COVID-19 patients with sleep disorders at higher risk: study

TORONTO – A new study suggests that people with specific sleep disorders may be at risk for more serious outcomes if they contract COVID-19, with a 31% higher hospitalization and death rate.

The study, conducted by the Cleveland Clinic and published in JAMA Networks Open, examined data from approximately 5,400 patients at the clinic.

They found that even though people with sleep disorders do not contract COVID-19 at higher rates than others, they have worse outcomes if they do catch the virus.

“As the COVID-19 pandemic continues and disease remains highly variable from patient to patient, it is critical to improve our ability to predict who will have the most severe disease so that we can allocate the resources appropriately, ”Dr Mehra, Director of Sleep. Disorder Research At The Cleveland Clinic, said in a press release. “This study has improved our understanding of the association between sleep disturbances and the risk of adverse outcomes from COVID-19. It suggests that biomarkers of inflammation may mediate this relationship.”

Researchers looked at the clinic’s database of patients who had been tested for COVID-19, focusing on the 5,400 patients for whom the clinic also had sleep data.

The study pointed out that there is “a strong overlap between sleep breathing disorders (SDB) […] and co-morbidities associated with the severity of COVID-19 ”, but that while SDB has been correlated in observational studies with a higher risk of poor COVID-19 outcomes, sleep disturbances themselves have not not targeted for a COVID-19 study.

SDB is a generalized term that encompasses different breathing difficulties that a person may have while sleeping, including things like sleep apnea.

The researchers looked at patients who had different measures of SDB, as well as patients who suffered from sleep-related hypoxia – that is, when there was not enough oxygen supply to sustain your fabrics.

Of the 5,400 patients with sleep data, 1,935, or 35%, had tested positive for COVID-19 at some point. Fifty percent of them, or 1,018 patients, had SDB.

“Sleep-related hypoxia measurements were significantly associated with increased clinical outcomes designated by the WHO on the COVID-19 ordinal scale, even after adjusting for patient characteristics, BMI, comorbidities, smoking history and health system site, ”the study says.

People with sleep-related hypoxia had a 31% higher risk of hospitalization and death.

“Our results suggest that baseline sleep-related hypoxia is associated with the progression of hypoxic insult and hypoxia-related injury in the pathophysiology of COVID-19, thus serving as an amplifier,” said the study.

The study added that there are probably multiple reasons for this, as hypoxia can affect all tissues in the body to varying degrees in different patients, leading to different outcomes.

Researchers say more studies should be done to determine whether early treatments such as PAP (positive airway pressure) or administration of oxygen could improve outcomes of COVID-19 in these patients.

“Our results have important implications, because a decrease in hospitalizations and mortality could reduce the strain on health systems,” said Cinthya Pena Orbea, MD, of the Sleep Disorders Center at the Cleveland Clinic and first author of the study, in the press release.

“If indeed sleep-related hypoxia results in worse COVID-19 outcomes, risk stratification strategies should be implemented to prioritize early assignment of COVID-19 therapy to this subgroup of patients. ”