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People With Sleep Disorders At Higher Risk Of COVID-19 Hospitalization, Death

Although people with sleep disorders are as likely as other adults to get infected with COVID-19, they have a higher risk of being hospitalized or dying from the illness, revealed a new study.

Published in JAMA Network Open, the study suggested that if a patient with sleep apnea or other sleep disorders develop COVID-19 infection, then they should be prioritized to receive anti-COVID therapies in case of short supply of resources.

For the study, Pena Orbea, assistant professor of medicine at the Cleveland Clinic Lerner College of Medicine, and her team looked at nearly 360,000 patients tested for COVID-19 at the Cleveland Clinic system. They found that people with sleep disorders have 31% increased risk of getting severe COVID-19 or dying from the disease, after accounting for other factors such as obesity, heart and lung disease, cancer, and smoking.

The study has helped identify another group at potential risk for worse outcomes from COVID-19, which may help medical staff put assets and resources where needed, noted senior study author Reena Mehra, MD, director of sleep disorder research at the Cleveland Clinic.

Sleep disorders and COVID-19 infection

Why people with sleep disorders are more likely to develop severe COVID-19 than other adults? The exact mechanism behind it remains unknown, but inflammation may play a role, Mehra stated in a press release.

Indira Gurubhagavatula, chair of the American Academy of Sleep Medicine's COVID-19 Task Force, also supported this theory. She stated that sleep apnea itself causes increased inflammation, and severe COVID-19 infection is also linked with cytokine storm, which is an overwhelming inflammatory load that leads to injury to organs, including lung tissue.

Pena Orbea and colleagues plan to continue their study to understand better how sleep disorders could raise the risk of severe COVID-19, as well as how to help patients with sleep disorders limit their risk of developing worse outcomes from COVID-19.

Do you have obstructive sleep apnea? Here's how to find out

In obstructive sleep apnea (OSA), breathing repeatedly stops for 10 seconds or more during sleep. The disorder results in less oxygen in the blood which can lead to chronic health disorders like diabetes, hypertension, MI (myocardial infarction), stroke, obesity etc.

Loud and chronic snoring is the most common symptom of OSA. Other symptoms include excessive daytime sleepiness, choking or gasping during sleep, lack of concentration, restless sleep, and headache in the morning.

Excess weight or obesity is identified as the most common cause of obstructive sleep apnea in adults. Most OSA patients are found to be either overweight (BMI of 25-29.9) or obese (BMI of 30.0 or above). Having a narrow throat, a round head, hypothyroidism , deviated septum, and smoking are some other factors that may increase risk for OSA.

Screening For OSAS

STOP-Bang Questionnaire is a widely used screening method for OSA.

  • Do you snore loudly?

  • Do you feel tired, sleepy, fatigued the entire day?

  • Has anybody observed you stop breathing (Obstruction) during sleep?

  • Do you have high blood pressure?

  • Is your BMI (body mass index) more than 35 Kg/m2?

  • Are you over the age of 50?

  • A neck circumference greater than 40 cm

  • Gender Are you a male?

Yes to 0 to 2 questions indicates low risk of OSA while 'Yes' to 3 to 4 questions means intermediate risk of OSA. You have high risk of OSA if have ticked yes to 5 to 8 questions.

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