Study links sleep breathing disorders to severe COVID-19 outcomes

“As the COVID-19 pandemic continues, and the disease remains highly variable from patient to patient, it is critical to improve our ability to predict who will have more severe illness so that we can appropriately allocate resources,” says Dr. Reena Mehra. 

Dr. Mehra is the senior investigator of the new Cleveland Clinic study, which has identified certain sleep disorders as factors that may result in more severe COVID-19 outcomes.

The study finds that people with COVID-19 who experience sleep disordered breathing have a 31% higher likelihood of hospitalization and death.

The study authors write, “Chronic exposure to sleep-related hypoxia may serve as a priming mechanism to the untoward consequences of COVID-19 illness.”

The study’s lead author, Dr. Cinthya Peña Orbea, explained to Medical News Today:

“It is possible that increased hypoxia caused by disordered breathing during sleep leads to increased inflammation in different organs in our body, including the brain, lungs, and heart, resulting in more severe COVID-19.”

The research found no evidence that any of the breathing disorders makes a person more likely to acquire SARS-CoV-2, the virus that causes COVID-19.

Sleep medicine specialist Dr. Atul Malhotra, who was not involved in the study, told MNT that there is likely a much simpler reason that many people contract the infection:

“I think the risk of who gets [the infection] is probably related to wearing a mask and getting vaccinated and also social distancing, those kinds of things.”

The Cleveland Clinic is a nonprofit academic medical center in Cleveland, OH. The new study has been published in JAMA Network Open.

What is sleep disordered breathing?

Sleep disordered breathing is a common syndrome, characterized by an abnormal respiratory pattern during sleep. It includes snoring, upper airway resistance syndrome, and obstructive sleep apnea. Recent data suggests that it affects 1 billion people globally.

The syndrome is known to cause hypoxia, an insufficient supply of oxygen. “Hypoxia” is also used as shorthand for “hypoxemia,” which refers to an inadequate amount of oxygen in the blood.

Snoring

“Between a third and half of people snore,” said Dr. Malhotra. “Not everyone who snores has sleep apnea.”

“So,” he continued, “when we worry about snoring is if it’s habitual, like they snore all night every night, or if it’s very loud, where the spouse is in a different room. The other time you worry about it is if somebody has daytime sleepiness. Then we take it more seriously.”

“But what I usually say is just, ‘If you’re concerned about it, talk to your doctor.’ There are different questionnaires that have been validated, but basically, the history and physical exam can be quite helpful.”