Physical Inactivity Is Associated with Moderate-Severe Obstructive Sleep Apnea

Abstract

Study Objectives: To investigate whether low levels of physical activity were associated with an increased occurrence of obstructive sleep apnea (OSA), OSA-related symptoms, and cardiometabolic risk. Methods: A case-control study design was used. OSA cases were patients referred to a sleep clinic for suspected OSA (n = 2,340). Controls comprised participants from the Busselton community (n = 1,931). Exercise and occupational activity were derived from questionnaire data. Associations were modelled using logistic and linear regression and adjusted for confounders. Results: In comparison with moderate exercise, the high, low, and nil exercise groups had an odds ratio (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), respectively. Relative to men in heavy activity occupations, men in medium, light and sedentary occupations had an OR for moderate-severe OSA of 1.7 (95% CI 1.1-2.5), 2.1 (95% CI 1.4-3.2), and 1.8 (95% CI 1.2-2.8), respectively. Relative to women in medium activity occupations, women in light and sedentary occupations had an OR for moderate-severe OSA of 4.2 (95% CI 2.6-7.2) and 3.5 (2.0-6.0). OSA patients who adequately exercised had lower: levels of doctor-diagnosed depression (p = 0.047); symptoms of fatigue (p < 0.0001); systolic (p = 0.015) and diastolic blood pressure (p = 0.015); and C-reactive protein (CRP) (p = 0.003). Conclusions: Low levels of physical activity were associated with moderate-severe OSA. Exercise in individuals with OSA is associated with lower levels of depression, fatigue, blood pressure and CRP.

Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis

“…Twenty of the included studies used a cross sectional design [10], [11], [13], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], nine were case controlled [5], [12], [40], [41], [42], [43], [44], [45], [46], and two were cohort studies [47], [48]. Eleven were conducted in Asia (five studies in Korea, two studies in India, one study in Israel, one study in Taiwan, one study in Japan, and one study in Pakistan) [5], [11], [24], [25], [28], [29], [30], [38], [39], [40], [42]; ten in US [13], [23], [27], [34], [35], [36], [37], [44], [47], [48], four in Australia [33], [43], [45], [46]; five in Europe (Denmark, United Kingdom, Ireland, Norway, Germany) [10], [12], [26], [32], [41], and one in Africa [31].…”

“…Eleven were conducted in Asia (five studies in Korea, two studies in India, one study in Israel, one study in Taiwan, one study in Japan, and one study in Pakistan) [5], [11], [24], [25], [28], [29], [30], [38], [39], [40], [42]; ten in US [13], [23], [27], [34], [35], [36], [37], [44], [47], [48], four in Australia [33], [43], [45], [46]; five in Europe (Denmark, United Kingdom, Ireland, Norway, Germany) [10], [12], [26], [32], [41], and one in Africa [31].…”

“…Twenty three studies ascertained sleep apnoea using polysomnography either measuring its presence and severity using the Apnoea-Hypopnoea Index (AHI) [5], [11], [12], [25], [26], [27], [28], [29], [32], [35], [37], [38], [39], [40], [41], [43], [44], [45], [46], [47], [48] or the Respiratory distress index (RDI) [10], [33]. Seven studies relied on self-report [23], [24], [30], [31], [34], [36], [42] and in the remaining study, sleep apnoea was ascertained using ICD codes [13].…”

“…A further eight studies presented average levels of consumption of alcohol in people with and without OSA [10], [26], [33], [35], [43], [44], [45], [48]. A meta-analysis of these studies found that people with OSA consumed, on average, approximately two units alcohol per week more than people without OSA (pooled mean difference 1.93, 95% CI -2.62 to 6.49, I 2  = 66%, Fig.…”

Obstructive sleep apnoea independently predicts lipid levels: Data from the European Sleep Apnea Database

“…Important to note, the current data set provided no information on physical exercise or fitness which may have influenced in particular the HDL‐C data. Patients with OSA are generally known to have a sedentary lifestyle as shown in several previous studies . A prospective analysis examining the effects of CPAP therapy on the lipid profile in OSA patients included in the ESADA cohort is warranted in order to address some of these study limitations.…”