Sleep apnea accelerates aging, but treatment

image: Rene Cortese, PhD, assistant professor in the Department of Child Health and the Department of Obstetrics, Gynecology, and Women’s Health at the University of Missouri School of Medicine.
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Credit: Justin Kelley, MU Health Care

Obstructive sleep apnea (OSA) affects 22 million people in the United States and is linked to a higher risk of high blood pressure, heart attack, stroke, diabetes and many other chronic diseases. But now researchers from the University of Missouri School of Medicine found that untreated OSA also accelerates the biological aging process and that appropriate treatment can slow or possibly reverse the trend.

The age acceleration test involves a blood test that analyzes DNA and uses an algorithm to measure a person’s biological age. The phenomenon of a person’s biological age exceeding their chronological age is called “epigenetic age acceleration” and is linked to overall mortality and chronic disease.

“Aging acceleration is not unique to OSA – it can be caused by a variety of environmental factors like smoking, poor diet, or pollution,” said René Cortese, PhD, Assistant Professor in the Department of Child Health and the Department of Obstetrics, Gynecology and Women’s Health. “In Western culture, it is not uncommon for people to experience epigenetic age acceleration, but we wanted to know how OSA affects systemic age acceleration compared to those without this disease.”

Cortese’s team studied 16 adult non-smokers who were diagnosed with OSA and compared them to eight unconditional control subjects to assess the impact of OSA on epigenetic age acceleration on a one year period. After a baseline blood test, the OSA group received continuous positive airway pressure (CPAP) therapy for a year before being tested again.

“Our results revealed that OSA-induced sleep disturbances and lower oxygen levels during sleep promoted faster biological age acceleration compared to the control group,” Cortese said. “However, OSA patients who adhered to CPAP showed epigenetic age deceleration, while age acceleration trends did not change for the control group. Our results suggest that the acceleration biological age is at least partially reversible when an effective treatment for OSA is implemented.

Cortese said the key to CPAP’s success in slowing down aging is strong adherence to using the device for at least four hours a night. It is unclear how accelerating age will affect clinical outcomes and how it applies to other risk groups or children with OSA.

“Since children with OSA are treated differently than adults, this research raises many questions,” Cortese said. “We need to know more about the mechanisms and biology behind these findings. This is very exciting and challenging research.

In addition to Cortese, study authors include colleagues from MU Leila Kheirandish-Gozal, MD, director of the Child Health Research Institute; and David Gozal, MDthe Marie M. and Harry L. Smith Chair in Child Health.

their study, “Epigenetic acceleration of age in obstructive sleep apnea is reversible with adherent treatment,” was recently published in the European Respiratory Journal.

This work was partially supported by grants from the National Institutes of Health, Tier 2 and TRIUMPH grants from the University of Missouri, and a Leda J. Sears Charitable Trust grant. The authors disclose no conflict of interest.

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