[News] CLIMATE CHANGE AND OSA

[srlevine1]

What else can they blame on climate change? 

Climate change is making it harder for us to sleep: Study
Obstructive sleep apnea affects about 1 billion people globally.

ByMatthew Glasser and Dr. Ilan Kokotek

Rising temperatures, amplified by climate change, are contributing to an increase in cases of sleep apnea, a condition in which breathing repeatedly stops during sleep, according to a new study published in the journal Nature Communications.

"If temperature keeps rising the way they project it to, the burden and prevalence of sleep apnea may double, increasing by 20-100%, depending on greenhouse gas emission reduction," Bastien Lechat, the study's author and a senior research fellow at Flinders University in Australia, told ABC News.

Obstructive sleep apnea, or OSA, affects about 1 billion people globally, and 80% of people who have it are unaware and untreated, according to the American Medical Association. Common symptoms of OSA include loud snoring, daytime tiredness, high blood pressure and headaches upon waking, even if "sleeping" eight hours, according to the Mayo Clinic.

OSA has been linked to an increased risk of heart disease, stroke, dementia, diabetes and depression. People with OSA also have two times greater risk of getting in a car accident, according to Lechat.

The study followed over 115,000 people from numerous countries for up to two years, measuring their sleep quality with below-the-mattress sleep monitors and then cross-referencing this information with weather data to evaluate the relationship between temperature and OSA.

When comparing 80-degree Fahrenheit days to days in the 40s, there was a 40 to 45% increase in the frequency or severity of sleep apnea. The risk was even higher for males and individuals who normally sleep longer or have higher body weight.

Extreme heat can exacerbate OSA by making it even harder to sleep, the study noted. Higher temperatures can disrupt the body's ability to cool down during the night, which interferes with the natural sleep cycle. This can lead to more frequent awakenings, shallower sleep and worsened airway instability, resulting in more apnea events.

Using existing health-economic models, the researchers estimated over 788,000 healthy years of life were lost or disabled in 2023 due to temperature-related increases in OSA, equivalent to a loss of approximately $68 billion, according to the models.

"When you look at the rate of years of life lost per 100,000 people, this is similar to a disorder like Parkinson's disease, or bipolar disorder, or similar to low physical activity as a risk factor, so it's a significant burden," Lechat told ABC News.

Lechat said that increased access to air conditioning and better diagnosis and treatment of OSA could offset some of the increases caused by climate change.

As our planet warms, heat waves are becoming increasingly more common, having doubled in major U.S. cities since the 1980s, according to the federal government's Fifth National Climate Assessment.

Overnight low temperatures are rising nearly twice as fast as afternoon highs, and this lack of relief during the night poses a significant health risk -- particularly for those without access to air conditioning, according to the assessment.  Climate change is making it harder for us to sleep: Study - ABC News
Global warming may increase the burden of obstructive sleep apnea | Nature Communications

[StevesSp]

I think we must be up to our tenth "Five years to avert climate disaster" warning by now, if not more.

Meanwhile, here in Australia, the Great Barrier Reef stubbornly refuses to die, the dams (reservoirs) that would never fill again are overflowing and the snow that children would never see is falling on the Snowy Mountains as we speak. Oceanfront property continues to climb in value and Brisbane still isn't underwater.

It also seems that climate change is so boring now that even the Scowling Goblin of Doom (St Greta) has had to find something else to protest about. Yawn.

[Sleeprider]

Full text of the article on Nature Communications https://www.nature.com/articles/s41467-025-60218-1
I would really like to see who funded this, but the references are full of IPCC sources, and the use of the Withings health app (Nokia) to collect sleep and temperature data among a cohort of Withings App users. I'm trying my best not to dismiss this as complete B.S. without any attempt at correlation or confidence in the analyses.

[srlevine1]

Sleeprider, your skepticism is well-founded. 

In reading studies of this nature, the scientific method demands skepticism.

Look for the weasel-words, "modeled," "consistent," projected," "estimates, "would be, and "may." All raising questions of interpretation and the lack of error estimates. Where models are involved, one must suspect "p-hacking," where you re-run data scenarios until you reach a publisable outcome that supports the hypothesis."

"Modelled temperatures consistent with the continuation of government climate change policies implemented by 2020 are projected to lead to global warming of 2.1 to 3.4 °C by 2100.  The health and economic impact of these estimates would be consequential, and the increase inOSA prevalence due to rising temperatures in such scenario may double the overall OSA burden." 

[b]Statistical findings often come with a confidence interval, which, in many cases, are rendered irrelevant by confounding factors. Few people read or skip over the caveats, which are determinative to the integrity, accuracy, and usefulness of the study.[/b]

"Furthermore, since we lacked access to precise geographical locations and the indoor temperature of users, exact temperaturerelated effects could not be calculated. The potential confounding effect of air pollution on the association between high temperature and nightly OSA status may also have been underestimated since we lacked precise geographical locations and indoormeasurements of air pollution. We also lacked clinical information on participants’ comorbidities, treatment status, daytime symptoms, and impairments, and thus, could not explore potential modifiable effects of these conditions and symptoms on the detected association."

Large temperature datasets often contain inconsistencies, missing values, duplicates, or measurement errors, and the more comparisons you make, the higher the probability that some will appear statistically significant due to random variation. As for OSA data, one must consider the impact of wake-sleep junk and other conditions normally unaccounted for. 

"Data for final analysis was acquired from 116,620 regular users of the under-mattress OSA sensor."  "The under-mattress sensor used in this study does not measure
the contribution of some physiological aspects of OSA (e.g., hypoxia, arousals) which may undermine OSA detection. However, existing validation studies versus gold standard polysomnography in over 150 participants support the device performance characteristics.

Wow! Sensor is "validated" by a minuscule number of polysom participants. Consider the commercial product (https://withingshealthsolutions.com/devices/sleep-rx/), and you can't help but imagine the study's findings enhancing the device's credibility in sales literature. The company openly recruits willing researchers. 


Can the results be replicated, and can the findings be used to "project" future occurrences, which may be back-tested for accuracy?

Even though the authors provide access to the underlying code and data used to produce the illustrations in their work, it is unlikely that a second review will be undertaken to identify and address analytical inconsistencies. 

Hooray, something got published, but is it valuable in the sense that the findings are useful? Not unless you are a politician demanding "something be done" and consider your job is done with identifying a problem without a rational solution. Or a commercial enterprise wanting to impute scientific accuracy or value of a device. 

-- Steve