• Posted March 21, 2022

Sleep Apnea Speeds Aging, But CPAP Can Help

Add this to the ever-growing list of health problems tied to sleep apnea: New data shows it ages you.

But the same new small study also found that using a CPAP (continuous positive airway pressure) machine for at least four hours a night for a year could slow or possibly reverse that trend.

"This highlights the need for both detection of the sleep apnea and for the efficient treatment of the sleep apnea," said study author Rene Cortese, an assistant professor at the University of Missouri.

"Even people that are being treated, sometimes CPAP is not the most comfortable treatment and people don't adhere to the treatment that they're supposed to, but this highlights the need for an efficient treatment," he said.

Obstructive sleep apnea is a condition in which the upper airway is blocked during sleep, causing breathing problems and repeated awakenings. It can be caused by a person's physical structure or other health conditions and can affect oxygen levels in the blood.

The standard treatment is using a CPAP machine. Through a mask covering the nose and mouth, a patient's airways are kept open to receive a steady flow of oxygen so he or she can breathe normally.

The new study looked at apnea along with a phenomenon known as epigenetic age acceleration. Simply put, it means that a person's biological age is older than their age in years. It's linked to chronic diseases and early death.

The researchers recruited 24 nonsmokers between 28 and 58 years of age -- 16 who had been diagnosed with sleep apnea and eight who had not. All underwent a sleep study. Their blood and DNA was analyzed using a computer algorithm to measure their biological age. Individuals were then retested after a year of CPAP use.

Cortese said sleep apnea speeds up the aging process through oxidative stress and chronic inflammation. While prior sleep disruptions and lower oxygen levels had accelerated apnea patients' biological aging, regular CPAP treatment had paid off.

"At least partially it will slow down the aging effect of the sleep apnea," Cortese said.

Epigenetic clocks are tissue-specific so what's happening with one organ might not be the same in another, but blood is systemic, which is why researchers chose to analyze it, he explained.

The study also controlled for other factors that affect sleep apnea, such as diet and smoking.

About 22 million Americans have obstructive sleep apnea -- with 80% of moderate and severe cases undiagnosed, according to the American Sleep Apnea Association.

Dr. Seema Khosla, medical director of the North Dakota Center for Sleep in Fargo, said while some may consider the disorder no more than nuisance snoring, untreated sleep apnea can lead to high blood pressure in the lungs, stroke and mental decline, among other health problems. CPAP is the standard treatment and one Khosla prescribes to her patients.

The new study was timely, according to Khosla, who wasn't part of the research. A report recently commissioned by Medicare sought to find out whether funding CPAP machines was beneficial, she noted, and the issue had become a point of discussion among sleep specialists.

"We don't want to miss this potential opportunity to treat our patients right, with something that is, in many cases, very lifesaving and life-altering," Khosla said. "Reading this study made me appreciate that people are still looking at this and being really creative about it."

Future research might include studying whether improving a person's sleep apnea would have an impact on their other health issues.

Age acceleration can also be caused by smoking, poor diet and pollution, he said.

What isn't clear is if other treatments for sleep apnea such as drug therapies or surgery would have the same impact CPAP had in this study, Cortese said.

The researchers also did not examine whether kids with sleep apnea experience the same types of accelerated aging, though CPAP would not be a typical treatment option for patients in that age group.

"I cannot tell you that any other treatment will work the same way at least on the epigenetic deceleration," Cortese said.

The findings were recently published in the European Respiratory Journal.

More information

The U.S. National Heart, Lung, and Blood Institute has more on sleep apnea.

SOURCES: Rene Cortese, PhD, assistant professor, departments of child health and obstetrics, gynecology and women's health, University of Missouri, Columbia; Seema Khosla, MD, pulmonologist and medical director, North Dakota Center for Sleep, Fargo; European Respiratory Journal, Jan. 27, 2022

Erin Sparnon, senior engineering manager, device evaluation. ECRI; Aveek Das, researcher, Palo Alto Networks' Unit 42