Untreated sleep apnea linked to premature cardiovascular aging and increased mortality: Study

A new study published in npj Aging, one of the leading journals in gerontology and geriatrics, provides compelling evidence that untreated obstructive sleep apnea (OSA) accelerates cardiovascular aging and significantly increases the risk of premature death.

Researchers at the University of Missouri School of Medicine and the Marshall University Joan C. Edwards School of Medicine led by David Gozal, M.D., M.B.A., Ph.D. (Hon), vice president of health affairs at Marshall University and dean of the Joan C. Edwards School of Medicine, used a long-term mouse model that simulates the intermittent drops in oxygen levels characteristic of sleep apnea.

The research team examined how prolonged exposure to intermittent hypoxia during the time corresponding to usual sleep behaviors in mice influences cardiovascular health across the lifespan. In this model, prolonged intermittent hypoxia was associated with significantly higher mortality compared to normal oxygen conditions. The model also demonstrated clear signs of accelerated cardiovascular aging, including increased blood pressure, impaired heart function, reduced vascular flexibility, diminished coronary flow reserve and abnormalities in cardiac electrical activity. Together, these findings show that the chronic physiological stress created by untreated sleep apnea fundamentally alters cardiovascular structure and function in ways that can shorten lifespan.

“Our findings demonstrate that the consequences of obstructive sleep apnea extend far beyond poor sleep quality,” said lead author Mohammad Badran, Ph.D., MSc., assistant professor of pediatrics and medical pharmacology and toxicology at the University of Missouri School of Medicine. “Prolonged intermittent hypoxia creates a cumulative burden on the cardiovascular system that accelerates biological aging and elevates mortality risk. This underscores how critically important it is to diagnose and treat sleep-disordered breathing as early as possible.”

Gozal emphasized the study’s relevance to human health. “While clinical studies have long shown associations between sleep apnea and cardiovascular disease, our experimental model allows us to observe these effects across the lifespan in the absence of other confounding factors,” he said. “The results make the message unmistakably clear: untreated sleep apnea is not benign. It is a progressive condition with potentially fatal consequences.”

The implications of this research are especially significant for Appalachia, where both cardiovascular disease and undiagnosed sleep apnea are prevalent. Early screening and intervention, including the use of continuous positive airway pressure (CPAP) therapy and other treatment options, may play a key role in improving long-term cardiovascular outcomes, particularly in rural and underserved communities.

Reference:

Badran, M., Puech, C. & Gozal, D. Prolonged intermittent hypoxia accelerates cardiovascular aging and mortality: insights from a murine model of OSA. npj Aging 11, 92 (2025). https://doi.org/10.1038/s41514-025-00283-4