Association of Obstructive Sleep Apnea with Post-Acute Sequelae of SARS-CoV-2 Infection

• Published in: The American journal of medicine Vol. 137; no. 6; pp. 529 - 537.e3
• Main Authors: Quan, Stuart F., Weaver, Matthew D., Czeisler, Mark É., Barger, Laura K., Booker, Lauren A., Howard, Mark E., Jackson, Melinda L., Lane, Rashon I., McDonald, Christine F., Ridgers, Anna, Robbins, Rebecca, Varma, Prerna, Wiley, Joshua F., Rajaratnam, Shantha M.W., Czeisler, Charles A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2024
• Subjects: Adult; Aged; COVID-19; COVID-19 - complications; COVID-19 - epidemiology; Cross-Sectional Studies; Female; Humans; Long COVID; Male; Middle Aged; Obstructive sleep apnea; PASC; Post-Acute COVID-19 Syndrome; Post-acute sequelae of SARS-CoV-2 infection; Prevalence; Risk Factors; SARS-CoV-2; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - epidemiology; United States - epidemiology; United States; COVID-19; PASC; Long COVID; Post-acute sequelae of SARS-CoV-2 infection; Obstructive sleep apnea
• ISSN: 0002-9343; 1555-7162; 1555-7162
• DOI: 10.1016/j.amjmed.2024.02.023

Obstructive sleep apnea is associated with COVID-19 infection. Less clear is whether obstructive sleep apnea is a risk factor for the development of post-acute sequelae of SARS-CoV-2 infection (PASC). Cross-sectional survey of a general population of 24,803 US adults to determine the association of obstructive sleep apnea with PASC. COVID-19 infection occurred in 10,324 (41.6%) participants. Prevalence of persistent (>3 months post infection) putative PASC-related physical and mental health symptoms ranged from 6.5% (peripheral edema) to 19.6% (nervous/anxious). In logistic regression models, obstructive sleep apnea was associated with all putative PASC-related symptoms with the highest adjusted odds ratios being fever (2.053) and nervous/anxious (1.939). In 4 logistic regression models of overall PASC derived from elastic net regression, obstructive sleep apnea was associated with PASC (range of adjusted odds ratios: 1.934-2.071); this association was mitigated in those with treated obstructive sleep apnea. In the best fitting overall model requiring ≥3 symptoms, PASC prevalence was 21.9%. In a general population sample, obstructive sleep apnea is associated with the development of PASC-related symptoms and a global definition of PASC. Treated obstructive sleep apnea mitigates the latter risk. The presence of 3 or more PASC symptoms may be useful in identifying cases and for future research.