Two newly published research studies examine the links between obstructive sleep apnea (OSA) and patients’ environments and activities.
“Social Apnea: Obstructive Sleep Apnea Is Exacerbated on Weekends,” accepted by the American Journal of Respiratory and Critical Care Medicine” on Aug. 7, studied how weekend sleep habits can affect OSA. The study’s authors pointed out that though there are “well-established insights on variations in sleep patterns across the week, no study has evaluated day-of-week differences in OSA severity.”
Investigators researched changes in OSA severity on different days of the week by looking at sleep data from more than 70,000 consumers who used under-mattress home OSA monitors. Researchers examined multi-night sleep data from January 2020 to September 2023 for participants described as “middle-aged, predominantly male, and overweight.”
Results showed that the severity of OSA “significantly increased on weekends, such that the odds of OSA were 18% higher on Saturdays compared to Wednesdays.” Investigators also noticed that this weekend effect was more commonly seen in men vs. women, and in study participants who were younger than 60 years old vs. those older than 60.
“Weekend catch-up sleep of ≥45 minutes and social jetlag of ≥60 were associated with a further 47% and 38% increase in the weekend odds of OSA, respectively,” investigators said.
A 2021 study, “Social Jetlag and Related Risks for Human Health: A Timely Review,” published by Nutrients and the National Institutes of Health, defined social jetlag as “the discrepancy between biological time, determined by our internal body clock, and social times, mainly dictated by social obligations such as school or work. In industrialized countries, two-thirds of the studying/working population experiences social jetlag, often for several years.”
The new study said, “Since OSA is typically more severe during REM [Rapid Eye Movement] sleep, weekend catch-up sleep and social jetlag are likely to exacerbate OSA severity.”
The authors added, “Regardless of the underlying mechanisms, the observed increase in OSA severity on weekends may carry significant population-level societal costs, given the high prevalence and wide-ranging health and safety implications of OSA. Indeed, previous health economic analyses of OSA burden suggest that small variations in OSA prevalence may yield large well-being burden and costs at the population level.”
The prevalence of increased OSA severity during weekends also raises questions about whether sleep apnea testing done on weeknights fully captures the nuances of a patient’s sleep health. “These findings further highlight the potential for OSA misdiagnosis and misclassification with conventional OSA testing typically occurring on weeknights,” the study said. “The findings may also have implications for therapeutic management of OSA.”
Another study, published in July by Communications Medicine, looked at environmental impact on sleep apnea.
“Obstructive sleep apnea severity varies by season and environmental influences such as ambient temperature” studied how environmental factors could explain OSA severity varying from night to night. Authors, studying the same data that authors of the social jetlag study used, looked at geographical locations, variations in sleep time, ambient temperature, and air pollution. These investigators also studied data predominantly for males who were overweight.
Researchers found higher apnea-hypopnea index (AHI) scores during summer and winter months vs. spring and fall months in northern hemisphere participants. Higher ambient temperatures also were associated with increased AHI scores.
“Here we demonstrate a seasonal component to OSA severity, partially explained by ambient temperature and seasonal variation in sleep duration,” researchers said. “Our findings highlight the need to report data collection months in OSA clinical trials, and further study to uncover the physiology behind seasonal variation in OSA severity are required.”
Image: Pexels/Anna Tarazevich
