Sleeping in on the weekend? You could be triggering ‘social apnoea’

If you’re struggling to get through the Monday slump, “social apnoea” may be to blame.

Published on Wednesday in the American Journal of Respiratory and Critical Care Medicine, an Australian-led team of researchers analysed global data from more than 70,000 people, finding a significant and consistent increase in obstructive sleep apnoea (OSA) on weekends.

What is obstructive sleep apnoea?

Obstructive sleep apnoea is a sleep disorder in which airways are partially or completely blocked during sleep.

The condition is associated with higher all-cause mortality, and if left untreated, increases the risk of cardiovascular disease, stroke, type 2 diabetes, cognitive impairment and motor vehicle crashes.

Common symptoms include daytime sleepiness, loud snoring and pauses in breathing during sleep that others may notice.

What did this new study find?

Professor Danny Eckert, director of Flinders’ Health and Medical Research Sleep Health Centre and senior author on the paper, says the research was significant for its scale.

Most clinical diagnoses of sleep apnoea are based on only a single night’s data, usually collected on a weekday. By collecting data from participants with an under-mattress tracker, they were “able to measure people over multiple nights, and in this case, on average using about one year’s worth of data”, Eckert says.

“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 unable to determine the exact cause of the phenomenon, Eckert suspects one cause may be social jetlag – a misalignment of our circadian rhythm that tends to occur at 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 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, Eckert says.

“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.”

Those under 60 were more significantly affected, with a 24 per cent higher risk at weekends compared with 7 per cent for the over 60s.

Pinilla says people may also be less inclined to wear sleep technology such as CPAP machines at 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 with 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, Eckert says.

Sleep Health Foundation chief executive Moira Junge says the condition can be asymptomatic and vary in severity, but daytime sleepiness is a huge red flag.

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

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

While Junge says personal tracking devices can help, they are not a diagnostic tool, and it’s as important to pay attention to how you’re feeling as studying data points.

“People just buying CPAP machines and stuff online without having a proper assessment is a big concern of ours,” she says. “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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