Sleep disorders, including obstructive sleep apnea (OSA) and insomnia, are common in patients hospitalized for COVID-19, but these disorders do not appear to contribute to mortality or severe outcomes associated with the novel coronavirus, according to study results published in the Journal of Clinical Sleep Medicine.
The study included 572 adult patients who were hospitalized for COVID-19 within the University of Michigan hospital system. Study researchers evaluated electronic medical records to identify the prevalence of sleep disorders. Diagnostic sleep studies, performed in 13% of the study population, were either performed in a laboratory or outside the center using type 3 portable monitoring devices.
The study researchers conducted an analysis to evaluate the association of sleep disorders with mechanical ventilation requirements, the need for vasopressor treatment, and death.
Approximately 19.8% (n=113) of the 572 patients hospitalized for COVID-19 had OSA. Only 0.7% (n=4) of the overall cohort had central sleep apnea, while 11.0% (n=63) had insomnia. Findings indicated hypoventilation in 0.9% (n=5) of hospitalized patients, and restless legs syndrome or periodic limb movements disorder (RLS/PLMD) in 3.9% (n=22) of patients.
While the overall prevalence of sleep disorders in the study population was high, the study researchers found no significant association between specific sleep disorder diagnoses or indices of sleep disordered breathing with disease severity and outcomes in an analysis adjusted for age, sex, body mass index, and race.
The presence of OSA and insomnia was associated with increased odds of death (OR, 1.83; 95% CI, 0.89-3.75) and need for vasopressors (OR, 1.86; 95% CI, 0.98-3.56). There was no significant association between the presence of OSA, insomnia, or RLS/PLMD and mechanical ventilation utilization, vasopressor requirement, length of stay, or death.
Limitations of this study included the reliance on diagnostic codes for identifying sleep disorders and the lack of available data on treatments used for sleep disorders in the cohort.
The study researchers concluded that “sleep disorders may be relevant for long-term cardiac outcomes given their contribution to cardiovascular health” in patients with COVID-19, but it “remains an open question if new sleep disorders will be long-term sequelae in those who recover from severe COVID-19.”
Goldstein CA, Rizvydeen M, Conroy DA, et al. The prevalence and impact of pre-existing sleep disorder diagnoses and objective sleep parameters in patients hospitalized for COVID-19. J Clin Sleep Med. Published online February 9, 2021. doi:10.5664/jcsm.9132