Sleep apnea – a disorder marked by snoring and breathing interruptions – affects millions of adults. When left untreated, it can increase the risk of high blood pressure, heart attack, stroke, obesity and diabetes.

The most effective at-home treatment for sleep apnea is called CPAP (continuous positive airway pressure) which uses mild air pressure to keep the airways open – but it’s a challenge for many because a breathing mask must be worn while sleeping.

But now a study from the University of Michigan Health System and Michigan Technological University may get more people to use the treatment; researchers have found that CPAP increases a user’s attractiveness.

Sleep neurologist Ronald Chervin, M.D., M.S., director of the U-M Sleep Disorders Center, led the study, which was inspired by anecdotal evidence that sleep center staff often noticed a difference in appearance with patients who had started CPAP. The team decided to adopt a scientific approach to assess appearance before and after sleep treatment.

Using a special "face mapping" technique usually used by surgeons, combined with a group of independent "appearance raters," the study determined distinct changes in 20 apnea patients who had used CPAP for a just a few months.

"The common lore, that people ‘look sleepy’ because they are sleepy, and that they have puffy eyes with dark circles under them, drives people to spend untold dollars on home remedies," notes Chervin. "We perceived that our CPAP patients often looked better, or reported that they’d been told they looked better, after treatment. But no one has ever actually studied this."

Along with U-M plastic and reconstructive surgeon Steven Buchman, they employed the face mapping technology – called photogrammetry – to take a series of images in identical conditions before and after the treatment. The technique is sensitive to the smallest of differences in facial contours and is used to assess objective outcomes of plastic surgery.

The photogrammetry results showed that after treatment, patients’ foreheads "were less puffy, and their faces were less red." They also perceived a reduction in forehead wrinkles. Curiously, the researchers were unable to confirm a reduction in the aesthetic detriments usually associated with a lack of sleep.

"We were surprised that our approach could not document any improvement, after treatment, in tendency to have dark blue circles or puffiness under the eyes," says Chervin.

The team also gathered the subjective opinions of 22 raters who were instructed to select which they thought were the before and after images, and then to rank attractiveness, alertness and youthfulness.

Two-thirds of the time, the raters correctly selected the right before and after pictures, and two-thirds of the time they also noted that in the post-treatment photos, the patients looked more alert, more youthful and more attractive.

Chervin plans to continue to study the effect of sleep apnea treatment. "We want sleep to be on people’s minds, and to educate them about the importance of getting enough sleep and getting attention for sleep disorders," he says.

And if the risk of risk of high blood pressure, heart attack, stroke, obesity, and diabetes isn’t enough, maybe the allure of looking good will be.

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