Obstructive sleep apnea is frequent in patients with Long COVID fatigue but is not significantly associated with alterations of quality of life and cognition

Abstract Neurologic manifestations of Long COVID, also called post-acute sequelae of SARS-CoV-2 infection (PASC), include fatigue, cognitive dysfunction, sleep disturbances, and headaches, which can be debilitating. Since these symptoms overlap with those of obstructive sleep apnea (OSA), we sought to determine the prevalence of OSA in the population of a Neuro-COVID-19 clinic. We performed home sleep testing in 100 consecutive patients with Long COVID and no prior history of OSA who reported fatigue after an episode of COVID-19 not requiring hospitalization. The average age was 46.4 years and 70% of patients were female. OSA was present in 53% of patients, including 33% with mild OSA (apnea-hypopnea index (AHI) 5–14.9) and 20% with moderate to severe OSA (AHI ≥ 15). Male sex, higher age, and body mass index were significantly associated with OSA. However, there were no significant differences in other comorbidities, Long COVID symptom burden, quality of life measures (QoL), and objective cognitive function test results between groups. Additionally, multiple linear regression models demonstrated that neither AHI nor mean desaturation nadir were significant predictors of QoL or cognitive function. Although OSA is nearly twice as prevalent among our study participants compared to the general adult population of the US, it was not significantly associated with Long COVID symptoms, alteration of QoL, or objective cognitive dysfunction. However, 20% of patients were diagnosed with moderate to severe OSA, a clinically significant finding that warrants intervention to prevent irreversible cardiopulmonary complications.