COVID-19 patients with this sleep problem may have worse outcomes

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In a new study, researchers found people who have been diagnosed with obstructive sleep apnea could be at increased risk of adverse outcomes from COVID-19.

The conclusion is drawn from a systematic review of studies that reported outcomes for COVID-19 patients that were also diagnosed with obstructive sleep apnea.

The study highlights the need to further examine the impact of the virus on those with the sleep condition and to better identify those currently undiagnosed with it.

The research was conducted by a team from the University of Warwick.

Obstructive sleep apnea is a condition characterized by complete or partial blockage of the airways during sleep when the muscles there become weaker.

It is commonly diagnosed in people who snore or appear to stop breathing or make choking sounds during sleep, and those who are obese in particular are more likely to experience it.

If you are told that you make strange noises when you sleep or seem to stop breathing during sleep, you should speak to their GP about being referred to a sleep service to be checked for the condition.

Many of the risk factors and comorbidities associated with sleep apnea, such as diabetes, obesity and high blood pressure, are similar to those associated with poor COVID-19 outcomes.

However, the researchers wanted to test whether being diagnosed with obstructive sleep apnea conferred an additional risk on top of those factors.

Their review looked at eighteen studies up to June 2020 with regards to obstructive sleep apnea and COVID-19, of these eight were mainly related to the risk of death from COVID-19, and ten were related to diagnosis, treatment, and management of sleep apnea.

Although few studies of obstructive sleep apnea in COVID-19 had been performed at the time, there is evidence to suggest that many patients who presented to intensive care had obstructive sleep apnea and in diabetic patients, it may confer an increased risk that is independent of other risk factors.

In one large study in patients that had diabetes, who were hospitalized for COVID-19, those being treated for obstructive sleep apnea were at 2.8 times greater risk of dying on the seventh day after hospital admission.

Researchers believe that in the UK up to 85% of obstructive sleep apnea disorders are undetected, suggesting that the 1.5 million people in the UK currently diagnosed with the condition may be just the tip of the iceberg.

With obesity rates and other related risk factors on the increase, the researchers also believe that rates of obstructive sleep apnea are also increasing.

The review highlights that the pandemic has also had worldwide effects on the ongoing diagnosis, management, and treatment of patients with this and other sleep conditions.

Moving forward it may be necessary to explore new diagnoses and treatment pathways for these people.

Treatment for obstructive sleep apnea with continuous positive airway pressure (CPAP) has been shown to have some beneficial effects on these mechanisms and it is important that treatment is optimized for these people.

The researchers feel it is important that those diagnosed with obstructive sleep apnea are aware of the potential additional risk and are taking appropriate precautions to reduce their exposure to the virus.

Further research is required to determine whether these individuals need to be added to the list of vulnerable groups that may need to shield if the transmission of the virus increases.

One author of the study is Dr. Michelle Miller of Warwick Medical School.

The study is published in the journal Sleep Medicine Reviews.

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