Patients hospitalized with a positive COVID-19 test had a 41% higher risk of new-onset obstructive sleep apnea (OSA) compared with uninfected patients, according to a retrospective study of over 910,000 individuals conducted by researchers at Albert Einstein College of Medicine. The study, which followed patients for up to 4.5 years post-infection, revealed elevated OSA risk for both severe and non-severe COVID-19 cases.
The research, utilizing data from Montefiore Health System in the Bronx between March 2020 and August 2024, indicated that hospitalized COVID-19 patients were 41% more likely to receive an OSA diagnosis than those who remained uninfected. Non-hospitalized patients with COVID-19 also demonstrated a 33% increased risk. OSA, characterized by repeated upper-airway collapse during sleep and intermittent low oxygen levels, affects an estimated 10% to 30% of adults globally and is linked to cardiovascular, metabolic, and cognitive diseases.
The association between COVID-19 and new-onset OSA appeared stronger in specific demographic groups. The risk was more pronounced among women, Hispanic patients, and individuals with pre-existing major underlying illnesses, according to the study published on the preprint server medRxiv. Notably, vaccination status did not appear to influence the risk, with both vaccinated and unvaccinated patients exhibiting similar rates of new-onset OSA.
Researchers posited that factors associated with COVID-19 hospitalization – including prolonged immobilization, corticosteroid use, and weight gain – could contribute to OSA development. They also suggested that post-acute sequelae of COVID-19, often referred to as “long COVID,” may impair respiratory function and sleep architecture, potentially triggering OSA even in those who were not hospitalized.
A separate study, published in the Journal of Sleep Research in 2024, examined the impact of a COVID-19 diagnosis on a patient’s risk for OSA, specifically focusing on patients screened by a hospital sleep medicine team. Another study, published in Frontiers in Medicine in March 2025, analyzed data from the US Nationwide Inpatient Sample 2020 and found that hospitalized COVID-19 patients with OSA had higher odds of respiratory failure, heart failure, and arrhythmias. However, the same study indicated that OSA was associated with lower odds of cerebrovascular accidents and reduced in-hospital mortality among patients aged 70 or older and among males.
The Einstein College of Medicine study also found that, after an OSA diagnosis, hospitalized COVID-19 patients exhibited a statistically significant higher risk of heart failure (hazard ratio of 2.33) and pulmonary hypertension. The researchers have not yet released findings regarding potential long-term interventions or preventative measures.
