Annals of the American Thoracic Society | 2021
Association of Obstructive Sleep Apnea with the Aging Process.
Abstract
Rationale Evidence suggests that the physiopathological consequences of obstructive sleep apnea (OSA) resemble those induced by aging. Some studies report that the deleterious effects associated with OSA might be age dependent. Objectives The objectives of the study were to evaluate the association of OSA with the aging process and to determine whether this association is maintained across different age-groups. Methods Observational-prospective study including 599 patients with suspected OSA. Five hallmarks of aging were evaluated: alteration of cellular communication (serum C-reactive protein concentration), deregulation of nutrient sensing (insulin resistance), telomere attrition (leukocyte telomeric length), mitochondrial dysfunction (leukocyte mitochondrial mtDNA copy number) and genomic instability (urinary 8-hydroxy-2-deoxyguanosine concentration). For age-stratified analyses, subjects were divided into four groups according to the apnea-hypopnea index (AHI) and the median age (50 years): young non-OSA patients (age <50 years old, AHI <15 events/h), young OSA patients (age <50 years old, AHI ≥15 events/h), elderly non-OSA patients (age ≥50 years old, AHI <15 events/h) and elderly OSA patients (age ≥50 years old, AHI ≥15 events/h). Results A dose-response relationship was found between AHI, arousal index and night time with oxygen saturation less than 90%, and the following hallmarks: alteration of cellular communication, deregulation of nutrient sensing, mitochondrial dysfunction and genomic instability. Considering age-stratified analyses, OSA was associated with an increase in several hallmarks of aging in young patients, but no significant association of OSA was identified in elderly patients. Conclusions In subjects under 50 years of age, OSA is associated with an increase in specific hallmarks of aging, independent of several known confounding factors.