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REM - predominant obstructive sleep apnea in adults with a history of COVID-19 infection : A case-control study

Calik, Ipek and Peker, Yüksel LU (2025) In Sleep Medicine 139.
Abstract

STUDY OBJECTIVES: An association between COVID-19 and obstructive sleep apnea (OSA) has been reported in literature. We aimed to address the occurrence and phenotypes of OSA in adults with a history of COVID-19 infection and its possible association with long-COVID.

METHODS: In this matched case-control study, 152 individuals with a history of COVID-19 and 152 without were evaluated in a sleep laboratory. Groups were matched for age, sex, and body mass index. OSA was defined as an apnea-hypopnea index (AHI) ≥15/h. Rapid Eye Movement (REM)-predominant OSA was defined as AHI ≥15/h and REM-AHI/non-REM-AHI ≥2. Fatigue, reported as "frequent/very frequent," was used as a surrogate marker of long-COVID.

RESULTS: The prevalence of... (More)

STUDY OBJECTIVES: An association between COVID-19 and obstructive sleep apnea (OSA) has been reported in literature. We aimed to address the occurrence and phenotypes of OSA in adults with a history of COVID-19 infection and its possible association with long-COVID.

METHODS: In this matched case-control study, 152 individuals with a history of COVID-19 and 152 without were evaluated in a sleep laboratory. Groups were matched for age, sex, and body mass index. OSA was defined as an apnea-hypopnea index (AHI) ≥15/h. Rapid Eye Movement (REM)-predominant OSA was defined as AHI ≥15/h and REM-AHI/non-REM-AHI ≥2. Fatigue, reported as "frequent/very frequent," was used as a surrogate marker of long-COVID.

RESULTS: The prevalence of OSA was significantly lower in the case group (50.0 %) compared to the control group (77.6 %) (p < 0.001). However, 36 cases (47.4 %) exhibited REM-predominant OSA while 21 controls (17.8 %) demonstrated this phenotype (p < 0.001). In a multiple logistic regression analysis, there was a significant correlation between prior COVID-19 infection and the occurrence of REM-predominant OSA (Odds ratio [OR] 3.14; 95 % confidence interval [CI] 1.89-5.25; p < 0.001). Fatigue was observed in 52.8 % of patients with REM-predominant OSA and 35.7 % of patients without REM-predominant OSA (p = 0.033). In the entire cohort, the factors determining the fatigue were female sex (OR 2.02; 95 % CI 1.12-3.64, p = 0.019) and REM-predominant OSA (OR 2.18; 95 % CI 1.29-3.69; p = 0.004).

CONCLUSIONS: REM-predominant OSA is highly prevalent among individuals with prior COVID-19 infection and is significantly associated with fatigue, underscoring the need to recognize this phenotype in the evaluation and management of Long-COVID.

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author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Sleep Medicine
volume
139
article number
108729
publisher
Elsevier
external identifiers
  • pmid:41411839
ISSN
1878-5506
DOI
10.1016/j.sleep.2025.108729
language
English
LU publication?
yes
additional info
Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.
id
a0553852-14d7-46bf-ba56-d9630cb060cd
date added to LUP
2025-12-19 08:43:59
date last changed
2025-12-19 08:43:59
@article{a0553852-14d7-46bf-ba56-d9630cb060cd,
  abstract     = {{<p>STUDY OBJECTIVES: An association between COVID-19 and obstructive sleep apnea (OSA) has been reported in literature. We aimed to address the occurrence and phenotypes of OSA in adults with a history of COVID-19 infection and its possible association with long-COVID.</p><p>METHODS: In this matched case-control study, 152 individuals with a history of COVID-19 and 152 without were evaluated in a sleep laboratory. Groups were matched for age, sex, and body mass index. OSA was defined as an apnea-hypopnea index (AHI) ≥15/h. Rapid Eye Movement (REM)-predominant OSA was defined as AHI ≥15/h and REM-AHI/non-REM-AHI ≥2. Fatigue, reported as "frequent/very frequent," was used as a surrogate marker of long-COVID.</p><p>RESULTS: The prevalence of OSA was significantly lower in the case group (50.0 %) compared to the control group (77.6 %) (p &lt; 0.001). However, 36 cases (47.4 %) exhibited REM-predominant OSA while 21 controls (17.8 %) demonstrated this phenotype (p &lt; 0.001). In a multiple logistic regression analysis, there was a significant correlation between prior COVID-19 infection and the occurrence of REM-predominant OSA (Odds ratio [OR] 3.14; 95 % confidence interval [CI] 1.89-5.25; p &lt; 0.001). Fatigue was observed in 52.8 % of patients with REM-predominant OSA and 35.7 % of patients without REM-predominant OSA (p = 0.033). In the entire cohort, the factors determining the fatigue were female sex (OR 2.02; 95 % CI 1.12-3.64, p = 0.019) and REM-predominant OSA (OR 2.18; 95 % CI 1.29-3.69; p = 0.004).</p><p>CONCLUSIONS: REM-predominant OSA is highly prevalent among individuals with prior COVID-19 infection and is significantly associated with fatigue, underscoring the need to recognize this phenotype in the evaluation and management of Long-COVID.</p>}},
  author       = {{Calik, Ipek and Peker, Yüksel}},
  issn         = {{1878-5506}},
  language     = {{eng}},
  month        = {{12}},
  publisher    = {{Elsevier}},
  series       = {{Sleep Medicine}},
  title        = {{REM - predominant obstructive sleep apnea in adults with a history of COVID-19 infection : A case-control study}},
  url          = {{http://dx.doi.org/10.1016/j.sleep.2025.108729}},
  doi          = {{10.1016/j.sleep.2025.108729}},
  volume       = {{139}},
  year         = {{2025}},
}