Obstructive sleep apnea (OSA) is a disease that manifests with snoring, excessive daytime sleepiness, and fatigue. OSA is the mother of many diseases. COVID-19 is such a disease that can cause greater harm to the patients with OSA. The prevalence of clinically significant OSA where an urgent intervention was required was 6–17% in the adult population, whereas the prevalence was as high as 49% in the advanced age-group. The prevalence of OSA is always more in adult men than in adult women. Expressions of COVID-19 among different peoples are varied. But four main determinants are the following: (1) renin–angiotensin–aldosterone system (RAAS), (2) oxidative stress of the individual, (3) endothelial dysfunction, and (4) immune responses. All of these four systems are in deranged state in OSA patients; they are already in the hyperactive states due to intermittent hypoxia, sympathetic activation, and poor sleep quality. So any acute insult like COVID-19 may throw these systems out of control. The acute “happy hypoxia” of COVID-19 can really be dangerous in the presence of “chronic intermittent happy hypoxia” of OSA.
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