Weekend lie-ins, late nights and drinking could be making a dangerous sleep disorder worse, scientists have discovered.
Obstructive sleep apnoea is a condition that causes repeated pauses in breathing during sleep and extreme snoring—affecting between eight and ten million people in the UK, and up to 30 million Americans.
However researchers have coined the term ‘social apnoea’ to describe a weekend spike in severity of the problem, linked to lifestyle changes such as alcohol use, smoking and irregular sleep patterns.
The phenomenon was identified by an international team led by Flinders University in Australia, who analysed sleep data from more than 70,000 people worldwide.
Using a clinically validated under-mattress sleep monitor, they found participants were 18 per cent more likely to have moderate to severe apnoea on Saturdays than on Wednesdays.
The condition occurs when the airway repeatedly collapses during sleep, leading to breathing pauses, drops in blood oxygen, disrupted rest and daytime sleepiness.
Untreated, it raises the risk of heart disease, type 2 diabetes, depression, dementia and accidents, due to poor sleep and subsequent tiredness.
Research presented this year at the American Society of Clinical Oncology conference in Chicago also found it significantly increases the risk of deadly lung cancer.
Weekend lie-ins, late nights and drinking could be making dangerous sleep disorder obstructive sleep apnoea worse, scientists warn
‘Sleep apnoea is already a major public health issue, but our findings suggest its true impact may be underestimated,’ said lead author Dr Lucia Pinilla, from the Adelaide Institute for Sleep Health at Flinders.
‘Most clinical testing is done on a weeknight, missing the weekend effect we’re now calling social apnoea.’
The weekend risk was particularly high in men (21 per cent increase versus nine per cent in women) and in under-60s (24 per cent versus seven per cent in over-60s).
Sleeping in for 45 minutes or more on weekends increased the odds of worse apnoea by 47 per cent, and shifting the sleep schedule by more than an hour—dubbed social jetlag—raised it by 38 per cent.
Professor Danny Eckert, Director of FHMRI Sleep Health and senior author, said: ‘We don’t yet know exactly why, but alcohol use, lighter sleep and less consistent use of OSA therapies likely play a role.’
He recommends maintaining a regular sleep routine, using any prescribed therapy every night—even at weekends—and aiming for the recommended seven to nine hours of sleep.
The weekend effect emerged alongside evidence from a second, related study showing severity also varies by season.
Published in Communications Medicine, the research—led by Dr Bastien Lechat of Flinders—used the same dataset to track changes over 3.5 years across 23 countries.
Sleep deprivation increases the risk of obesity, memory loss, diabetes, heart disease, heightened and unstable emotions, impaired ability to learn and a reduced immune response
It found the apnoea-hypopnoea index (AHI)—the measure of breathing interruptions per hour—was up to 19 per cent higher in summer and winter than in spring and autumn in the northern hemisphere, and 10 to 15 per cent higher in summer versus spring in the southern hemisphere.
Higher temperatures were linked to worse apnoea, with nights at 18°C on average producing a 6.4 per cent higher AHI than cooler nights at 6°C.
The researchers believe several factors could be driving these peaks. Hot weather can reduce sleep duration and quality, leading to more light sleep, which is associated with more frequent apnoea events.
In winter, people tend to sleep longer—particularly in the early morning—increasing time in REM sleep, a stage that occurs before and after deep sleep, when apnoea is typically worse.
Sleeping longer than usual by over two hours was linked to a 5.8 per cent increase in AHI, while even shorter sleep than average caused a small rise.
Behavioural changes may also play a part as other research has shown alcohol consumption, weight gain, lower physical activity, and respiratory illnesses all vary seasonally.
The findings from both studies raise questions about how the condition is diagnosed and treated. Most patients have their condition assessed via a single-night sleep study, often during the week.
This, the researchers warn, risks missing important variability—and underestimating severity in some patients.
Dr Lucia Pinilla and Professor Danny Eckert, Director of FHMRI Sleep Health at Flinders University in Australia
A CPAP (pictured) machine is a mask that gently pumps air into the mouth and nose during sleep, designed to improve breathing in OSA patients
‘A seasonal effect that accounts for around 20 per cent of the variation in AHI is meaningful,’ Dr Lechat concluded in his paper.
‘Some trials [of OSA treatments] only show modest reductions in severity of 10 to 20 per cent.’
If diagnosis or assessment happens in a low-severity period, he suggests, it could influence treatment decisions.
The studies also suggest the long-standing practice of allowing patients to skip continuous positive airway pressure (CPAP) therapy on weekends may need re-evaluation.
The treatment involves wearing a mask connected to a small machine that delivers a steady stream of air to keep the airway open during sleep—and skipping it could make symptoms worse at the weekend.
For those worried they might have sleep apnoea, common warning signs include loud snoring, choking or gasping during sleep, unrefreshing rest, and excessive daytime fatigue.
Doctors can refer patients for diagnostic testing, which may involve in-lab polysomnography or home-based monitoring.
While the observed fluctuations may not be dramatic for an individual, the authors stress that at a population level, they could have significant implications for health and safety.
Even small increases in severity can raise the risk of cardiovascular events, mental health problems and accidents, especially for people who drive or operate machinery.
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