Social events on weekends can worsen sleep apnea

Late nights, alcohol, and smoking on weekends may be doing more than ruining Monday mornings. Researchers from Flinders University warn that these habits could trigger a newly identified sleep issue called “social apnea.”

Published in the American Journal of Respiratory and Critical Care Medicine, the study describes social apnea as a weekend spike in obstructive sleep apnea (OSA) severity caused by lifestyle changes and irregular sleep patterns.

Sleep apnea is underestimated

The research analyzed data from over 70,000 people worldwide using a validated under-mattress sleep sensor. This device, which is FDA-cleared, accurately measures the apnea-hypopnea index (AHI) and sleep timing.

“Sleep apnea is already a major public health issue, but our findings suggest its true impact may be underestimated,” said lead author Dr. Lucia Pinilla.

“Most clinical diagnostic testing is done on a single night, typically a weeknight, missing the weekend effect we’re now calling social apnea.”

Weekend habits and social apnea

Dr. Pinilla explains that the weekend surge in sleep-disordered breathing could raise risks for heart disease, depression, dementia, and fatigue-related accidents.

Participants were 18% more likely to have moderate to severe OSA on Saturdays compared to Wednesdays. Men had a 21% higher risk, while women had a 9% increase. Younger adults under 60 faced a 24% higher risk, compared to 7% in those over 60.

Weekend catch-up sleep of at least 45 minutes increased weekend OSA odds by 47%, while social jetlag of 60 minutes or more raised it by 38 percent.

Danny Eckert, a professor at Flinders University, says this study is the first time researchers have found proof that OSA gets worse on weekends compared to weekdays.

“We don’t yet know exactly why, but alcohol use, lighter sleep, and less consistent use of OSA therapies likely play a role.”

Seasons can make symptoms worse

Dr. Bastien Lechat, lead author of a related study published in Communications Medicine, says seasonal changes may trigger similar OSA fluctuations.

“OSA tends to be worse during summer and winter, with severity increasing by 8-19% compared to spring and autumn,” said Dr. Lechat.

“This seasonal spike is partly explained by higher temperatures, which disrupt sleep and lead to lighter sleep stages which is associated with worse OSA. In winter, longer sleep and later wake up times, increase time spent in REM sleep, which is also linked to more frequent apnea events.”

These findings mirror the weekend pattern and highlight that both social and environmental factors influence obstructive sleep apnea.

Why weekend changes matter

The study revealed that apnea-hypopnea index levels were on average 6% higher on weekends, equivalent to nearly one more apnea event per hour at the group level.

Irregular sleep patterns were strongly linked to this effect. Those with consistent sleep schedules showed no significant weekend increase.

Since OSA is often worse during REM sleep, weekend sleep-ins may extend REM stages, intensifying symptoms.

Such patterns could carry major public health costs. Even small increases in OSA severity may significantly impact wellbeing and healthcare expenses.

Tests may miss social apnea

Professor Eckert warns that relying on a single-night sleep study may lead to underdiagnosis or misclassification. OSA testing usually happens on weeknights, overlooking weekend variability.

Historically, OSA treatment adherence has been measured over five nights a week, allowing for lower weekend use. The findings suggest that inconsistent weekend therapy use could be a key driver of social apnea.

To reduce weekend spikes, Professor Eckert advises maintaining a steady sleep schedule. “Try to keep the same sleep schedule throughout the week and weekend, ensuring that you get the recommended 7-9 hours of sleep a night.”

“Keeping a fixed wake-up time and using your prescribed OSA therapy, even on weekends, and going to bed when you feel sleepy will help ensure you frequently get enough restorative sleep which can help combat the weekend spike in OSA.”

Understanding OSA and its impact

OSA affects about one billion people worldwide and is caused by repeated airway collapse during sleep. Untreated, it raises the risk of heart disease, diabetes, cognitive decline, depression, and even death.

People concerned about their sleep should consult their doctor for assessment. The study confirms that social apnea is a global phenomenon, with consistent weekend increases in OSA severity across different countries and climates.

The study is published in the American Journal of Respiratory and Critical Care Medicine.

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