Sleep Apnea Is Prevalent After Intensive Care Unit Stay for COVID-19 Pneumonia

At 3 months after an ICU stay for COVID-19 pneumonia, 91% of patients studied had sleep apnea, with most experiencing obstructive events.

Those who recovered from SARS-CoV-2 pneumonia in the intensive care unit (ICU) have a high prevalence of sleep apnea (SA) 3 months after their ICU stay, according to study findings published in the journal Nature and Science of Sleep.

Using data collected in a French single-center observational cohort study (COV-RECUP; identifier: NCT04519320), investigators assessed 68 patients who had recovered from COVID-19-related pneumonia 3 months after leaving the ICU to determine the prevalence of SA as well as variations in patients’ apnea-hypopnea index (AHI). Among study participants, 91% (62 of 68) had known comorbidities (hypertension in 34, obesity in 21, dyslipidemia in 20, and type 2 diabetes in 16) and 19.1% (13 of 68) has preexisting SA.

In this study, a prospective cohort of patients in the ICU for severe COVID-19 infection took part in a comprehensive follow-up program 3 months after the onset of their symptoms. Follow-up included home polygraphy as well as pulmonary function tests, 6-minute walk tests, and chest computed tomography (CT) scans. Patients with an AHI of 5 or greater were classified as having SA.

The investigators found that at 3 months, 91% (62 of 68) of participants had SA, with 85.5% of these individuals experiencing obstructive events. No SA or mild SA (AHI of <15) was observed in 24 participants, and 44 patients reported moderate to severe SA (AHI of ≥15). The presence of ischemic heart disease affected those in the moderate to severe SA arm exclusively. Notably, the investigators found that symptoms of COVID-19 had been mostly more severe in the participants with moderate to severe SA, who had required a longer curarization, more prone positioning sessions, and more frequent administration of tracheostomy.

Our study highlights the high prevalence of SA three months after an ICU stay for COVID-19, which deserves systemic screening.

Several limitations of the present study should be noted. The results might have had more power if study recruitment was of a larger population from several different centers, along with the use of a centralized, double-blind interpretation of the polygraphy findings. Additionally, there was no long-term follow-up of sleep disturbances identified in the study.

“Our study highlights the high prevalence of SA three months after an ICU stay for COVID-19, which deserves systemic screening,” study authors concluded. However, they added, “SA shares common risk factors with severe COVID-19 infection, but is underdiagnosed, and therefore might have only been diagnosed after hospitalization for COVID-19.” The researchers further noted that the high frequency of SA might be partly attributable to mechanical ventilation and/or neuromuscular blocking agents received in the ICU.

Disclosure: Some of the study authors have declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Traore I, Eberst G, Claudé F, et al. Prevalence and characteristics of sleep apnea in intensive care unit survivors after SARS-CoV-2 pneumonia. Nat Sci Sleep. 2022;14:2213-2225. doi:10.2147/NSS.S377946