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A study into sleep apnoea - a condition marked by snoring and breathing interruptions - has shown that people with the condition appeared less attractive, youthful and alert than restful sleepers.
Sufferers who were treated for the condition also appeared more attractive - with two thirds of the patients in the study being rated more highly in photos taken after treatment than before.
Researchers used a sensitive 'face mapping technique' - more commonly used by surgeons - along with a panel of independent appearance raters to judge changes in 20 middle-aged apnoea patients who used a new treatment called CPAP to help them breathe better during sleep.
They found that patients had puffier foreheads and redder faces before treatment.
The 22 raters, who were asked to look at 'before' and 'after' pictures to rank attractiveness, also said people appeared to have fewer wrinkles after treatment.
They also correctly identified patients 'after' treatment two-thirds of the time.
However, the researchers didn't see a big change in facial characteristics more commonly associated with sleepiness, such as dark circles and puffiness under the eyes.
Sleep apnoea affects millions of adults and puts them at higher risk of heart-related problems and daytime accidents.
CPAP is known to stop snoring, improve daytime alertness and reduce blood pressure.
Researchers say the findings may eventually give apnoea patients even more reason to stick with CPAP treatment - a challenge for some because they must wear a breathing mask in bed.
Study leader and sleep neurologist Doctor Ronald Chervin, director of the University of Michigan Sleep Disorders Centre, U.S., said the study grew out of anecdotal evidence that staff often saw in sleep apnoea patients when they visited the centre after using CPAP.
The team sought a more scientific way to assess appearance before and after sleep treatment.
Dr Chervin said: '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.
'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.'
Tired: Researchers said signs usually associated with lack of sleep, such as dark circles, did not change
Capable of measuring tiny differences in facial contours, the system helps surgeons plan operations and assess their impact.
Dr Buchman said: 'One of the breakthroughs in plastic surgery over the last decade has been our aim to get more objective in our outcomes.
'The technology used in this study demonstrates the real relationship between how you look and how you really are doing, from a health perspective.
'Further research is needed, to assess facial changes in more patients, and over a longer period of CPAP treatment.
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