Age Acceleration Associated with Sleep Disordered Breathing

by | Mar 16, 2020 | 2019, Aging, Sleep

Written by Joyce Smith, BS. Study suggests an association between sleep disordered breathing severity and epigenetic age acceleration.

sleepEpigenetic age is an estimate of biological age, based on changes in DNA methylation at various locations along the genome and epigenetic age acceleration is a DNA methylation (DNAm)-based marker of fast biological aging. Recent research suggests that, like chronological age, environmental and physiological risk factors such as smoking and heart disease, epigenetic age can predict life expectancy.

Sleep disordered breathing (SDB), a highly prevalent chronic and treatable condition, is characterized by recurrent episodes of apnea, which causes episodes of complete or partial upper airway obstruction during sleep 1 and consequently leads to interrupted sleep and decreased oxygenation of blood hemoglobin 1 These episodes of apnea, more prevalent in men, and increasing over the last twenty years 2,3, have been linked to age-related cognitive decline 2 and chronic diseases like stroke, coronary heart disease, and heart failure 4. Modifiable lifestyle factors such as smoking, diet, exercise, and alcohol consumption are known aging accelerants 5. However, sleep behaviors and disorders, while potentially modifiable, have been studied very little for their potential role in epigenetic age acceleration.

In a current cross-sectional and prospective study 6, researchers analyzed data from 622 adults (mean age 69, 53% women), who participated in the Multi-Ethnic Study of Atherosclerosis (MESA), underwent blood testing to measure DNAm and in-home polysomnography to measure the apnea-hypopnea index (AHI) (the percentage of sleep time during which hemoglobin oxygen saturation was lower than 90%), and arousal index. In this ethnically diverse cohort, 44.7% of women and 47.4% of men were white, 23.9% of women and 18.6% of men were black, and 31.4% of women and 34% of men were Hispanic. Statistical analyses adjusted for variables associated with aging, including health behaviors, body-mass index, and sociodemographic factors. Findings from the MESA were as follows:

  • Apnea-hypopnea index (AHI) score was associated with greater age acceleration according to the (DNAm) PhenoAge measure (β = 0.03; 95% CI 0.00-0.06). A one-unit increase in AHI was associated with 0.03 years (or 11 days) of DNAm-PhenoAge acceleration which was equivalent to 215 days of increased biological age for each standard deviation (1-SD) increase in AHI.
  • Arousal index was associated with greater DNAm age acceleration (β = 0.04; 95% CI 0.01-0.07). A one unit increase in arousal index was associated with 0.04 years (or 15 days) of DNAm-Age acceleration, which was equivalent to 321 days of DNAm age acceleration for each 1-SD increase in arousal index.
  • Both associations were stronger in women compared with men, and the associations were independent of measured confounders.

Researchers did a secondary analysis involving 530 individuals from the Farmington Heart Study (FHS) to study possible associations between SBD traits and epigenetic age acceleration in a predominantly white cohort. A meta-analysis of both cohorts was done to confirm the results.

Study strengths included the use of two well-established measures of epigenetic age acceleration that enabled Li and colleagues to capture fast biological aging. Also, the comprehensive data allowed for analysis using multiple potential cofounders. The fact that the study cohort was both racially and ethnically diverse and included both men and women allowed for generalization. While this cross-sectional, prospective analysis could not prove causality, it did demonstrate an association between more severe sleep disordered breathing and epigenetic accelerated aging. Additional research is needed to further explore the role of SDB on aging and the potential for SDB treatment to improve age-related chronic conditions and increase life expectancy.

Source: Li, Xiaoyu, Roby Joehanes, Ina Hoeschele, Stephen S. Rich, Jerome I. Rotter, Daniel Levy, Yongmei Liu, Susan Redline, and Tamar Sofer. “Association between sleep disordered breathing and epigenetic age acceleration: Evidence from the Multi-Ethnic Study of Atherosclerosis.” EBioMedicine 50 (2019): 387-394.

© 2019 The Author(s). This is an open access article under the CCBY-NCND license. (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Posted March 16, 2020.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

References:

  1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. New England Journal of Medicine. 1993;328(17):1230-1235.
  2. Rosenzweig I, Glasser M, Polsek D, Leschziner GD, Williams SC, Morrell MJ. Sleep apnoea and the brain: a complex relationship. The Lancet Respiratory Medicine. 2015;3(5):404-414.
  3. Gaspar LS, Álvaro AR, Moita J, Cavadas C. Obstructive sleep apnea and hallmarks of aging. Trends in molecular medicine. 2017;23(8):675-692.
  4. Gottlieb DJ, Yenokyan G, Newman AB, et al. A Prospective Study of Obstructive Sleep Apnea and Incident Coronary Heart Disease and Heart Failure: The Sleep Heart Health Study. Circulation. 2010;122(4):352-360.
  5. Redline S, Yenokyan G, Gottlieb DJ, et al. Obstructive sleep apnea–hypopnea and incident stroke: the sleep heart health study. American journal of respiratory and critical care medicine. 2010;182(2):269-277.
  6. Quach A, Levine ME, Tanaka T, et al. Epigenetic clock analysis of diet, exercise, education, and lifestyle factors. Aging (Albany NY). 2017;9(2):419.