Letting your hair down at the weekend might be a well-known recipe for a hangover, but researchers say it might also increase the severity of a common sleep disorder.
Obstructive sleep apnoea (OSA) involves complete pauses in breathing or partial reductions in airflow that arise because muscles in the back of the throat relax, causing the airways to narrow or close. It is more common in groups such as older people and people who are overweight or obese.
Now researchers have found the severity of the condition increases at the weekend. The study cannot prove the cause, but suggests it could be down to lifestyle factors such an increase in drinking and smoking, or changes in the type or patterns of sleep – all of which can increase the risk of the condition. As a result, they have called the phenomenon “social apnoea”.
“Obviously, people tend to drink more on the weekend. They tend to smoke more on the weekend if they are prone to smoking,” said Prof Danny Eckert, a co-author of the research at Flinders University in Australia, adding that as well as a possible effect from irregular sleep patterns, it might also be that people were less likely to use devices such as continuous positive airway pressure (Cpap) machines to manage the condition at the weekend.
The researchers say regardless of the underlying cause, the results matter given the health and safety implications of OSA. It is known to raise the risk of conditions including stroke, high blood pressure and type 2 diabetes, and can also affect driving safety as a result of sleepiness, have an impact on relationships, and reduce quality of life.
Writing in the American Journal of Respiratory and Critical Care Medicine, Eckert and colleagues report how they analysed de-identified data from 70,052 people – the majority of whom were middle-aged, male, and overweight – who used a commercially available under-mattress sleep sensor that can track heart rate, snoring and sleep apnoea.
All participants had four or more sleep recordings a week, at least 28 sleep apnoea measurements a year, and five or more breathing disruptions an hour during sleep, on average, a year.
The team found the odds of moderate to severe sleep apnoea, meaning 15 or more breathing interruptions an hour, were 18% higher on Saturdays compared with Wednesdays, and the effect was more pronounced in men and people under the age of 60.
They also found weekend catch-up sleep of 45 minutes or more, compared with less than six minutes, and social jetlag – in other words, a clock-shift in sleep patterns – of 60 minutes or more, compared with less than 18 minutes, was associated with 47% and 38% greater odds of having moderate to severe OSA respectively.
Dr Sriram Iyer, an NHS respiratory and sleep consultant, who was not involved in the work, said the study highlighted the night-to-night variability in OSA symptoms, and the team’s assumptions about the cause of the weekend uptick were “perfectly reasonable”.
Ryan Chin Taw Cheong, a consultant ENT and sleep surgeon at the Cleveland clinic, London, praised the size of the study, saying it was the first of its kind to look at variability in the severity of the condition throughout the week.
While he noted that study did not include data on participants’ lifestyles, meaning it could not prove the cause of the increased severity of OSA at the weekends, he said factors such as smoking and drinking were known to exacerbate symptoms, and addressing such issues – alongside diet and weight – should be one of the first steps taken to tackle the condition.
“With the best intentions, we can try to treat you medically. But if you’re consuming lots of alcohol or smoking heavily, whatever we’re doing as medical professionals will be just a drop in the ocean,” Cheong said.
