A new study has found that adults with obstructive sleeping apnea are at an increased risk of long-term Covid following a SARS/CoV-2 infection by up to 75%.
According to the analysis, women with obstructive sleeping apnea were at a higher risk of death by up to 89%, and men had an increased risk of 59%, based on electronic health data from nearly 1.8million people.
The condition is dangerous because it causes breathing to stop for 10 seconds at a time multiple times throughout the night. This occurs when soft tissues or heavy tissue in the mouth and throat block the airways.
The study was part of RECOVER (Researching Covid to Improve Recovery), which aims to understand why some people develop long Covid and how to detect, treat, and prevent the condition. RECOVER, a National Institutes of Health project, aims to understand why some people suffer from long Covid, as well as how to best detect, treat and prevent it.
Why is there such a huge difference? The larger study included people with additional health issues, or comorbidities. These include obesity, diabetes and high blood pressure.
She said that the range between 12% and 75% was likely due to different study populations, different levels of comorbidities but also different definitions for long Covid. We didn't have a working term for long Covid before October 2021.
Thorpe, professor and director of NYU Grossman's Division of Epidemiology, said: "I think the risk is probably in the middle. But we'll need to do more studies to confirm that."
Thorpe stated that a third analysis of the medical records of 102,000 sleep-apnea children found no correlation between long Covid and sleep apnea after all confounding conditions had been eliminated.
She added that 'by using three large networks of electronic medical records, we were also able to perform this study three different times. This is one of its strengths'. This is the first study of its kind to show that adults with sleep disorders are more likely to develop long-term COvid.
The RECOVER Adult Study at the University of Arizona Health Sciences is a principal investigator and professor of Medicine, Dr. Sairam Parhasarathy.
Parthasarathy said that a prospective study is needed to confirm this association. If confirmed, these findings could have implications for the treatment of long Covid.
He added that obstructive sleeping apnea treatment may help to improve long Covid symptoms.
Initiatives backed by the government
The study published in the journal Sleep on Thursday is one of several released studies since Congress allocated $1.15billion to NIH to study long-term effects over a period of four years. The agency has spent $811 million on research to date.
Researchers were interested in the role that sleep apnea plays in Covid because of the association between this condition and worse outcomes following a Covid infection.
Thorpe stated that people with sleep apnea were at a higher risk of a severe Covid-19 infection, hospital admission for intensive care, and mortality.
Dr. Bhanu Prakash Kolla, sleep medicine specialist at the Mayo Clinic's Center for Sleep Medicine in Rochester, Minnesota, said that obstructive sleep disorders can cause inflammation and disrupted sleeping patterns, which may lead to increased susceptibility to infections.
Kolla, a researcher who wasn't involved in the study, said that this could explain how obstructive sleeping apnea increases the risk of Covid as well as... (long Covid).
Risk in women vs. men
Parthasarathy, a University of Arizona professor, says that sleep apnea can affect both men and women.
He said that it is conservatively estimated by him that 80% of those with obstructive sleeping apnea are not diagnosed. These analyses also assume that OSA patients will be treated. Nearly half of these patients do not use the treatment.
Why do women face a higher risk of cancer than men, up to 89%? This issue was not addressed in the study.
But, 'one could postulate that this difference is based on our knowledge of sex-specific differences in immune responses and sleep patterns,' explained Dr. Phyllis Zee of Northwestern University Feinberg Medical School in Chicago.
Zee coauthored the first study published on the link between severe Covid infection and sleep apnea.
Zee stated that women tend to have a stronger immune response against viral infections and are therefore more susceptible to inflammation after infection. Women in general suffer from more insomnia, and long Covid is often accompanied by fatigue and insomnia.
Thorpe suggested that another reason could be because sleep apnea was historically considered a disease of men. This could mean that when a woman's apnea becomes diagnosed, it is already more advanced.
She said that doctors tend to look more for sleep apnea in men.
Thorpe stated that as scientists continue to learn about Covid's long life, more information will be available. People with sleep apnea, or those who snore and snort at night -- all of which are signs of this condition -- need to be extremely careful when contacting Covid.
Thorpe stated that people with sleep apnea should get early treatment for Covid and may want to consider Paxlovid - the oral medication prescribed by doctors to reduce severe outcomes. They should also maintain their vaccinations in order to reduce the risk of infection.