More physical activity and less sitting associated with a lower risk of sleep apnea

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Sleep Disorders | Sleep Review

A new study by researchers at Brigham and Women’s Hospital examined the link between an active lifestyle and the risk of obstructive sleep apnea (OSA). The study followed approximately 130,000 men and women in the United States for a follow-up period of 10 to 18 years and found that higher levels of physical activity and lower levels of sedentary behavior were associated with a lower risk of OSA. Their results will be published in the European Respiratory Journal.

“In our study, more physical activity and fewer hours of watching TV and sitting at work or away from home were associated with lower incidence of OSA after potential confounders were considered,” says Tianyi Huang, MSc, ScD, an associate epidemiologist at Brigham, in a publication. “Our results suggest that promoting an active lifestyle can have significant benefits for both the prevention and treatment of OSA.”

Using the Nurses ‘Health Study (NHS), Nurses’ Health Study II (NHSII), and the Health Professionals Follow-Up Study (HPFS), the research team used statistical models to compare physical activity and sedentary hours with a diagnosis of OSA . Both moderate and vigorous physical activity were examined separately and both correlated strongly with a lower risk of OSA and showed no significant differences in activity intensity. However, stronger associations were found in women, adults over 65 years of age, and those with a BMI greater than or equal to 25 kg / m2.

“Most of the previous observational studies on the association of physical activity and sedentary behavior with OSA have been cross-sectional studies with incomplete exposure assessments and inadequate control of confounders,” says Huang. “This is the first prospective study that simultaneously assesses physical activity and sedentary behavior in relation to the risk of OSA.”

This study also differs from others because of its large sample size and detailed assessment of physical activity and sedentary behavior. The research team was able to consider many related factors, including the age of the participants, body mass index, and whether they smoked or drank alcohol.

[RELATED: WHO Releases Guidelines on Sleep, Physical Activity, Sedentary Behavior for Children Under 5]

The authors note that all data collected, both on OSA diagnosis and on physical activity or sedentary behavior, were self-reported. Although all study participants were healthcare professionals, mild OSA is often difficult to detect and can go undetected clinically. In addition, only sporting leisure activities were taken into account, with any physical activity in the professional environment being omitted. Sedentary behavior was only counted as sitting while watching TV and sitting outside the home or at work.

Huang says, “We saw a clear correlation between physical activity, sedentary behavior and OSA risk. People who followed the World Health Organization’s current physical activity guidelines, which included at least 150 minutes of moderate activity per week, and who watched TV for less than four hours a day, had a significantly lower risk of OSA. Importantly, we have seen that any additional increase in physical activity and / or a reduction in sedentary hours could have benefits that reduce the risk of OSA.

“The difference in OSA risk between sedentary work and sedentary television time could be explained by other behaviors associated with these activities. For example, snacking and drinking sugary beverages is more likely to be associated with watching TV than sitting down at work or elsewhere, such as sitting while traveling. This could lead to additional weight gain, which we know is a risk factor for OSA. “

According to Huang, the next steps in research would be to collect data using actigraphy, home sleep apnea testing, and polysomnography instead of self-reports.

Given the results, the researchers encourage doctors to highlight the benefits of physical activity in lowering the risk of OSA.

“We found that physical activity and sedentary behavior are independently linked to OSA risk,” says Huang. “This means that for people who spend many hours sitting down every day, increased physical activity in their free time can reduce the risk of OSA in the same way. Similarly, for those who are unable to do a lot of physical activity due to physical limitations, reducing the number of hours seated by standing or doing some light activity could lower their risk of OSA. However, those who can shorten the sitting time and increase physical activity have the lowest risk. “

Anita Simonds, who was not involved in the research, is President of the European Respiratory Society and Advisor on Respiratory and Sleep Medicine at Royal Brompton Hospital, UK. She said in a press release, “OSA is a widespread and widespread disease that can have serious effects on people’s quality of life. Although modern treatments can treat OSA, only a minority of studies focus on prevention. Healthcare professionals should make prevention a priority and help people at risk for developing OSA to get more active before it is too late.

“This study highlights the importance of maintaining an active lifestyle in preventing lung disease, and it is encouraging that even a small increase in physical activity or a reduction in sedentary hours could bring potential benefits. It is therefore an important message that we can convey to our patients and their families in primary care and in ventilation clinics. “

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