4.5 Article

Association of Obstructive Sleep Apnea with the Aging Process

Journal

ANNALS OF THE AMERICAN THORACIC SOCIETY
Volume 18, Issue 9, Pages 1540-1547

Publisher

AMER THORACIC SOC
DOI: 10.1513/AnnalsATS.202007-771OC

Keywords

obstructive sleep apnea; OSA; aging; hallmarks of aging

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Evidence suggests that OSA is associated with specific hallmarks of aging in individuals under 50 years old, regardless of known confounding factors. No significant association of OSA with aging was identified in older patients.
Rationale: Evidence suggests that the physiopathologic 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: To evaluate the association of OSA with the aging process and to determine whether this association is maintained across different age groups. Methods: This was an observational, prospective study including 599 patients with suspected OSA. Five hallmarks of aging were evaluated: alteration of cellular communication (serum CRP [C-reactive protein] concentration), deregulation of nutrient sensing (insulin resistance), telomere attrition (leukocyte telomeric length), mitochondrial dysfunction (leukocyte mitochondrial DNA copy number), and genomic instability (urinary 8-hydroxy-2deoxyguanosine concentration). For age-stratified analyses, subjects were divided into four groups according to the apnea-hypopnea index (AHI) and the median age (50 yr): young patients without OSA (age >= 50 yr old, AHI >= 15 events/h), young patients with OSA (age < 50 yr old, AHI > 15 events/h), older patients without OSA (age >= 50 yr old, AHI >= 15 events/h), and older patients with OSA (age >= 50 yr old, AHI > 15 events/h). Results: A dose-response relationship was found between the AHI, arousal index, and time during the night spent with an 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 older 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.

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