What you do on the weekend can trigger a new sleep disorder

The combination of staying up late, drinking alcohol, and smoking on weekends can cause more than just a terrible headache on Monday morning. It could trigger a newly identified sleep disorder known as social apnea , researchers at Flinders University warn.

The international study, published in the American Journal of Respiratory and Critical Care Medicine, presents social apnea as a new trend in sleep medicine and refers to the increase in the severity of obstructive sleep apnea (OSA) on weekends, driven by irregular sleep habits and patterns.

The study, which analyzed data from more than 70,000 people worldwide, revealed a consistent and significant increase in OSA severity on weekends. Experts at the FHMRI Sleep Health Center coined the term "social apnea" to describe this phenomenon.

“ Sleep apnea is already a major public health problem , but our findings suggest its true impact may be underestimated. Most clinical diagnostic tests are performed on a single evening, usually during the week, avoiding the weekend effect we now call social apnea,” said lead author and researcher Lucía Pinilla, PhD, from FHMRI Sleep Health.

Dr. Pinilla explains that this increase in sleep-disordered breathing during the weekend can increase the risk of serious health problems, such as heart disease, depression , dementia, extreme fatigue, and traffic and other accidents.

The study found that participants were 18% more likely to have moderate to severe OSA on weekends (Saturdays) than midweek (Wednesdays).

Changes in sleep schedules, such as staying up later or sleeping in , worsened sleep apnea. Sleeping an extra 45 minutes or more on weekends increased the risk of more severe sleep apnea by 47%. Men were also 21% more likely to be affected, compared with a 9% increase in women.

Younger adults (under 60) had a 24% higher risk on weekends, compared with 7% for those 60 and older.

Professor Danny Eckert, Director of Sleep Health at the FHMRI and senior author of the paper, notes that this is the first evidence that OSA severity increases over the weekend. "We don't yet know exactly why, but alcohol consumption, lighter sleep, and less consistent use of OSA therapies likely play a role," he adds.

For his part, Dr. Bastien Lechat, lead author of a separate paper recently published in the prestigious journal Nature's Communications Medicine, suggests that similar mechanisms may influence seasonal variability in OSA severity. " Obstructive sleep apnea tends to worsen during the summer and winter , with an 8% to 19% increase in severity compared to spring and fall," says Dr. Lechat.

This seasonal increase is partly explained by higher temperatures, which disrupt sleep and lead to lighter sleep phases, which is associated with worse OSA. In winter, sleeping longer and waking up later increases REM sleep time, which is also linked to a higher frequency of sleep apnea episodes.

Professor Eckert says these findings align with the concept of "social apnea" and highlight the need for multi-night sleep assessments and more personalized approaches to diagnosis and treatment. "Relying on a single-night sleep study can miss important variations, leading to underdiagnosis or misclassification of OSA severity," he says.

To combat social apnea, Professor Eckert recommends maintaining a regular sleep routine. "Try to maintain the same sleep schedule during the week and on weekends, ensuring you get the recommended 7 to 9 hours of sleep per night ," he says.

OSA is a common sleep disorder affecting approximately one billion people worldwide. It results from repeated airway collapse during sleep and, if left untreated, increases the risk of heart disease, diabetes, cognitive decline, depression, and even death.