ArticleSleep & breathing = Schlaf & Atmung2026
Obstructive sleep apnea, positive airway pressure therapy, and COVID-19 outcomes.
Article in Sleep & breathing = Schlaf & Atmung, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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15 authors.
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Abstract
purposeTo quantify the association between obstructive sleep apnea (OSA) and COVID-19 outcomes and test whether adherence to positive airway pressure (PAP) therapy modifies this relationship.
methodsThis retrospective cohort study compared groups with and without OSA, stratified by degrees of PAP adherence (February 1, 2020 to July 31, 2020) from an integrated healthcare system (Kaiser Permanente Southern California). Rates of COVID-19 infection and hospitalization were compared. Multivariable logistic regression estimated adjusted associations, controlling for demographic and clinical factors.
resultsAmong 78,317 patients analyzed, a pattern revealed increased COVID-19 infection rate in those with OSA and decreased with PAP therapy: No OSA 1.9%; Untreated OSA (PAP use < 2 h/night) 2.2%; Moderately-treated OSA (PAP use 2–3.9 h/night) 1.9%; Well-treated OSA (PAP use ≥ 4 h/night) 1.4% (P < 0.0001). In adjusted models (reference: untreated OSA), odds of infection were lower for patients without OSA (aOR 0.83, 95% CI 0.71–0.97), similar with moderately-treated (2.0–3.9 h/night; aOR 0.88, 95% CI 0.70–1.12), and lower with well-treated OSA (≥ 4 h/night; aOR 0.71, 95% CI 0.62–0.82). Compared with White patients, Black and Hispanic patients had higher odds of infection (aORs 1.46 [1.21–1.77] and 2.14 [1.89–2.43]) and hospitalization (2.02 [1.22–3.35] and 1.66 [1.12–2.46]), highlighting disparities. Neither OSA nor PAP use appeared to influence COVID-19 hospitalization rates, although overall incidences were small.
conclusionsOSA was associated with higher risk of COVID-19 infection, whereas greater PAP adherence was associated with lower risk, suggesting potential pathogenic effects of untreated OSA and protective effects of PAP.
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