Poor sleep quality is associated with mortality as much as other diseases – and people age faster when they sleep badly. Could patients suffering from sleep apnea therefore age faster?
Obstructive sleep apnea (OSA) consists of multiple episodes of partial or complete closure of the upper airway that occur during sleep, leading to breathing cessation lasting more than ten seconds and sometimes even several minutes, followed by arousals and deep breathing. Symptoms include lack of concentration, fatigue and excessive daytime sleepiness, all of which lower the quality of life and can be incapacitating. Untreated patients are at risk for hypertension, cardiovascular disease, heart failure and diabetes, among other health problems, as well as poor memory and concentration.
A recent study conducted at the Federal University of São Paulo (UNIFESP) in Brazil and published in the journal Sleep shows that the telomere shortening that naturally occurs with aging and is accelerated by OSA can be mitigated by the use of continuous positive airway pressure (CPAP), a method of respiratory therapy in which air is pumped into the lungs through the nose and mouth during spontaneous breathing.
The researchers assessed 46 male patients aged 50–60 and diagnosed with moderate or severe OSA for six months. They divided these volunteers into two groups, treating one with CPAP and the other with placebo (a CPAP machine with a hidden leak in the exhaust port of the mask to disperse the therapeutic pressure). In monthly visits, they checked adherence to CPAP, considered complex and hard to get used to. They took blood samples to measure telomere length at the start of the trial, three months later and at the end of the intervention. They also analyzed inflammatory and oxidative stress markers.
“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 Priscila Farias Tempaku, first author of the article and a researcher in sleep biology at UNIFESP’s Department of Psychobiology.
In their investigation of the molecular mechanisms associated with OSA and telomere shortening, the researchers observed that inflammation is probably the main pathway via tumor necrosis factor alpha (TNF-α), a cytokine known to be involved in the pathogenesis of some inflammatory and autoimmune diseases. “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,” Tempaku explained.
“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, last author of the article and head of UNIFESP’s Sleep Institute.
This article is based on a press release by Fundação de Amparo à Pesquisa do Estado de São Paulo. You can find the original publication here and by following the link in our text.
Image source: Amisha Nakhwa, unsplash
