Some research indicates that sleep apnea is linked to a higher risk of getting COVID-19. Additionally, some sleep apnea risk factors are also risk factors for severe COVID-19 disease.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on the COVID-19 pandemic.

The above information comes from a 2022 study published in Cardiovascular Diabetology. It is important to note that the study only included participants with type 2 diabetes.

Further, obstructive sleep apnea (OSA) may be a risk factor for severe COVID-19. Older adults, people with diabetes, and those with a higher body mass index (BMI) are more likely to develop sleep apnea. These individuals are also more vulnerable to severe COVID-19 disease.

Therefore, sleep apnea correlates with a higher risk of severe COVID-19. People with sleep apnea may be able to lower their risk by treating the condition, managing risk factors, and getting vaccinated.

Read more to learn about the link between COVID-19 and sleep apnea, potential complications, and more.

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Having sleep apnea may make a person more likely to develop a severe infection if they contract COVID-19. It can also increase their risk of complications. And contracting COVID-19 may worsen a person’s sleep apnea.

Increased risk of severe COVID-19

A 2021 study looked at participants with COVID-19, and 8.5% had OSA. Of those with sleep apnea, 20.9% were hospitalized — a higher hospitalization rate than that of the general population.

Even when researchers controlled for health risk factors associated with OSA, sleep apnea remained an independent risk factor for hospitalization. People with OSA were at a higher risk of being hospitalized for COVID-19 regardless of their age, sex, BMI, or pre-existing conditions.

Although that study did not conclude that people with sleep apnea were more likely to get SARS-CoV-2, another 2021 study did.

Worse sleep apnea

Some people with sleep apnea may find that their symptoms worsen when they have a COVID-19 infection. It may cause inflammation in the airway, making breathing at night more difficult.

Additionally, people with mild OSA may be more likely to get long COVID. A 2021 case study details the experience of two people — one male and one female — who developed daytime fatigue following a COVID-19 infection. This indicates that having COVID-19 may uncover existing sleep apnea.

People with sleep apnea have a higher risk of severe COVID-19 for two reasons.

First, medical conditions that elevate the risk of severe COVID-19 are more common among people with sleep apnea. People with sleep apnea are more likely to be older, have diabetes, or have a high BMI.

Sleep apnea may also be an independent risk factor for severe COVID disease.

The previously mentioned 2021 study included 445 people with COVID-19 and followed 38 (8.5%) with obstructive sleep apnea. Almost half of those with sleep apnea were hospitalized. Many people with OSA had comorbidities elevating the risk of severe disease, but hospitalization and severe disease rates remained high even when researchers controlled for these risk factors.

Another 2021 study suggests that low oxygen when sleeping may account for the higher risk among people with OSA. There was a higher rate of severe COVID-19 among people whose blood oxygen levels were lower than 90% for longer periods at night.

Overall, there was a 31% higher risk of hospitalization and mortality.

The COVID-19 outlook for people with sleep apnea is worse than for people without sleep apnea. OSA is a risk factor for dying of heart-related health issues, and it is also a risk factor for severe COVID-19 illness.

A 2020 study found that even after controlling for risk factors associated with severe COVID-19 disease, people with sleep apnea were more likely to:

  • be hospitalized
  • need a ventilator
  • be admitted to the intensive care unit (ICU)

This suggests a poorer outlook for people with sleep apnea, but it does not predict the outcome for any individual.

It is important to note that this study was conducted in 2020, before vaccines and before most COVID-19 treatments became available. As of 2022, vaccines and treatments are more widely available, so the overall outlook is likely better.

People with OSA can also improve their outlook by treating their sleep apnea. A 2021 study found that nighttime CPAP usage correlates with a lower risk of contracting COVID-19 among people with OSA.

Learn more about treatments for sleep apnea.

People with COVID-19 who have OSA should contact a doctor if they have symptoms.

A person should also contact a doctor if they:

  • develop trouble breathing
  • need guidance about when it is safe to return to work
  • are not currently treating their OSA

A person should go to the emergency room if they:

  • have chest pain
  • feel unable to stay awake
  • experience their lips, tongue, toes, or fingers turning blue
  • feel confused or disoriented

People with risk factors for severe COVID-19 are eligible for certain treatments, including the drug Paxlovid, remdesevir, and monoclonal antibodies. Treatment is generally more effective if a person begins it early in the disease course.

Sleep apnea correlates with several medical conditions that elevate the risk of severe COVID-19 disease. It may also be an independent risk factor for severe disease, hospitalization, and death.

Although researchers have not thoroughly studied this, preliminary research suggests that low blood oxygen might be a factor that increases inflammation and elevates COVID-19 risk. People with OSA should treat their condition or ask a doctor about using a CPAP machine.