Sleep medicine and Coronavirus disease 2019

From the early stages of the COVID-19 pandemic, a potential interaction between COVID-19 and sleep disorders became apparent. Several risk factors for severe COVID-19 illness (e.g., age, obesity, male gender, cardiometabolic disease) were shared with obstructive sleep apnea (OSA), and subsequent data suggested that an OSA diagnosis was associated with increased risk of infection and worse outcomes with COVID-19. COVID-19 has also had a hugely disruptive effect on sleep medicine services, forcing the adoption of novel care strategies focused on remote care and telehealth. Sleep disorders may also be relevant to the care of people with long COVID, many of whom will experience poor quality nocturnal sleep alongside daytime fatigue and tiredness. This review will discuss how COVID-19 interacts with OSA, how positive airway pressure (PAP) therapy may modify any effect of OSA on COVID-19 outcomes, how sleep medicine services have innovated to deliver care during the pandemic, and how sleep and sleep disorders may play a part in the long-COVID syndrome.