Are you at increased risk of a serious coronavirus infection if you have obstructive sleep apnea? No one knows, although one day that information will be available. What do you do when placed in a situation with an unknown that can affect you drastically? What we always do; look for information and compare it with our previous similar experiences. Leaving our home for a day’s activity when the clouds are dark and rain is in the forecast, it is only smart to take along the umbrella or raincoat. The same is true for the coronavirus. We need to consider:
What do the experts tell us?
What is our experience with other infections?
Experts
The experts tell us coronavirus is a contagious respiratory infectious agent. It may cause life-threatening illness and it also may infect people without causing illness. The number infected is not known and the percent of life threatening illnesses is not established, but it is gradually appearing that it is a smaller percentage than was initially predicted.
What causes some to be very ill and even die? The picture is becoming clearer with time. The elderly, the chronically ill, the immunosuppressed and others with poor health are more likely to be severely ill. The death rate for those individuals is much higher than for the population in general. In some areas, over half of those who die with the illness are from these groups.
Are there others? Yes there are. We have heard the ‘news’ reports about them. Why in otherwise healthy individuals can the infection cause severe illnesses? Experts can only speculate on the subject. The possibilities include exposure to a heavy dose of the virus. A heavy dose is more likely to make someone severely ill than a lighter dose. The healthy person may have unrecognized underlying medical conditions. They may have an unrecognized deficiency in their ability to fight off this specific type of viral infection. For most of these unfortunate individuals, no one will be able to explain why.
We do know that heart disease, hypertension, diabetes and obesity are frequently cited as problems associated with dying from an infection with the coronavirus.
Experience
What does our experience tell us? A common experience most of us will have is with influenza. In fact, as time passes, coronavirus has begun to act like a severe influenza. Coronavirus is more contagious than influenza, but it is beginning to appear to have a similar mortality. There is no immunization available at present to prevent the illness and it is certainly best to avoid catching it.
Older individuals are familiar with other infectious agents. Some will remember polio, SARS, H1N1 (swine flu) and the early concerns about HIV. With knowledge and experience, we have learned to live with some of these problems, to treat some and to watch as others pass from importance. So it will be with the coronavirus.
Obstructive sleep apnea and coronavirus
What about you as an obstructive sleep apnea patient? You should listen to experts and rely on experience. As a specialist in sleep medicine, I would advise you that obstructive sleep apnea is an underlying medical condition that places you at increased risk of a more severe infection if you contract the coronavirus. In addition, many individuals with obstructive sleep apnea also have hypertension, diabetes and weight problems. Hypertension, diabetes and weight problems are known risk factors for severe coronavirus infections.
We know that patients with untreated sleep apnea have more respiratory infections. They develop problems with many chronic illnesses. These problems are related to the severity of their apnea. The number of obstructive breathing events per hour (the apnea hypoxia index) without treatment is a measure of the underlying severity. The more events recorded the more severe your apnea. It is a fact that patients successfully treated with CPAP have less respiratory infections and fewer complications from chronic illnesses.
I suspect these facts will prove to be the same for the coronavirus. Untreated significant apnea will prove to be a risk factor for developing severe coronavirus infection . However, successfully treated patients should have substantially less risk.
In summary
Having obstructive sleep apnea increases the risk of a severe coronavirus infection.
The risk will increase with the severity of the apnea.
Treatment of apnea will reduce the risk.
If you have apnea, consider yourself to be at increased risk for a coronavirus infection.