Cleveland Clinic Study Suggests Sleep Disorders Linked with More Severe Outcomes from COVID-19

Research shows 31 percent increased risk for hospitalization and mortality in patients with sleep-disordered breathing and sleep-related hypoxia

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A new Cleveland Clinic study found that people with certain sleep disorders have more severe outcomes from COVID-19, including a 31 percent higher rate of hospitalization and mortality.

The research team, led by Reena Mehra, M.D., analyzed retrospective data from 5,400 Cleveland Clinic patients. The findings, published in JAMA Network Open, showed that while patients with sleep-disordered breathing and sleep-related hypoxia do not have increased risk of developing COVID-19, they have a worse clinical prognosis from the disease.

“As the COVID-19 pandemic continues and the disease remains highly variable from patient to patient, it is critical to improve our ability to predict who will have more severe illness so that we can appropriately allocate resources,” said Dr. Mehra, director of Sleep Disorder Research at Cleveland Clinic. “This study improved our understanding of the association between sleep disorders and the risk for adverse COVID-19 outcomes. It suggests biomarkers of inflammation may mediate this relationship.”

Researchers used Cleveland Clinic’s COVID-19 research registry, which includes data from nearly 360,000 patients tested for COVID-19 at Cleveland Clinic, of which 5,400 had an available sleep study record. Sleep study findings and COVID-19 positivity were assessed along with disease severity. The team also accounted for co-morbidities such as obesity, heart and lung disease, cancer and smoking.

The findings set the stage for additional studies to identify whether early effective treatments such as PAP (positive airway pressure) or oxygen administration can improve COVID-19 outcomes.

“Our findings have significant implications as decreased hospitalizations and mortality could reduce the strain on healthcare systems,” said first author of the study Cinthya Pena Orbea, M.D, of Cleveland Clinic’s Sleep Disorders Center. “If indeed sleep-related hypoxia translates to worse COVID-19 outcomes, risk stratification strategies should be implemented to prioritize early allocation of COVID-19 therapy to this subgroup of patients.”

The study was funded by a Neuroscience Transformative Research Resource Development Award that was given to Dr. Mehra.

About Cleveland Clinic
Cleveland Clinic – now in its centennial year – is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 70,800 employees worldwide are more than 4,660 salaried physicians and researchers, and 18,500 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,500-bed health system that includes a 173-acre main campus near downtown Cleveland, 19 hospitals, more than 220 outpatient facilities, and locations in southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2020, there were 8.7 million total outpatient visits, 273,000 hospital admissions and observations, and 217,000 surgical cases throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries. Visit us at clevelandclinic.org. Follow us at twitter.com/ClevelandClinic. News and resources available at newsroom.clevelandclinic.org.

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