Social jetlag and obstructive sleep apnea severity: A retrospective study based on polysomnography

Area of Science:

• Sleep Medicine
• Chronobiology
• Public Health

Background:

• Social jetlag, the discrepancy between biological and social sleep timing, is linked to poor health.
• The relationship between social jetlag and obstructive sleep apnea (OSA) severity is not well understood.

Purpose of the Study:

• To investigate the association between social jetlag and obstructive sleep apnea (OSA) severity, measured by the apnea-hypopnea index (AHI).
• To explore the mediating role of daytime sleepiness and effect modification by demographic and clinical factors.

Main Methods:

• Retrospective analysis of 2383 OSA patients undergoing polysomnography.
• Social jetlag quantified by mid-sleep difference between work and free days (minimal, moderate, severe).
• Multiple linear regression and mediation analysis, with subgroup and generalized additive models (GAM).

Main Results:

• Severe social jetlag was independently associated with higher AHI (p=0.004).
• Epworth Sleepiness Scale (ESS) mediated 19.4% of the social jetlag-AHI association.
• Stronger associations observed in males and smokers; non-linear increase in AHI with social jetlag.

Conclusions:

• Severe social jetlag independently elevates AHI in OSA patients, partly mediated by daytime sleepiness.
• Circadian misalignment emerges as a potential modifiable factor influencing OSA severity.
• Findings highlight the importance of addressing social jetlag in OSA management, particularly for males and smokers.