchers said in the study.

Of the 26,539 participants who responded to the survey, 20,598 completed the full questionnaire and provided complete data on their comorbidities. The average respondent was in their 40s and the most commonly reported comorbidities were diabetes, depression, hypertension, cardiovascular disease and insomnia.

In the analysis of their findings, the researchers found that participants at high risk of OSA had higher odds of being diagnosed with COVID-19, and were two times more likely to be treated in a hospital or ICU.

Being male, having a high risk of OSA, diabetes and depression were also associated with increased risk of hospitalization and ICU treatment related to COVID-19. 

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