Sleep Apnea May Increase Long COVID Risk by 75%

Obstructive sleep apnea may increase the risk of long COVID in adults by as much as 75%, according to a new study published in the journal Sleep.

This common sleep condition causes breathing to be interrupted for brief periods throughout the night. It’s also been linked to a greater risk of stroke, high blood pressure, diabetes, heart disease, and hospitalization from a COVID-19 infection.

About one in 13 U.S. adults have long COVID symptoms such as fatigue and shortness of breath, according to survey data from the National Center for Health Statistics. But scientists are still learning more about the biological mechanisms behind long COVID, said Hannah Mandel, MS, a co-author of the study and senior research scientist for the RECOVER Initiative at NYU Langone Health.

“We really need more research to identify treatments, because that’s crucial for those with ongoing symptoms who can’t really wait for us to do more research on the mechanisms,” Mandel told Verywell.

Women May Have Different Risks

Not all people with obstructive sleep apnea seem to have the same level of risk for developing long COVID. Data from one of the study’s research groups suggests that women with obstructive sleep apnea had an 89% chance of developing long COVID, compared to 59% for men with the same condition.

Some evidence suggests that women in general are more likely to develop long COVID than men, but it could also be related to the actual sleep apnea diagnosis.

The differences could also be related to how this sleep condition affects people of different genders.

“There are absolutely, without a doubt, differences in how sleep apnea manifests and presents in men and women. That’s due to physiologic reasons that we understand as well as things we have less understanding of,” said Ravi S. Aysola, MD, chief of the sleep medicine section in the division of pulmonary, critical care, and sleep medicine at UCLA Health.

The researchers hypothesized that the women included in the study might have more severe cases of sleep apnea since they had received a diagnosis, but more studies are needed to validate the correlation between sleep apnea and long COVID risk.

Experts Recommend Sleep Apnea Screening and Treatments 

For the study, the researchers were not able to study how COVID vaccination status or treatments for sleep apnea played a role in the findings.

Phyllis C. Zee, MD, PhD, director of the Center for Circadian and Sleep Medicine at Northwestern University Feinberg School of Medicine, told Verywell that these new findings do have implications for screening COVID patients for sleep apnea.

It’s important to “ask people at risk for sleep apnea about symptoms such as snoring, gasping for breath, and excessive daytime sleepiness,” she said, while also ensuring that people already diagnosed with sleep apnea get effective treatment.

“Obstructive sleep apnea results in intermittent low oxygen levels and fragmented sleep, both of which can affect immune function and chronic inflammation, which may increase the risk for long COVID,” Zee said.

Aysola added that it’s best for people to optimize breathing during sleep. “So if you have a confirmed diagnosis of obstructive sleep apnea, making sure that that’s treated effectively is your best option,” he said.