Obstructive sleep apnea is highly prevalent in COVID19 related moderate to severe ARDS survivors: findings of level I polysomnography in a tertiary care hospital

Goyal, Abhishek; Saxena, Khushboo; Kar, Avishek; Khurana, Alkesh Kumar; Bhagtana, Parneet Kaur; Sridevi, Chinta Siva Koti Rupa; Pakhare, Abhijit

doi:10.1016/j.sleep.2021.06.015

Cited by 10 publications

(16 citation statements)

References 28 publications

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“…A high prevalence of moderate to severe OSA (obstructive sleep apnoea) of 73% was observed. As noted by the authors, untreated OSA could lead to cardiac complications and persistent symptoms such as fatigability and insomnia, thus partially explaining the increased prevalence of these symptoms in COVID-19 survivors [ 137 ].…”

Section: Quantitative and Qualitative Alterations Of Sleep In Acute A...mentioning

confidence: 99%

Time to Sleep?—A Review of the Impact of the COVID-19 Pandemic on Sleep and Mental Health

Neculicioiu

Colosi

Costache

et al. 2022

IJERPH

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Sleep is intrinsically tied to mental and overall health. Short sleep duration accompanies the modern lifestyle, possibly reaching epidemic proportions. The pandemic and subsequent lockdowns determined a fundamental shift in the modern lifestyle and had profound effects on sleep and mental health. This paper aims to provide an overview of the relationship between sleep, mental health and COVID-19. Contrasting outcomes on sleep health have been highlighted by most reports during the pandemic in the general population. Consequently, while longer sleep durations have been reported, this change was accompanied by decreases in sleep quality and altered sleep timing. Furthermore, an increased impact of sleep deficiencies and mental health burden was generally reported in health care workers as compared with the adult general population. Although not among the most frequent symptoms during the acute or persistent phase, an increased prevalence of sleep deficiencies has been reported in patients with acute and long COVID. The importance of sleep in immune regulation is well known. Consequently, sleep deficiencies may influence multiple aspects of COVID-19, such as the risk, severity, and prognosis of the infection and even vaccine response.

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Section: Quantitative and Qualitative Alterations Of Sleep In Acute A...mentioning

confidence: 99%

Time to Sleep?—A Review of the Impact of the COVID-19 Pandemic on Sleep and Mental Health

Neculicioiu

Colosi

Costache

et al. 2022

IJERPH

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“…First, the comorbidities of obstructive sleep apnea, such as obesity and hypertension are same as poor outcomes of COVID-19 infection. 7,23,26 Second, the Renin-Angiotensin system (RAS) pathway dysregulation and angiotensin II elevation due to sleep interruption noted in patients with obstructive sleep apnea, which is likely to cause COVID-19 infection more easily. 23,24 Third, increased IL-6 and TNF-αlevel in patients with obstructive sleep apnea are prone to induce inflammatory reaction which resulted in more severe complications after COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of obstructive sleep apnea syndrome after COVID‐19 infection

Lin,

Wu,

Wang

et al. 2024

Journal of Medical Virology

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Obstructive sleep apnea is a well‐known risk factor regarding the severity of COVID‐19 infection. However, to date, relatively little research performed on the prevalence of obstructive sleep apnea in COVID‐19 survivors. The purpose of this study was to investigate the risk of obstructive sleep apnea after COVID‐19 infection. This study was based on data collected from the US Collaborative Network in TriNetX. From January 1, 2020 to June 30, 2022, participants who underwent the SARS‐CoV‐2 test were included in the study. Based on their positive or negative results of the COVID‐19 test results (the polymerase chain reaction [PCR] test), we divided the study population into two groups. The duration of follow‐up began when the PCR test was administered and continued for 12 months. Hazard ratios (HRs) and 95% confidence intervals (CIs) for newly recorded COVID‐19 positive subjects for obstructive sleep apnea were calculated using the Cox proportional hazards model and compared to those without COVID‐19 infection. Subgroup analyses were performed for the age, sex, and race, groups. The COVID‐19 group was associated with an increased risk of obstructive sleep apnea, at both 3 months of follow‐up (HR: 1.51, 95% CI: 1.48–1.54), and 1 year of follow‐up (HR: 1.57, 95% CI: 1.55–1.60). Kaplan–Meier curves regarding the risk of obstructive sleep apnea revealed a significant difference of probability between the two cohorts in the follow‐up periods of 3 months and 1 year (Log‐Rank test, p < 0.001). The risks of obstructive sleep apnea among COVID‐19 patients were significant in the less than 65 year of age group (HR: 1.50, 95% CI: 1.47–1.52), as well as in the group older than or equal to 65 years (HR:1.69, 95% CI: 1.64–1.73). Furthermore, the risks of obstructive sleep apnea were evident in both the male and female COVID‐19 groups. Compared to the control group, the risks of obstructive sleep apnea in the COVID‐19 participants increased in the subgroups of White (HR: 1.62, 95% CI: 1.59–1.64), Blacks/African Americans (HR: 1.50, 95% CI: 1.45–1.55), Asian (HR: 1.46, 95% CI: 1.32–1.62) and American Indian/Alaska Native (HR: 1.36, 95% CI: 1.07–1.74). In conclusion, the incidence of new diagnosis obstructive sleep apnea could be substantially higher after COVID‐19 infection than non‐COVID‐19 comparison group. Physicians should evaluate obstructive sleep apnea in patients after COVID‐19 infection to help prevent future long‐term adverse effects from occurring in the future, including cardiovascular and neurovascular disease.

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“…Our study can be compared to 2 others based on the same diagnosis criteria of SA using poly(somno)graphy. 44 , 45 The first study conducted by Labarca et al 44 evaluated a cohort of COVID-19 patients 3 and 6 months after diagnosis. Thirty-four patients with COVID-19 ARDS were compared with a control group of 28 patients with mild to moderate COVID-19 symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of OSA (79%) was lower than in our study, perhaps because COVID-19 infection was less severe in their patients, as reflected by a higher mean DLCO (85.5% (±22.6) vs 77.65% (±21.14) of predicted), fewer persistent CT abnormalities (67.6% vs 95.2%), a higher mean distance on 6MWT (509 meters (±121.9) vs 480.56 (±120.46)), less frequent intubation (70.5%), curarization (52.9%), prone positioning (41.1%), and shorter duration of ICU stay (10.8±8.9 days) and overall hospitalization (23.8±21). The second study by Goyal et al 45 was an Indian hospital-based longitudinal study conducted among COVID-19 ICU survivors followed over a period of two months. All consecutive COVID-19 patients with moderate to severe ARDS were evaluated 4–6 weeks after ICU discharge.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Characteristics of Sleep Apnea in Intensive Care Unit Survivors After SARS-CoV-2 Pneumonia

Traoré¹,

Eberst²,

Claudé³

et al. 2022

NSS

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Background: Sleep apnea (SA) was reported as possibly exacerbating symptoms of COVID-19, a disease induced by SARS-CoV-2 virus. The same comorbidities are common with both pathologies. This study aimed to estimate the prevalence, characteristics of SA and variation in AHI three months after severe COVID-19 requiring intensive care unit (ICU) admission. Methods: A prospective cohort of patients admitted to ICU for severe COVID-19 underwent an overnight home polygraphy 3 months after onset of symptoms, as part of a comprehensive follow-up program (pulmonary function tests, 6-minute walk tests and chest CTscan). Patients with an apnea hypopnea index (AHI) ≥5 were considered as having SA. We performed a comparative descriptive analysis of 2 subgroups according to the existence, severity of SA and indication for effective SA treatment: patients with absent or mild SA (AHI <15) vs patients with moderate to severe SA (AHI ≥15). Results: Among 68 patients included, 62 (91%) had known comorbidities (34 hypertension, 21 obesity, 20 dyslipidemia, 16 type 2 diabetes). It has been observed a preexisting SA for 13 patients (19.1%). At 3 months, 62 patients (91%) had SA with 85.5% of obstructive events. Twenty-four patients had no or a mild SA (AHI <15) and 44 had moderate to severe SA (AHI ≥15). Ischemic heart disease exclusively affected the moderate to severe SA group. Except for thoracic CT-scan which revealed less honeycomb lesions, COVID-19 symptoms were more severe in the group with moderate to severe SA, requiring a longer curarization, more prone position sessions and more frequent tracheotomy. Conclusion: SA involved 91% of patients in our population at 3 months of severe COVID-19 and was mainly obstructive type. Although SA might be a risk factor as well as consequences of ICU care in severe COVID-19 infection, our results underline the importance of sleep explorations after an ICU stay for this disease.

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Obstructive sleep apnea is highly prevalent in COVID19 related moderate to severe ARDS survivors: findings of level I polysomnography in a tertiary care hospital

Cited by 10 publications

References 28 publications

Time to Sleep?—A Review of the Impact of the COVID-19 Pandemic on Sleep and Mental Health

Time to Sleep?—A Review of the Impact of the COVID-19 Pandemic on Sleep and Mental Health

The prevalence of obstructive sleep apnea syndrome after COVID‐19 infection

Prevalence and Characteristics of Sleep Apnea in Intensive Care Unit Survivors After SARS-CoV-2 Pneumonia

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