summary: Continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) can alleviate the accelerated telomere shortening caused by this condition.
Telomeres, the protected ends of chromosomes, are involved in aging and tend to shorten earlier in OSA. The study revealed that CPAP not only combated her OSA symptoms, but also mitigated the effects of rapid aging. The results of this study highlight an important link between sleep quality and aging.
- Continuous positive airway pressure (CPAP) can mitigate the accelerated telomere shortening seen in patients with obstructive sleep apnea (OSA).
- A study at UNIFESP involved 46 male patients aged 50-60 years diagnosed with moderate-to-severe OSA and found that CPAP also reduced inflammation.
- It turns out that the effects of OSA are so severe that severe OSA is equivalent to aging another 10 years.
Obstructive sleep apnea (OSA) is multiple episodes of partial or complete closure of the upper airway during sleep, leading to cessation of breathing lasting more than 10 seconds and sometimes several minutes, followed by awakening and deep breathing. follows.
Symptoms include difficulty concentrating, fatigue, and excessive daytime sleepiness, all of which can reduce quality of life and lead to incapacitation. Untreated patients are at risk of poor memory and concentration, as well as health problems such as high blood pressure, cardiovascular disease, heart failure and diabetes.
A study conducted at the Federal University of São Paulo, Brazil (UNIFESP) found that telomere shortening, which occurs naturally with aging and is accelerated by OSA, was mitigated by the use of continuous positive airway pressure (CPAP), a method of respiratory therapy. shown that it can be done. Air is forced into the lungs through the nose and mouth during spontaneous breathing.
Telomeres are structures made up of DNA sequences and proteins at the ends of chromosomes. They play a central role in maintaining the integrity of the genetic material within the cell nucleus. Telomeres naturally shorten as cells divide to regenerate tissues and organs, and senescent cells stop dividing when telomeres become too short. Therefore, accelerated telomere shortening by OSA may cause premature cellular senescence.
This study was supported by FAPESP and reported in a journal article. sleep.
Investigators evaluated 46 male patients aged 50 to 60 years diagnosed with moderate or severe OSA for 6 months. They divided these volunteers into two groups, one treated with CPAP and the other with placebo (a CPAP device with a hidden leak in the mask vent to distribute treatment pressure).
At monthly visits, they checked compliance with CPAP, which is considered complex and difficult to get used to. They took blood samples to measure telomere length at the beginning of the study, after 3 months, and at the end of the intervention. They also analyzed inflammatory and oxidative stress markers.
“Telomere shortening is inevitable as it is associated with aging, inflammation and oxidative stress, but we found that OSA promotes telomere shortening and CPAP attenuates this promotion after 3 and 6 months.” said study lead author Priscilla Farias Tempak, a sleep researcher. She majored in Biology at the Department of Psychobiology at UNIFESP.
In studying the molecular mechanisms associated with OSA and telomere shortening, researchers investigated tumor necrosis factor-alpha, a cytokine known to play a role in the development of inflammation, possibly in some inflammatory and autoimmune diseases. observed to be the predominant pathway mediated by TNF-α). .
“In the placebo group, TNF-α affected telomere length, whereas no association was observed in the CPAP group. In addition to its perceived importance, we show that it reduces inflammation and therefore telomere shortening,” explained Tempaku.
“The results highlight the importance of sleep as a protective factor in aging and as a risk factor for patients with change. This is a great incentive as most people are reluctant to use CPAP.” said Sergio Tufik, the last author of this article and director of the UNIFESP Sleep Institute.
A pioneer in sleep research in Brazil and around the world, Professor Tufik founded the Episono (“Episleep”) project to investigate sleep epidemiology. He and his team have conducted census surveys of the city of São Paulo every 10 years since 1986 to investigate sleep-related health problems such as insomnia, snoring, and sleepwalking, and have published over 70 of his studies on the subject. published a paper in a scientific journal.
A 2015 study focused on the effects of telomere shortening over 10 years and showed that severe OSA corresponds to 10 years of aging. This finding, along with the results of the latest study, led researchers to conclude that the link between sleep and aging needs to be investigated more deeply.
“Sleep-deprived people age faster. Poor sleep quality is associated with mortality, as with other illnesses. No. CPAP is not provided by public or private health services and this needs to change,” Tufik said.
The prevalence of OSA is increasing in parallel with the development of obesity, as the two diseases are often associated. According to the Brazilian Society of Bariatric and Metabolic Surgery (SBCBM), 70% of obese people suffer from sleep disorders. For morbid obesity, the rate is 80%.
Diagnosis of OSA requires a polysomnogram, also known as a sleep study. Treatment includes lifestyle changes such as CPAP and weight loss, and avoidance of sleeping pills and alcoholic beverages at night.
About this brain aging and sleep apnea research news
author: Eloisa Reinert
contact: Eloisa Reinert – FAPESP
image: Image credited to Neuroscience News
Original research: open access.
“Effects of Obstructive Sleep Apnea and CPAP on Telomere Length and Related Mechanisms,” Priscila Farias Tempaku, et al. sleep
Effects of Obstructive Sleep Apnea Syndrome and CPAP on Telomere Length and Related Mechanisms
A growing body of evidence suggests a contribution of obstructive sleep apnea (OSA) in the molecular pathways of aging associated with maintenance of telomere length. This study aimed to investigate the effect of OSA and its treatment with continuous positive airway pressure (CPAP) on telomere length variation and its associated mechanisms.
For this, a randomized, double-blind, sham-controlled clinical trial was conducted for 6 months. Participants were randomly assigned to CPAP or sham CPAP, underwent clinical evaluation at seven visits, and had blood drawn to determine mean leukocyte telomere length (LTL) and amounts of metabolic and inflammatory markers.
Of the 127 people we contacted, 46 met our inclusion criteria. At baseline, individuals in both groups were uniform, including LTL (p=0.106). Adherence during the intervention was 5.29 ± 1.09 in the sham CPAP group and 5.71 ± 0.19 in the CPAP group. After 6 months of intervention, a statistically significant effect of treatment on LTL (p=0.001) was observed, with the sham CPAP group showed a decrease. CPAP group (1.0960 ± 0.1122, 1.0521 ± 0.1094, 1.0675 ± 0.1225). Additionally, a negative correlation was found between delta LTL and delta TNF-α at visits 7 and 1 with a sham CPAP intervention (rho=-0.383, p=0.009) (rho=-0.383, p=0.009). . Effects on CPAP use (rho=0.021, p=0.800).
We can conclude that CPAP affected LTL stability, potentially by regulating TNF-α when compared to sham CPAP placebo.
Support (if any)
Our research is supported by the Association of Pesquisa Funds (AFIP), the São Paulo Amparo Pesquisa Fund (FAPESP), the Coordinating Agency for the Improvement of Higher Education Human Resources (CAPES), and the National Council for the Development of Science and Technology (VA and ST). received a CNPq fellowship).