Obstructive sleep apnea speeds up aging on a cellular level

In the realm of sleep disorders, obstructive sleep apnea (OSA) stands out with its repeated episodes of halted breathing during sleep, sometimes extending for several minutes. 

As sleepers experience these episodes, they subsequently wake up abruptly, gasping for breath. Beyond its immediate effects, obstructive sleep apnea brings with it a plethora of symptoms including fatigue, excessive daytime sleepiness, and a striking lack of concentration. 

These symptoms are more than just an inconvenience – they degrade the quality of life and may even incapacitate affected individuals. 

Moreover, untreated OSA can be a prelude to a series of debilitating health issues such as heart failure, hypertension, cardiovascular disease, diabetes, and cognitive challenges including poor memory and focus.

Cellular aging

Experts from the Federal University of São Paulo (UNIFESP) in Brazil have unveiled another disconcerting side effect of obstructive sleep apnea. 

The researchers have found that obstructive sleep apnea accelerates cellular aging through the shortening of telomeres – intricate structures comprising DNA sequences and proteins located at the ends of our chromosomes. 

Telomeres, like silent guardians, ensure the genetic material within the cell nucleus remains undistorted. As cells undergo division for tissue and organ rejuvenation, telomeres inevitably shorten. 

A time comes when these telomeres shrink too much, signaling the cells to halt their division – a hallmark of aging. Obstructive sleep apnea fast-tracks this telomere shortening, thereby hastening the aging process at the cellular level.

How the study was conducted 

The researchers, led by Priscila Farias Tempaku of UNIFESP’s Department of Psychobiology, meticulously assessed 46 male participants. 

These individuals were between the ages of 50 and 60 and had been diagnosed with either moderate or severe OSA. 

Over six months, the participants were split into two groups: one received treatment via continuous positive airway pressure (CPAP) – a respiratory therapy method wherein air is channeled into the lungs through spontaneous breathing – while the other was administered a placebo.

Through rigorous monthly check-ups, the research team gauged adherence to CPAP treatment, taking into consideration its complexity and initial discomfort for many users. 

Telomere lengths 

Blood samples were drawn at regular intervals to determine telomere lengths. Additionally, markers for inflammation and oxidative stress were closely monitored.

“Telomere shortening is inevitable because it’s associated with aging, inflammation and oxidative stress, but OSA accelerates it and we found that CPAP attenuated this acceleration after three and six months,” said Tempaku.

The study delved deeper into the molecular pathways connecting obstructive sleep apnea and telomere shortening, pinpointing inflammation, especially through tumor necrosis factor alpha (TNF-α), as the prime suspect. This cytokine is notably implicated in certain inflammatory and autoimmune diseases.

CPAP reduces inflammation 

“In the placebo group, TNF-α influenced telomere length, whereas the association wasn’t observed in the CPAP group. This shows that in addition to its already recognized importance in mitigating cardiovascular and metabolic risk, CPAP also reduces inflammation and therefore attenuates telomere shortening,” explained Tempaku.

“The results underscore the criticality of sleep as a protective factor in aging and a risk factor in patients with alterations. This is an excellent incentive since most people are reluctant to use CPAP,” said Sergio Tufik, the head of UNIFESP’s Sleep Institute.

Years of aging

Every decade since 1986, Tufik and his team have been surveying São Paulo’s residents to better understand their sleep-related health issues ranging from insomnia to snoring and sleepwalking. 

The 2015 survey underscored the profound effects of telomere shortening over a decade, equating severe OSA to a decade of aging.

“People age faster when they sleep badly. Poor quality sleep is associated with mortality as much as other diseases. Around 30% of the population have OSA, but there’s no care for the disorder. CPAP isn’t provided by public or private health services, and this has to change,” said Tufik. 

Obesity epidemic

The upsurge in obstructive sleep apnea cases correlates with the burgeoning obesity epidemic, with both conditions often found hand in hand. 

Estimates suggest that a staggering 70 percent of obese individuals grapple with sleep disorders. This number jumps to 80 percent for those with morbid obesity.

Diagnosing obstructive sleep apnea requires a polysomnography test or sleep study. Treatments include CPAP and significant lifestyle alterations, including weight reduction and avoiding sleep medication or alcohol before bedtime. 

The study is published in the journal Sleep,

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