Team from the University of Coimbra studies disruptions in biological clocks caused by sleep apnea

A study on the impact of sleep apnea on our body’s biological clocks, published in the scientific journal EBioMedicine, The Lancet, points out the urgent need to find new strategies that improve and anticipate the diagnosis of this obstructive respiratory disease, one of the most prevalent sleep disorders in the world, but still very underdiagnosed.

Conducted by a team from the Center for Neuroscience and Cell Biology at the University of Coimbra (CNC-UC), the study aimed to understand to what extent sleep apnea, also called Obstructive Sleep Apnea Syndrome (OSAS), can «promote disruptions in the functioning of biological clocks, which in turn may be the basis of the different comorbidities associated with the pathology, including cardiovascular or metabolic diseases (such as diabetes or obesity), or contribute to their worsening», Explains Ana Rita Álvaro, principal investigator of the project.

Biological clocks, present in all cells of our organism, «are crucial to our health and well-being. They act as internal clocks, organizing all of our biological processes throughout the day, according to signals from the internal environment (food, physical activity) and external (light, temperature, oxygen levels)», Explains the CNC researcher.

To assess the impact of OSAS and its treatment, usually performed with a mask that emits continuous positive pressure (CPAP) during sleep, on the characteristics of biological clocks, the team recruited 34 patients with sleep apnea followed by team from the Center for Sleep Medicine at the Centro Hospitalar e Universitário de Coimbra (CHUC), before and after treatment with CPAP for 4 months and 2 years. Healthy individuals also participated for control purposes.

Using blood samples from the volunteers (patients at different stages of the study and healthy individuals), collected at four different times throughout the day, they were evaluated «the characteristics of biological clocks in cells present in the blood, namely gene expression, and levels of hormones involved in the regulation of biological clocks», Says Ana Rita Álvaro.

The results show that sleep apnea «promotes changes in the characteristics of biological clocks and that long-term treatment (2 years) shows to be more effective in combating the effect of OSAS in biological clocks, leading to a restoration of some of their characteristics», Notes Ana Rita Álvaro.

The laboratory evaluation was complemented with computational analyzes, including bioinformatics and machine learning, developed by the research group led by Angela Relógio, principal investigator at the Molecular Center for Cancer Research and the Institute of Theoretical Biology, Berlin Charité School of Medicine, and director of the Institute of Systems and Bioinformatics Medicine at the Faculty of Medicine of Hamburg (MSH).

This study reinforces the warning for «the importance of treating sleep apnea and also highlights the need for new strategies that improve and anticipate the diagnosis of OSAS and also its treatment. In this sense, this study shows that the analysis of biological clocks can have a promising application in the diagnosis and monitoring of the response to the treatment of this pathology, and certainly other diseases.», Says Cláudia Cavadas, co-author of the study and coordinator of the research group at CNC.

The research was co-financed by the European Fund for Regional Development (ERDF), through the Operational Program for Competitiveness and Internationalization – COMPETE 2020, and by the Foundation for Science and Technology (FCT). It also had the support of the German institution Einstein Foundation through graduated school Berlin School of Integrative Oncology (BSIO), the German Ministry of Education and Research (BMBF), and the Dr. Rolf M. Schwiete Stiftung Foundation.

In addition to Ana Rita Álvaro, Angela Relógio and Cláudia Cavadas, Laetitia Gaspar, Bárbara Santos, Catarina Carvalhas-Almeida, Joaquim Moita, Mafalda Ferreira, Janina Hesse and Müge Yalçin also participated in the study.

The scientific article published as part of the study, entitled “Long-term Continuous Positive Airway Pressure Treatment Ameliorates Biological Clock Disruptions in Obstructive Sleep Apnea”, is available: here.

Caption of the attached image: the treatment of obstructive sleep apnea, represented here by a facial device (CPAP), recovers the well-defined oscillations and the serenity of sleep. (Adapted from the painting “The Dream” by Henri Matisse, 1940). [designer Gil Costa]

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