Physically Active Lifestyle May Protect Against Obstructive Sleep Apnea

NEW YORK (Reuters Health) – Maintaining an active lifestyle may help protect against obstructive sleep apnea (OSA), according to new research that found higher levels of physical activity and fewer hours spent sitting were associated with a lower risk of OSA.

“The results are fairly expected, because we know that being physically active and less sedentary are effective in reducing obesity, which is a strong risk factor for OSA,” Tianyi Huang, with Brigham & Women’s Hospital in Boston, told Reuters Health by email.

“In addition to reducing obesity, an active lifestyle improves insulin resistance and lowers inflammation. Insulin resistance and inflammation are important mechanisms that may cause OSA. An active lifestyle during the day also reduces excessive body fluid retention; when people lie down asleep, these excessive body fluids can pressure the lung to reduce its volume and cause OSA,” Huang explained.

The findings are based on data from more than 118,000 women from the Nurses’ Health Study (2002-2012) and Nurses’ Health Study II (1995-2013) and more than 19,000 men from the Health Professionals Follow-up Study (1996-2012).

Every two to four years, participants reported their recreational physical activity (quantified by metabolic equivalent of task, or MET hours per week) and time spent sitting. Physician-diagnosed OSA was self-reported.

During roughly two million person-years of follow-up, 8,733 people developed OSA.

After adjusting for potential confounders, people who got 36 or more MET-hours per week of physical activity (vs less than six MET-hours/week) had a 54% lower risk of OSA (hazard ratio: 0.46; 95% CI: 0.43 to 0.50; P for trend<0.001), the researchers report in the European Respiratory Journal.

Compared with those spending less than four hours each week sitting watching TV, those spending 28 or more hours in front of the TV had a 78% increased risk of OSA (HR: 1.78; 95% CI: 1.60 to 1.98; P<0.001). The corresponding HR was 1.49 (95% CI: 1.38 to 1.62; P<0.001) for 28+ weekly hours sitting at work/away from home.

With additional adjustment for several metabolic factors including body mass index and waist circumference, the associations with physical activity and sitting hours at work/away from home were attenuated but remained significant (P<0.001), whereas the association with sitting hours watching TV was no longer statistically significant (P=0.18).

“Most prior observational studies on the associations of physical activity and sedentary behavior with OSA were cross-sectional, with incomplete exposure assessment and inadequate control for confounding,” Huang said in a news release. “This is the first prospective study that simultaneously evaluates physical activity and sedentary behavior in relation to OSA risk.”

“Promoting an active lifestyle can prevent OSA, and promoting an active lifestyle should not only focus on increasing physical activity but also reducing sedentary hours,” Huang told Reuters Health.

Funding for this work was provided by The National Heart, Lung and Blood Institute (NHLBI), part of the National Institutes of Health (NIH). Dr. Huang declares no conflicts of interest.

SOURCE: European Respiratory Journal, online July 21, 2021.

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