A study published in the journal Scientific Reports reveals that individuals who have contracted SARS-CoV-2 face an increased risk of developing new-onset obstructive sleep apnea (OSA) for up to 4.5 years post-infection. Researchers analyzing electronic medical records from the Montefiore Health System for over 910,000 patients found that COVID-19 infection is independently associated with a higher risk of OSA, regardless of whether the patient required hospitalization.
How does COVID-19 increase the risk of sleep apnea?
The research team identified that COVID-19 patients, both hospitalized and non-hospitalized, showed a higher likelihood of developing OSA compared to those who never tested positive. According to the data, adjusted hazard ratios for new-onset OSA stood at 1.41 for hospitalized COVID-19 patients and 1.33 for those who were not hospitalized. Experts hypothesize that this connection may stem from persistent systemic inflammation, autonomic dysregulation, and central nervous system involvement caused by the virus, which can disrupt normal respiratory patterns during sleep.
OSA is characterized by the repeated collapse of upper airways during sleep, leading to fragmented rest and hypoxia. When untreated, this condition is linked to long-term health risks including hypertension, stroke, and cognitive decline.
What are the secondary health risks after an OSA diagnosis?
The study suggests that an OSA diagnosis following a COVID-19 infection may serve as a precursor to other serious cardiovascular issues. Researchers used Poisson regression to evaluate secondary outcomes and found that hospitalized COVID-19 patients who later developed OSA faced a higher adjusted risk of heart failure and pulmonary hypertension. Conversely, the non-hospitalized group showed a statistically higher adjusted risk of obesity. These findings indicate that clinical monitoring should not stop at the initial COVID-19 recovery phase.
Which patient groups are at the highest risk?
Subgroup analyses revealed that the link between COVID-19 and OSA is not uniform across the population. According to the Scientific Reports study, the association between hospitalized COVID-19 and new-onset OSA was particularly strong among Black patients, individuals younger than 60, and those with a history of asthma. Among non-hospitalized patients, the risk was more pronounced in females, Hispanic patients, and those with significant pre-existing comorbidities. These findings suggest that clinicians should consider targeted screening for these specific demographics.
If you have a history of COVID-19 and experience persistent daytime fatigue or snoring, consult your primary care physician about a sleep study. Early detection of OSA allows for intervention strategies that can mitigate long-term cardiovascular damage.
Study limitations and methodological approach
The researchers, who utilized data from March 2020 through August 2024, acknowledged several limitations in their work. Because the study relied on ICD-10 diagnostic codes rather than uniform polysomnography (in-lab sleep studies), the results highlight an association rather than direct causation. Additionally, the study was limited to a single health system, meaning potential detection bias—where patients who recently had COVID-19 might be more likely to seek medical care—could influence the findings. Despite these limitations, the large sample size of 910,393 individuals provides a significant baseline for future respiratory health research.
Frequently Asked Questions
Can COVID-19 cause sleep apnea even if I wasn’t hospitalized?
Yes. The study found that even non-hospitalized individuals who tested positive for SARS-CoV-2 had a significantly higher risk of developing obstructive sleep apnea compared to those who never tested positive.
Does COVID-19 vaccination change the risk of OSA?
The researchers found no significant difference in the risk of incident OSA based on vaccination status within the studied cohorts.
What should I do if I suspect I have OSA?
If you notice symptoms such as loud snoring, gasping for air during sleep, or excessive daytime sleepiness, seek a referral for a diagnostic sleep assessment. Early diagnosis is key to preventing complications like heart failure or stroke.
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