Coronavirus cases have risen in the UK and new risks for poor outcomes from COVID19 have been identified. People who have been diagnosed with obstructive sleep apnoea could be at increased risk of adverse outcomes from COVID-19 according to a new study from the University of Warwick.
The conclusion is drawn from a systematic review of studies that reported outcomes for COVID-19 patients that were also diagnosed with obstructive sleep apnoea.
Published in the journal Sleep Medicine Reviews, the review highlights the need to further investigate the impact of the virus on those with the sleep condition and to better identify those currently undiagnosed with it.
Obstructive sleep apnoea is a condition characterised 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.
Lead author of the study Dr Michelle Miller of Warwick Medical School said: “Without a clear picture of how many people have obstructive sleep apnoea it is difficult to determine exactly how many people with the condition may have experienced worse outcomes due to COVID-19.
“This condition is greatly underdiagnosed, and we don’t know whether undiagnosed sleep apnoea confers an even greater risk or not.
“It is likely that COVID-19 increases oxidative stress and inflammation and has effects on the bradykinin pathways, all of which are also affected in obstructive sleep apnoea patients. When you have individuals in which these mechanisms are already affected, it wouldn’t be surprising that COVID-19 affects them more strongly.”
Treatment for obstructive sleep apnoea with continuous positive airway pressure (CPAP) has been shown to have some beneficial effects on these mechanisms and it is important that treatment is optimised for these individuals. In the UK, the British Sleep Society with the OSA alliance has released guidelines with regards to the use of CPAP during the pandemic.
The researchers feel it is important that those diagnosed with obstructive sleep apnoea 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 transmission of virus increases.
Dr Miller adds: “This is a group of patients that should be more aware that obstructive sleep apnoea could be an additional risk if they get COVID-19. Make sure you are compliant with your treatment and take as many precautions as you can to reduce your risk, such as wearing a mask, social distancing and getting tested as soon as you notice any symptoms. Now more than ever is the time to follow your treatment plan as diligently as possible.
“Hospitals and doctors should also be recording whether their patients have obstructive sleep apnoea as a potential risk factor, and it should be included in studies and outcomes data for COVID-19. We need more data to determine whether this is something we should be more concerned about.”