More exercise, less TV time may cut risk for obstructive sleep apnea
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More physical activity and less time spent sedentary were associated with a lower incidence of obstructive sleep apnea, according to new results published in the European Respiratory Journal.
“Although sedentary behavior is inversely correlated with physical activity, numerous studies have shown that sedentary behavior is associated with various health outcomes independent of levels of physical activity,” Tianyi Huang, ScD, assistant professor and associate epidemiologist at Brigham and Women’s Hospital and Harvard Medical School, and colleagues wrote. “Low physical activity levels and long sedentary time may increase OSA risk by promoting obesity, systemic inflammation and insulin resistance, which have been implicated in the pathogenesis of OSA.”
Researchers conducted a prospective study that included 50,332 women from the Nurses’ Health Study 2002-2012, 68,265 women from the Nurses’ Health Study II 1995-2013 and 19,320 men from the Health Professionals Follow-up Study 1996-2012. All participants did not have clinically diagnosed OSA at baseline. The researchers assessed recreational physical activity and sedentary time spent watching TV at work or away from the home using questionnaires distributed every 2 to 4 years. Patient self-reports were used to determine physician-diagnosed OSA.
Over more than 2 million person-years of follow-up, 8,733 incident OSA cases were reported; of those, 76.1% were in women.
Compared with participants with less than 6 metabolic equivalent of task-hours, or METs, per week, the HR for OSA incidence was 0.78 (95% CI, 0.73-0.83) for those with 6 to 11.9 MET-hours per week, 0.67 (95% CI, 0.63-0.71) for 12 to 20.9 MET-hours per week, 0.57 (95% CI, 0.53-0.61) for 21 to 35.9 MET-hours per week and lowest at 0.46 (95% CI, 0.43-0.5) for 36 or more MET-hours per week, after adjusting for potential confounders (P < .001 for all), according to the results.
OSA incidence rose in those who spent more time sedentary watching TV. Compared with participants who spent less than 4 hours per week sedentary watching TV, the HR for OSA incidence was 1.1 (95% CI, 1.02-1.18) for those with 4 to 6.9 hours per week, 1.25 (95% CI, 1.18-1.33) for 7 to 13.9 hours per week, 1.38 (95% CI, 1.3-1.48) for 14 to 27.9 hours per week and 1.78 (95% CI, 1.6-1.98) for 28 hours or more per week (P < .001 for all). In addition, researchers observed associations between OSA incidence and sedentary hours at work or away from the home: 4 to 6.9 hours per week (HR = 1.02; 95% CI, 0.94-1.11), 7 to 13.9 hours per week (HR = 1.13; 95% CI, 1.06-1.21), 14 to 27.9 hours per week (HR = 1.27; 95% CI, 1.19-1.36) and at least 28 hours per week (HR = 1.49; 95% CI, 1.38-1.62; P for trend < .001).
Physical activity remained significantly associated with sedentary hours at work or away from the home when adjusting for metabolic factors, including BMI and waist circumference (P < .001), but the association with sedentary watching TV was no longer statistically significant (P = .18).
This study adds to evidence supporting the importance of maintaining an active lifestyle to prevent lung disease, and even a small increase in physical activity or reduction in sedentary hours could provide benefit, according to a related press release.
“The difference in OSA risk between sedentary work and time spent sitting watching TV could be explained by other behaviors that are related to those activities. For example, snacking and drinking sugary drinks is more likely to go along with watching TV compared with being sedentary at work or elsewhere, such as sitting during traveling,” Huang said in the release. “This could lead to additional weight gain, which we know to be a risk factor for OSA.”