Obstructive sleep apnea severity varies by season and environmental influences such as ambient temperature

Abstract Background Obstructive sleep apnea (OSA) severity often varies considerably from night-to-night, but whether environmental factors play a role is unclear. This study investigated seasonal and temperature-related changes in OSA severity. Methods Data were acquired from 70,052 participants wi...

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Main Authors: Bastien Lechat, Duc Phuc Nguyen, Kelly Sansom, Lucia Pinilla, Hannah Scott, Amy C. Reynolds, Andrew Vakulin, Jack Manners, Robert J. Adams, Jean-Louis Pepin, Pierre Escourrou, Peter Catcheside, Danny J. Eckert
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-01016-0
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author Bastien Lechat
Duc Phuc Nguyen
Kelly Sansom
Lucia Pinilla
Hannah Scott
Amy C. Reynolds
Andrew Vakulin
Jack Manners
Robert J. Adams
Jean-Louis Pepin
Pierre Escourrou
Peter Catcheside
Danny J. Eckert
author_facet Bastien Lechat
Duc Phuc Nguyen
Kelly Sansom
Lucia Pinilla
Hannah Scott
Amy C. Reynolds
Andrew Vakulin
Jack Manners
Robert J. Adams
Jean-Louis Pepin
Pierre Escourrou
Peter Catcheside
Danny J. Eckert
author_sort Bastien Lechat
collection DOAJ
description Abstract Background Obstructive sleep apnea (OSA) severity often varies considerably from night-to-night, but whether environmental factors play a role is unclear. This study investigated seasonal and temperature-related changes in OSA severity. Methods Data were acquired from 70,052 participants with an average apnea-hypopnea index (AHI) ≥ 5 events/hour who used an under-mattress sleep sensor at least 4 times/week between January 2020 and September 2023. Fixed effect models were used to investigate the association between AHI and day of the year, adjusting for geographical location, variation in total sleep time, ambient temperature, and air pollution. Results Participants are middle-aged (mean ± SD, 53 ± 13 years), predominantly male (81%), overweight (BMI; 29 ± 6 kg/m2) and have an average of 492 ± 341 nights of data. Mean AHI is 18.0 ± 14.0 events/h and within-subject coefficient of variation is ±51%. AHI is ~5% higher during summer/winter compared to spring/autumn in the northern hemisphere, and 10–15% higher during summer compared to spring in the southern hemisphere. Higher ambient temperature (25th vs. 75th percentiles; 6 vs. 18 degrees Celsius) is associated with a 6.4% (95% CI; 6.3–6.5) increase in AHI. Results are consistent across 23 countries, although the effect of temperature on AHI is larger in Europe vs. the United States or Australia. Conclusions Here we demonstrate a seasonal component to OSA severity, partially explained by ambient temperature and seasonal variation in sleep duration. Our findings highlight the need to report data collection months in OSA clinical trials, and further study to uncover the physiology behind seasonal variation in OSA severity are required.
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spelling doaj-art-a7eedcdc5fd04512a71d01752f151d3a2025-08-20T04:03:06ZengNature PortfolioCommunications Medicine2730-664X2025-07-015111010.1038/s43856-025-01016-0Obstructive sleep apnea severity varies by season and environmental influences such as ambient temperatureBastien Lechat0Duc Phuc Nguyen1Kelly Sansom2Lucia Pinilla3Hannah Scott4Amy C. Reynolds5Andrew Vakulin6Jack Manners7Robert J. Adams8Jean-Louis Pepin9Pierre Escourrou10Peter Catcheside11Danny J. Eckert12Flinders Health and Medical Research Institute:Sleep Health, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute:Sleep Health, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute:Sleep Health, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute:Sleep Health, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute:Sleep Health, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute:Sleep Health, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute:Sleep Health, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute:Sleep Health, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute:Sleep Health, College of Medicine and Public Health, Flinders UniversityUniv. Grenoble Alpes, HP2 Laboratory, Inserm U-1300, CHU Grenoble AlpesCentre Interdisciplinaire du SommeilFlinders Health and Medical Research Institute:Sleep Health, College of Medicine and Public Health, Flinders UniversityFlinders Health and Medical Research Institute:Sleep Health, College of Medicine and Public Health, Flinders UniversityAbstract Background Obstructive sleep apnea (OSA) severity often varies considerably from night-to-night, but whether environmental factors play a role is unclear. This study investigated seasonal and temperature-related changes in OSA severity. Methods Data were acquired from 70,052 participants with an average apnea-hypopnea index (AHI) ≥ 5 events/hour who used an under-mattress sleep sensor at least 4 times/week between January 2020 and September 2023. Fixed effect models were used to investigate the association between AHI and day of the year, adjusting for geographical location, variation in total sleep time, ambient temperature, and air pollution. Results Participants are middle-aged (mean ± SD, 53 ± 13 years), predominantly male (81%), overweight (BMI; 29 ± 6 kg/m2) and have an average of 492 ± 341 nights of data. Mean AHI is 18.0 ± 14.0 events/h and within-subject coefficient of variation is ±51%. AHI is ~5% higher during summer/winter compared to spring/autumn in the northern hemisphere, and 10–15% higher during summer compared to spring in the southern hemisphere. Higher ambient temperature (25th vs. 75th percentiles; 6 vs. 18 degrees Celsius) is associated with a 6.4% (95% CI; 6.3–6.5) increase in AHI. Results are consistent across 23 countries, although the effect of temperature on AHI is larger in Europe vs. the United States or Australia. Conclusions Here we demonstrate a seasonal component to OSA severity, partially explained by ambient temperature and seasonal variation in sleep duration. Our findings highlight the need to report data collection months in OSA clinical trials, and further study to uncover the physiology behind seasonal variation in OSA severity are required.https://doi.org/10.1038/s43856-025-01016-0
spellingShingle Bastien Lechat
Duc Phuc Nguyen
Kelly Sansom
Lucia Pinilla
Hannah Scott
Amy C. Reynolds
Andrew Vakulin
Jack Manners
Robert J. Adams
Jean-Louis Pepin
Pierre Escourrou
Peter Catcheside
Danny J. Eckert
Obstructive sleep apnea severity varies by season and environmental influences such as ambient temperature
Communications Medicine
title Obstructive sleep apnea severity varies by season and environmental influences such as ambient temperature
title_full Obstructive sleep apnea severity varies by season and environmental influences such as ambient temperature
title_fullStr Obstructive sleep apnea severity varies by season and environmental influences such as ambient temperature
title_full_unstemmed Obstructive sleep apnea severity varies by season and environmental influences such as ambient temperature
title_short Obstructive sleep apnea severity varies by season and environmental influences such as ambient temperature
title_sort obstructive sleep apnea severity varies by season and environmental influences such as ambient temperature
url https://doi.org/10.1038/s43856-025-01016-0
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