As we approach the end of 2021, the world is still contending with how to stop the spread of COVID-19. Many of you may have even lost sleep over how the virus continues to impact your day-to-day life. This can be even worse if you normally experience a sleep disorder like insomnia or sleep apnea. But did you know that there’s a connection between COVID and sleep apnea?

Let me get this out of the way though— sleep apnea does not increase your risk of COVID-19 infection. But it does increase your risk of developing a more severe form of the virus, being hospitalized, and even dying from the disease. But why is this the case?

An interesting new study I’ve read dives into this, but before we examine that, let’s take a look at sleep apnea and its risks to your health, with or without COVID-19.

What is Sleep Apnea?

Sleep apnea is a serious sleep disorder characterized by intermittent pauses in breathing. Almost 1 billion people worldwide have sleep apnea, and up to 85 percent of those people are undiagnosed. There are three different types of sleep apnea:

  • Obstructive sleep apnea: The most common type of sleep apnea. Obstructive sleep apnea (OSA) occurs when your airways become partially or completely blocked while you sleep.
  • Central sleep apnea: Central sleep apnea occurs when your brain does not signal your respiratory system correctly while you sleep, causing pauses or stops in breathing during the night.
  • Complex sleep apnea: Complex sleep apnea is the least common form of sleep apnea, and occurs when you have both obstructive sleep apnea and central sleep apnea at the same time.

Any pauses in breathing while you sleep are a cause for concern, but if you have severe sleep apnea, you can experience more than 31 breathing interruptions per hour! Undiagnosed sleep apnea can be absolutely disastrous for your overall health, so it’s important to seek a proper diagnosis and treatment as soon as possible.

Symptoms of Sleep Apnea

It’s not always easy to tell if you’re showing symptoms of sleep apnea, especially if you can’t observe whether or not you’re experiencing the tell-tale pauses in breathing that sleep apnea patients have. Other sleep apnea symptoms to watch out for include:

  • Loud, obnoxious snoring
  • A sore throat or dry mouth in the morning— as a result of breathing through your mouth
  • Waking up gasping, coughing, or choking
  • Morning headaches
  • Feeling tired during the day despite getting a full night’s sleep
  • Waking up at least once during the night
  • Difficulty falling or staying asleep
  • Waking up too early in the morning

People with untreated sleep apnea are at much higher risk for developing or exacerbating health problems including:

A good night’s sleep is key to a healthy immune system, and poor sleep can make you more likely to get sick. Unfortunately nowadays, many feel that they have much more to worry about than catching the common cold.

New Study: Sleep Disordered Breathing Can Increase Risk of Severe COVID-19 Outcome

A recent study published by JAMA Network Open has found that sleep-disordered breathing including sleep apnea and sleep-related hypoxia— low oxygen levels while you sleep— can put you at increased risk of severe COVID-19 infection, hospitalization, and even death from the virus.

The study observed nearly 360,000 patients tested for COVID-19 in the Cleveland Clinic system, 5400 of whom had completed a sleep study. In the patients who tested positive for the virus, reduced baseline oxygen levels during sleep were associated with a 31 percent higher risk of hospitalization and COVID-19 mortality, even after considering other health factors including obesity, lung disease, heart disease, and cancer.

Researchers aren’t sure why sleep-disordered breathing increases the risk of more severe COVID-19 outcomes, but they believe that inflammation may be a major factor. Hypoxia increases inflammation throughout the body and promotes viral replication. It also promotes elevated inflammatory markers like increased white blood cell counts. As a result, the lack of oxygen caused by sleep-disordered breathing may amplify the severity of infection if you get sick.

To be clear, sleep apnea or sleep-disordered breathing does not make you more likely to contract COVID-19— but it does make you more likely to experience more severe illness if you do contract the virus.

How To Prevent Potential Health Problems with Better Sleep

While we’re all working on getting through the COVID-19 pandemic together, there are a few things you can do to make sure that poor sleep or sleep apnea don’t put you at risk for future health complications. Check out 3 of my suggestions below.

1. Prioritize Healthy Sleep

Even if you’re one of the healthiest people out there, getting the rest you need each night is one of the best things you can do for your immune system. There are a few simple steps you can make to ensure a good night’s sleep every night:

  • Follow a consistent bedtime and wake-up time each day, even on the weekends
  • Avoid caffeine, alcohol, and large meals at least a few hours before bedtime
  • Avoid using electronic devices like your phone or tablet 60 to 90 minutes before bed
  • Allow yourself plenty of time during the evenings to finish you day’s tasks, as well as time to relax before bed

For more information about how to sleep during the COVID-19 pandemic, check out my guide on the subject.

2. Get Tested for Sleep Disorders

You can’t treat a sleep disorder if you don’t know you have one. If you experience any of the symptoms outlined above, or if your bed partner or family member notices you stop breathing during the night, it’s a good idea to talk to your doctor or an accredited sleep expert for an evaluation.

If you’re not sure where to find accredited sleep experts near you, check out this tool by the American Academy of Sleep Medicine.

3. If You Have Sleep Apnea, Follow Your Prescribed Treatment

If you’ve already been diagnosed with sleep apnea, sticking to your treatment is crucial to sleeping better, feeling more rested during the day, and boosting your immunity. CPAP, or continuous positive airway pressure, is the most popular and effective treatment for sleep apnea available, but it only works as long as you use it as directed. Other treatments for sleep apnea are available if you struggle with CPAP therapy— contact your doctor or a sleep expert to explore your options if you feel that CPAP is not the best treatment for you.

The pandemic may not be going away any time soon, but there’s lots you can do to reduce your risk of contracting COVID-19, including getting a good night’s sleep. This is especially important if you or a loved one experience sleep-disordered breathing or sleep apnea— taking proper steps for healthy sleep can significantly boost your immunity and reduce your risk of severe infection.

Sweet Dreams,

Michael J. Breus, PhD, FAASM

The Sleep Doctor