A recent study that analyzed the data of 2.2 million Americans with Covid-19 warned that those who have sleep apnea might be at a 75% higher risk of developing long Covid compared to those who do not struggle with sleep disorders. Published in the journal Sleep, researchers say obstructive sleep apnea specifically is linked with higher risks of long Covid.

“People with obstructive sleep apnea should also keep up with their vaccinations to minimize the risk of infection,” said Lorna E. Thorpe, the study’s senior author and epidemiologist at New York University’s Grossman School of Medicine, in a press release.

The symptoms of obstructed sleep apnea are frequent blockages of airways during sleep that causes disruptions in breathing patterns, poor sleep, and even blood oxygen saturation. Around 20% of American adults live with obstructive sleep apnea. Studies have also linked sleep apnea to lifestyle conditions like diabetes, obesity, and hypertension.

In this analysis, the researchers accessed data from electronic health records from three RECOVER research networks — an initiative funded by the National Institutes of Health that aims to investigate the long term impacts of Covid-19. All of the studies’ participants had been diagnosed with Covid between March 2020 and February 2022.

Around 5% of them had also been diagnosed with sleep apnea. Those adults had a 75% higher risk of developing long Covid and the researchers further observed that this could be because they were more likely to have co-morbidities like obesity. “Obesity is a particularly well-known risk factor for both OSA and severity of acute COVID infections,” the researchers noted in the study.

Thorpe and colleagues further highlighted that women with obstructive sleep apnea were at a far higher risk (89%) of developing long Covid. In comparison, men with obstructive sleep apnea faced a 59% higher long Covid risk. While the reasons are unclear, women are at a greater risk of developing sleep apnea – especially during pregnancy and during or after menopause. Women who have polycystic ovarian syndrome might also have an increased risk of sleep apnea.

“Part of the challenge is that many of the risk factors for sleep apnea are also risk factors for COVID-19 outcomes,” Thorpe added. “We don’t know entirely why we are seeing this association.”

In the last year, other studies have also found an association between obstructive sleep apnea and Covid. In a 2022 study, researchers found that adults with the sleep disorder were at a higher risk of suffering from a fatal Covid infection compared to those who did not have obstructive sleep apnea. In another analysis of 21 studies, researchers warned that there is a significant association between obstructive sleep apnea and developing severe Covid infections that could require being admitted to the intensive care unit (ICU) and even being put on ventilation support.

“We still have a lot to learn about the long-term effects of this virus, but this study could inform clinical care by identifying patients who may benefit from closer monitoring,” said Marishka K. Brown, in a press release. Brown is the director of the National Center on Sleep Disorders Research.

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