Objective To examine the effect of COVID-19 on treatment adherence and self-reported sleep duration among patients with Obstructive Sleep Apnea MESHD Obstructive Sleep Apnea HP (OSA) treated with positive airway pressure (PAP) therapy. Methods Retrospective review of medical records of patients seen in Sleep and Circadian Clinic at Brigham Health during the immediate period of one month after the national lockdown was announced on March 15, 2020. Patients with OSA were included only if PAP adherence data was available in the 12- months prior and in the month after the lockdown. Patients with other sleep disorders and OSA patients without the adherence data were excluded. Results Mean age TRANS was 63.5 +/- 13.9 years, 55% of the participants were men, and mean BMI was 31.8 +/- 7.9 kg/m2. Severe OSA was noted among 59.5% compared to 29.3% moderate, and 11.2% mild OSA. Increased number of patients reported insomnia HP after the lockdown (41% vs 48%, p= 0.02). Gender TRANS stratification noted worsening insomnia HP only among women. There was no significant difference in PAP adherence as measured by the hours of use, self-reported sleep duration or in the use of sleep medications. Conclusion Post COVID-19 lockdown had a negative impact on sleep as evidenced by increased reporting of insomnia HP particularly among women, but no impact on PAP adherence or self-reported sleep duration.