Lifestyle change during the COVID-19 pandemic in Japan: implications for CPAP adherence in obstructive sleep apnea patient

Background: Coronavirus disease 2019 (COVID-19), a global pandemic, has greatly altered our daily lifestyle. Although there have been many reports on the association between COVID-19 and sleep disorders, none have examined this association with continuous positive airway pressure (CPAP) therapy control. Therefore, we aimed to elucidate the impact of lifestyle changes on CPAP users during the COVID-19 pandemic in Japan.

Methods: This study included patients with obstructive sleep apnea (OSA) who were treated with CPAP. We used an original lifestyle questionnaire to collect data on their exercise, amount of food, alcohol consumption, sleep time, and subjective stress. We classified the patients into the following four groups: (I) work from home (WFH); (II) WFH and commuting (hybrid working); (III) commuting; and (IV) unemployed. Downloaded data were used to analyze CPAP adherence. When we compared the physical activity and sleep duration, working respondents were categorized into two groups, namely: (I) the home group, which comprised WFH and hybrid working; and (II) the commuting group without telecommuting at home.

Results: Overall, 663 patients enrolled in this study, and among them, 506 (76.3%) were workers. Additionally, 364 (71.9%) participants changed their work style from commuting due to the COVID-19 pandemic. Physical activity decreased significantly in 60.9% of the participants in the home group (P<0.01). The sleep duration increased significantly in 19% of the participants (P<0.05). No significant difference was found in Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J) score among the groups classified based on work styles. CPAP use significantly shorter in working respondents who were hybrid or commuting workers (P<0.01).

Conclusions: The COVID-19 pandemic has resulted in many lifestyle changes. More than 50% of workers who was CPAP user changed their work style, resulting in decreased physical activity, and commuters tended to have shorter durations and lower rates of CPAP use compared to teleworkers.

Keywords: Coronavirus disease 2019 (COVID-19); obstructive sleep apnea (OSA); lifestyle; teleworking; continuous positive airway pressure (CPAP)