COVID and Obstructive Sleep Apnea

Research supporting the connection between COVID-19 infection rates and obstructive sleep apnea has focused primarily on shared co-morbidities and medical risk factors. New research reveals that people who suffer from severe obstructive sleep apnea are at greater risk of contracting COVID-19. While there are biological factors that come into play when evaluating the COVID-OSA connection, new research reveals indirect behavioral factors as well. Treatment for these two illnesses is further complicated by the multitude of co-morbidities they share, but research is also touching on how both can have improved outcomes.

According to the American Sleep Apnea Association, approximately 22 million Americans suffer from obstructive sleep apnea, with an estimated 80-90% that go undiagnosed. This chronic sleep disorder is characterized by repeated cycles of paused breathing that occur throughout the night. Those who suffer from obstructive sleep apnea are unable to achieve the deep, restful sleep that is needed for optimal health. The chronic co-morbidities that occur with obstructive sleep apnea include cardiovascular disease, diabetes, and hypertension. According to the National Institute of Health, gender, weight, and age are the risk factors most associated with obstructive sleep apnea. While men are 2-3 times more likely than women to develop OSA, the risk goes up for women post-menopause and with an increase in weight BMI.

A recent study conducted at Kaiser Permanente Southern California and reported by the American Thoracic Society collected data on a large cohort of patients with sleep disorders. The findings revealed that people with severe obstructive sleep apnea are at a greater risk of contracting COVID. These findings attribute the connection to the reduced respiratory function and airway inflammation in sleep apnea patients, in addition to the adverse effects of OSA’s characteristic fragmented sleep pattern. Other biological factors include the shared medical risk factors between OSA patients and those at risk for COVID, namely male gender, obesity, and the presence of cardiovascular disease. If patients have multiple co-morbid conditions, the risk of contracting COVID is even greater. The Kaiser Permanente study also released data on the behavioral relationship between COVID and obstructive sleep apnea. While sleep apnea patients are proportionally more likely to be older and male, the study found that as the patient’s age increased, the COVID rate decreased. They discovered that the older patients were more adherent to COVID health protocols such as masking and social distancing which protected them from contracting the virus.

While Continuous Positive Airway Pressure machines, better known as CPAP, have been the gold standard in obstructive sleep apnea care, the presence of COVID further complicates treatment.

Because COVID spreads from person to person through airborne respiratory droplets, there is some risk that CPAP can spread the virus from leaks around the mask or from the exhalation port. According to Sleep Medicine Reviews, many physicians feel patients that have both obstructive sleep apnea and COVID are best treated in a health care facility to avoid spreading the virus. Another treatment under investigation, as reported on medical news and education website Healio.com, is the use of melatonin to help reduce inflammation and stimulate the immune response in COVID patients with OSA. Melatonin also helps improve sleep quality, which in turn helps strengthen the immune response in patients with both obstructive sleep apnea and COVID.

While research examining the COVID-OSA connection is still relatively new, the best advice for patients with obstructive sleep apnea is to stay on treatment in order to get deep, restful sleep. Quality sleep is necessary to strengthen our immunity which helps fight off infection and illness. This is especially important with COVID in our lives.

To learn more about how BetterNight can help you provide more effective and efficient care to your at-risk sleep apnea patients, contact us.