Study Links Sleep Apnea to Long COVID Risk in Adults

Friday - May 12 2023, 15:02 UTC - 1 year ago

A study led by the National Institutes of Health’s RECOVER Initiative effectively established that having diagnosed sleep apnea significantly increases the risk of long COVID in adults, persisting after accounting for known factors contributing to long COVID such as obesity, hypertension, diabetes, and hospitalization during initial infection. Interestingly, and in contrast to adults, the risk of long COVID associated with sleep apnea in children disappeared when considering other factors like sex, race, and ethnicity.

A study led by the National Institutes of Health’s RECOVER Initiative and supported by NYU Langone Health found that sleep apnea significantly increases the risk of long COVID in adults.

The research team analyzed data from over 2 million patients across three networks and found that a prior diagnosis of sleep apnea led to a 12% increase in long-term symptoms in the PCORnet group and a 75% increase in the N3C group. The increased risk persisted even when accounting for other known factors contributing to long COVID, such as obesity, hypertension, diabetes, and hospitalization during initial infection.

Interestingly, the risk of long COVID associated with sleep apnea disappeared in children when controlling for other factors.

As of April 2023, more than 100 million Americans had been infected with the virus that causes COVID-19. As of April the U.S. Government’s Household Pulse survey estimated that about 6 percent of U.S. adults are experiencing symptoms associated with long COVID, including brain fog, fatigue, depression, and sleep problems.

Past studies have shown that patients with obstructive sleep apnea (OSA) tend to have more severe illness when initially infected with COVID-19. OSA affects about 1 in 8 adults but is often underdiagnosed.

To better understand links between sleep apnea and long-term COVID symptoms, the research team reviewed data across three RECOVER research networks of patients who had tested positive for COVID-19 between March 2020 and February 2022, according to their health records. Two networks included adult patients – the National Patient-Centered Clinical Research Network (PCORnet) with 330,000 patients – and the National COVID Cohort Collaborative (N3C) with 1.7 million patients. The third patient cohort in the study analysis included the pediatric-focused network PEDSnet, made up of 102,000 children.

Published online on May 11 in the journal Sleep, this study found that a prior diagnosis of sleep apnea in the PCORnet group came with a 12 percent increase in risk for long-term symptoms months after patients’ initial infections. In the N3C patient group, in which patients had higher levels of other chronic conditions than those in PCORnet, sleep apnea came with a 75 percent increase in risk for long COVID compared to those without sleep apnea. The observed increases in risk for long COVID in adults with sleep apnea remained significant even when the research team accounted for obesity, hypertension, diabetes, and hospitalization at the time of their initial COVID infection, all known to independently contribute to risk for long COVID.

The researchers hypothesize that the differences in the percentage increases in long COVID risk between the study groups may be further explained by variations in definitions of long COVID, study populations, and in analysis methods of patient records, across the large study. In contrast to the patterns seen in adults, the contribution of sleep apnea to the risk of long COVID disappeared in children when accounting for other factors, including sex, race, and ethnicity.