Obstructive sleep apnoea more severe on weekends, finds new Australian study

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“This allows us for the first time to see what the natural patterns are across the week of people’s sleep apnoea.”

Associate professor Bradley Edwards, head of the Sleep Disorders Research Laboratory at Monash University, who was not involved in the study, says the research is “eye-opening and first of its kind”, both in its large sample size and time period.

“This sort of work really highlights the importance of multi-night monitoring for not only the diagnosis of sleep apnoea, but also in terms of treatment and management,” he says.

“If there are fluctuations in sleep apnoea severity, there are potentially more people at risk and more people not being optimally treated,” adds Edwards.

Lead author Dr Lucia Pinilla says they coined the term “social apnoea” to describe the increased weekend severity of OSA’s potential social link.

While researchers were not able to determine the exact cause of the phenomenon, Eckert suspects one cause may be social jetlag – a misalignment of our circadian rhythm, which tends to occur on weekends.

“People tend to go to bed later and they sleep in, and that’s out of sync with your circadian rhythm [and weekday sleep schedule].”

Indeed, they found sleeping just an extra 45 minutes on weekends increased the risk of more severe sleep apnoea by 47 per cent.

Another contributing factor could be that people tend to drink more alcohol and smoke more on weekends, says Eckert.

“Alcohol blocks the nose, it might relax the muscles around the throat, and it also lightens your sleep overall… smoking can also worsen your breathing during sleep.”

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Those under 60 were also more significantly impacted, with a 24 per cent higher risk on weekends compared to 7 per cent for those over 60.

Pinilla says that people may also be less inclined to wear sleep technology such as CPAP machines on weekends, increasing the severity of OSA.

Edwards acknowledges the paper’s limitations in identifying causes but agrees with the authors’ conclusions. He believes the work “sets the scene for the next evolution of research” to more firmly identify causes, which can then shape diagnosis, treatment and management.

Other risk factors for OSA not linked to days of the week include obesity and ageing. Another recent study published in Nature (also co-authored by Pinilla) found the condition was 8 to 19 per cent more severe in summer and winter compared to spring and autumn.

Identifying and managing sleep apnoea

To avoid social apnoea, Eckert says it’s important to maintain a consistent sleep schedule.

“People need to prioritise not only getting enough sleep but keeping a regular sleep pattern.”

Avoiding smoking, minimising alcohol intake and consistently wearing treatment devices is also important, says Eckert.

Sleep Health Foundation CEO Moira Junge points out the condition can be asymptomatic and vary in severity but daytime sleepiness is one of the biggest red flags.

“Don’t put up with excessive amounts of sleepiness, because there will be an explanation and there will be a solution.”

“Sleep needs to be taken as seriously in society as diet and exercise.”

While she says personal tracking devices can be helpful, they are not a diagnostic tool, adding it’s equally important to pay attention to how you’re feeling as it is looking at data points.

“People just buying CPAP machines and stuff online without having a proper assessment is a big concern of ours. We want people to make sure they are having any kind of assessment or treatment of their sleep apnoea under the guidance of a qualified health professional.”

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