Association of self-reported physical activity with obstructive sleep apnea: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Abstract

We examined associations of mild and moderate to severe obstructive sleep apnea (OSA; apnea-hypopnea index ≥5 and ≥15, respectively) with recommended amounts of moderate-vigorous physical activity (MVPA) or vigorous physical activity (VPA) and by type of activity (i.e., recreational, transportation, and work activity). The Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multicenter population-based study, enrolled individuals from 2008 to 2011 from four U.S. metropolitan areas (Bronx, New York; Chicago, Illinois; Miami, Florida; San Diego, California). Participants in this study included 14,206 self-identified Hispanic/Latino ages 18 to 74 years from theHCHS/SOL. Survey logistic regression analysis was used to compute odds ratios [OR] and 95% confidence intervals [CI], adjusting for sociodemographics, smoking status, and body mass index (BMI). Relative to being inactive, performing some MVPA (>0 to <150 minutes/week) or meeting the recommended MVPA (≥150 minutes/week) were associated with lower odds of mild OSA (ORs and 95% CIs 0.70 [0.61-0.82] and 0.76 [0.63-0.91], respectively), as well as moderate to severe OSA (ORs and 95% CIs 0.76 [0.62-0.93] and 0.76 [0.59-0.98], respectively). Associations of VPA with OSA were not significant. Engaging in medium or high levels of transportation activity was associated with lower odds of mild OSA (OR: 0.84, 95% CI: 0.74-0.96; OR: 0.64, 95% CI: 0.43-0.95, respectively). Performing some recreational MVPA was associated with lower likelihood of mild and moderate to severe OSA (OR: 0.82, 95% CI: 0.71-0.93; OR: 0.79, 95% CI: 0.64-0.97, respectively). Health promotion and OSA prevention efforts should encourage individuals to engage in at least some MVPA.

Physical activity as a moderator for obstructive sleep apnoea and cardiometabolic risk in the EPISONO study

“…Another important finding of our study is the negative association between physical activity level and OSA severity, even when adjusted for BMI. Previous epidemiological studies suggested this association; however, it was not possible to establish a causal relationship because they were cross-sectional [27][28][29][30]. A casecontrol study showed an OR for moderate-severe OSA of 0.6 (95% CI 0.5-0.8), 1.6 (95% CI 1.2-2.0) and 2.7 (95% CI 1.9-3.7) in high, low and nil exercise groups, respectively [8].…”

Cardiorespiratory fitness and long‐term risk of sleep apnea: A national cohort study

“…Because this study was based on Swedish military conscripts, the cohort consisted entirely of men. However, other studies have found that associations between BMI or physical activity and sleep apnea severity are similar in women compared with men (Aiello et al., ; Iftikhar et al., ; Murillo et al., ; da Silva et al., ; Young et al., ). Sleep apnea may have been substantially under‐diagnosed in the present cohort.…”

“…TA B L E 1 Characteristics of 18-year-old men who were or were not subsequently diagnosed with sleep apnea, Sweden, 1969Sweden, -2012 To our knowledge, this is the first study to examine CRF in relation to the risk of sleep apnea. Prior studies have suggested that high physical activity or exercise levels are associated with reduced symptoms and improved outcomes in patients with existing OSA, irrespective of body weight or BMI (Aiello et al, 2016;Iftikhar et al, 2014;Mendelson et al, 2018;Murillo et al, 2016;da Silva et al, 2017). For example, three meta-analyses of small clinical trials reported that exercise training was independently associated with reduced severity of apnea symptoms in patients with OSA (Aiello et al, 2016;Iftikhar et al, 2014;Mendelson et al, 2018).…”

“…In addition, a cohort study of 14,087 Hispanic/Latino adults found that meeting the recommended levels of moderate or vigorous physical activity was linked with reduced risk of OSA, independent of BMI (e.g. adjusted odds ratio for moderate to severe OSA, 0.76; 95% CI, 0.59–0.98; Murillo et al., ). A cross‐sectional study of 5,453 Brazilian adults reported that structured physical exercise was associated with 23% lower odds of moderate OSA and 34% lower odds of severe OSA, after adjusting for BMI (da Silva et al., ).…”

“…Selfreported high physical activity or exercise has been associated with improved symptoms and outcomes in patients with existing OSA, irrespective of weight loss (Aiello et al, 2016;Iftikhar, Kline, & Youngstedt, 2014;Mendelson et al, 2018). However, few studies have examined physical activity in relation to the risk of developing OSA (Murillo et al, 2016;da Silva et al, 2017), and none has examined objectively measured cardiorespiratory fitness (CRF). Selfreported physical activity is a poor proxy for CRF, the underlying physiological factor affected by physical activity that may more directly influence sleep apnea risk (Lee et al, 2011).…”