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Obstructive Sleep Apnea Might Make COVID-19 Worse, Study Finds

Woman using a CPAP machine.

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Key Takeaways

  • People with obstructive sleep apnea who are diagnosed with COVID-19 may suffer from more severe illness symptoms leading to poor outcomes including hospitalization, and mechanical ventilation.
  • Obstructive sleep apnea is associated with other COVID-19 risk factors like obesity, hypertension, and type 2 diabetes.

A new October study found that a significant number of patients hospitalized with COVID-19 also have obstructive sleep apnea (OSA) suggesting that the condition could be associated with poor outcomes and severe illness for those with the virus. The study was published in Sleep Medicine and Disorders: International Journal.

Researchers from Turku University Hospital and the University of Turku examined the medical records of 278 COVID-19 patients in the spring of 2020 and discovered that 29% of the patients had OSA.

The findings raised the possibility that OSA could be a risk factor for COVID-19. Obesity—another co-morbidity for severe COVID-19 illness—is also a common denominator shared by people diagnosed with OSA.

Those diagnosed with obstructive sleep apnea tend to be older, obese, and also have other co-morbidities including diabetes, and hypertension,” Robson Capasso, MD, chief of sleep surgery at Stanford University School of Medicine in California, tells Verywell. “These are the same conditions that are considered risk factors for poor outcomes in patients with COVID-19.”

Capasso also noted that many individuals with OSA are undiagnosed. A systematic study in the U.K. reviewing COVID-19 and OSA estimated that more than 85% of potential OSA cases remain undetected. This means there's the potential that a large number of unidentified individuals may be at increased risk of experiencing severe COVID-19 outcomes.

What is Obstructive Sleep Apnea?

The American Sleep Apnea Association defines sleep apnea as an involuntary cessation of breathing that occurs when a patient is asleep. OSA affects more than 18 million Americans. While the condition is generally associated with being male, overweight, and older than the age of 40, OSA can affect anyone (even children).

OSA is caused by a repetitive partial or complete blockage of the airway during sleep. The block leads to pauses in breathing, blood oxygen desaturation, and arousal from sleep.

Untreated OSA can have serious health consequences including:

  • Hypertension
  • Cardiovascular disease
  • Memory problems
  • Headaches

What This Means For You

If you or a family member has signs and symptoms of OSA, talk to your healthcare provider. Once diagnosed, OSA is treatable. Not only can treating OSA improve your health (and sleep), it can potentially help prevent an increased likelihood of poor outcomes if you contract COVID-19.

How the Pandemic Changed OSA Diagnosis

Before the pandemic, an in-lab sleep study—or an at-home sleep test for some patients—was the gold standard in diagnosing sleep apnea.

However, with COVID-19 restrictions, an in-lab sleep study might not be an option. Instead, providers are using telehealth and other tools to quickly identify OSA and help patients get treatment to guard against any possible COVID-19 risk factors.

“We are relying more on our clinical judgment to diagnose sleep apnea,” Capasso says. “We are using more algorithm tools to help diagnose our patients, and this can eventually lead to an improvement in testing. The pandemic might be accelerating this trend.”

Apps have been created to help diagnose sleep disorders. While the apps do not provide a clinical diagnosis, they can give providers critical data that can shape their clinical judgment.

Many technology companies have started to integrate health tracking apps into their devices. It's likely they'll continue to become mainstream for the general public and medical professionals alike.

The American Academy of Sleep Medicine (AASM) launched the SleepTM website and app to connect sleep specialists with patients through video. Patients can also use common wearable data tracking devices (like a Fitbit) to eliminate logistical barriers and provide a no-touch consult that can lead to a quicker diagnosis and treatment plan.

Treatment

According to the American Lung Association, there are several treatment options that can successfully treat OSA.

Continuous Positive Airway Pressure (CPAP)

A CPAP machine gently blows air into your airway to keep it open while you sleep. You wear a mask that either fits into your nostrils over your nose and/or mouth. A CPAP is often the first treatment healthcare providers will suggest and should be used every night for the best results.

Oral Appliances

Oral appliances are dental devices that open the throat by bringing the jaw forward while you sleep. These devices are most effective for treating mild to moderate sleep apnea. 

Surgery

If other treatment options are not right for you, you might be given surgical options. Sleep apnea surgery reduces the tissue in the back of your throat, pulls your tongue forward, and inserts a nerve stimulator to open your airway so you can breathe easier while sleeping.

Your provider might suggest surgery to remove tonsils or adenoids if they are blocking your airway.

Lifestyle Changes

There are a number of lifestyle changes that can be made alongside other treatments, including:

  • Lose weight. Losing just 10% of your body weight can improve your sleep apnea, and sometimes even cure it.
  • Avoid alcohol and sedatives. Your provider may recommend that you do not drink alcohol at least four hours before bed and avoid taking sedatives like sleeping pills.
  • Quit smoking. Stopping smoking can improve your sleep apnea because cigarette smoke causes inflammation that narrows your airways.
  • Don't sleep on your back. Sleeping on your back may make your sleep apnea worse. Use a pillow to support sleeping on your side.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

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Article Sources
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  7. SleepFoundation.org. How weight affects sleep apnea. Updated August 28, 2020.