SLEEP 2026 | Higher CPAP adherence linked to lower risk of COVID-19 infection in individuals with OSA

During the COVID pandemic, we utilized our large data set from Kaiser Permanente Southern California to evaluate a number of different outcomes, one of which was COVID-19 outcomes. And so we did a retrospective cohort study in which we took our cohort of patients who were tested for obstructive sleep apnea. So some patients, a minority of patients did not have OSA, but the majority of our patients did have OSA, and we were able to stratify their severity. The other thing that we were able to stratify was their CPAP adherence during the exposure period. So we were able to organize patients into those that had low adherence, medium adherence, and high adherence. And so through a combination of being able to, a combination of looking at sleep apnea severity, as well as CPAP adherence, we were able to take a look at the relationship between those components, those factors with COVID-19 infection rate. And what we found is that patients with high adherence had lower rates of developing COVID-19, and those with lower adherence had higher rates of developing COVID-19. And so this is a retrospective study. We’re not able to determine causality, but it did support our notion that CPAP therapy could be protective, the mechanism of which is still a little bit unsure. But through this study and the results that we were able to glean from it, it did help guide management in that our patients with obstructive sleep apnea, we very much did promote and encourage them to use CPAP during the pandemic period. And whether this actually translates into a reduced infection rate of other types of respiratory infections such as influenza remains unknown. But based on the results of our study, we feel like it’s encouraging.

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