Undiagnosed obstructive sleep apnea syndrome as a treatable cause of new‐onset sleepiness in some post‐COVID patients

• Published in: European journal of neurology Vol. 31; no. 3; pp. e16159 - n/a
• Main Authors: Menzler, Katja, Mayr, Petra, Knake, Susanne, Cassel, Werner, Viniol, Christian, Reitz, Lena, Tsalouchidou, Panagiota‐Eleni, Janzen, Annette, Anschuetz, Katja, Mross, Peter, Koehler, Ulrich
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.03.2024
• Subjects: Apnea; Body mass; Body mass index; Body size; Complications; COVID-19; COVID-19 - complications; Daytime; Disorders of Excessive Somnolence - complications; Disorders of Excessive Somnolence - etiology; Fatigue; Fatigue - complications; Humans; long COVID; OSAS; Patients; polysomnography; post COVID; Risk factors; RNA, Viral; SARS-CoV-2; Signs and symptoms; Sleep and wakefulness; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnosis; Sleep disorders; Sleepiness; United States; Viral diseases; United States; fatigue; long COVID; OSAS; polysomnography; post COVID
• ISSN: 1351-5101; 1468-1331; 1468-1331
• DOI: 10.1111/ene.16159

Background and purpose Infection with COVID‐19 can lead to persistent sequelae, such as fatigue, daytime sleepiness or disturbed sleep, that can remain for more than 12 weeks and that are summarized as post‐COVID syndrome. The causes remain unclear. The present study investigated the presence of sleep disorders in patients with post‐COVID syndrome using polysomnography. Methods Thirty‐four patients with post‐COVID syndrome and new‐onset fatigue and sleepiness after a SARS‐CoV2 infection underwent polysomnography in accordance with American Association of Sleep Medicine (AASM) standards as part of their clinical workup. Analysis was performed visually based on AASM criteria (scoring manual version 2.6, 2020). Results Polysomnography revealed a sleep efficiency of <80% in 50% of patients and a mean respiratory disturbance index (RDI) of 9.9 ± 15.4/h. Excluding central apneas, 12 patients (35%) had an RDI of ≥5/h, pointing to obstructive sleep apnea syndrome (OSAS; AASM 2014). Patients with a high RDI were significantly older (p = 0.01) and showed a trend towards a higher body mass index (p = 0.08) than patients with a normal RDI but had no other risk factors for OSAS. Six patients agreed to long‐term treatment of their OSAS and all reported discontinuation of daytime symptoms. Conclusions Post‐COVID symptoms such as daytime sleepiness, fatigue and memory and concentration problems may in part be a result of reduced sleep efficiency and sleep apnea in a relevant percentage of patients. This possibly treatable cause of the symptoms should be kept in mind in patients presenting with post‐COVID syndrome.