Healthy lifestyle is associated with reduced cardiovascular disease, depression and mortality in people at elevated risk of sleep apnea.

Publisher: Published on behalf of the European Sleep Research Society by Blackwell Scientific Publications Country of Publication: England NLM ID: 9214441 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2869 (Electronic) Linking ISSN: 09621105 NLM ISO Abbreviation: J Sleep Res Subsets: MEDLINE

Original Publication: Oxford ; Boston : Published on behalf of the European Sleep Research Society by Blackwell Scientific Publications, c1992-

Cardiovascular Diseases*/mortality ; Cardiovascular Diseases*/epidemiology ; Cardiovascular Diseases*/etiology ; Depression*/epidemiology ; Healthy Lifestyle*; Humans ; Male ; Female ; Middle Aged ; Cross-Sectional Studies ; Adult ; Risk Factors ; Sleep Apnea, Obstructive/mortality ; Sleep Apnea, Obstructive/complications ; Body Mass Index ; Aged ; Survival Analysis ; Disorders of Excessive Somnolence/epidemiology ; Smoking/epidemiology ; Exercise

We assessed: (1) the independent and joint association of obstructive sleep apnea risk and healthy lifestyle with common consequences (excessive daytime sleepiness, depression, cardiovascular disease and stroke) of obstructive sleep apnea; and (2) the effect of healthy lifestyle on survival in people with increased obstructive sleep apnea risk. Data from 13,694 adults (median age 46 years; 50% men) were used for cross-sectional and survival analyses (mortality over 15 years). A healthy lifestyle score with values from 0 (most unhealthy) to 5 (most healthy) was determined based on diet, alcohol intake, physical activity, smoking and body mass index. In the cross-sectional analysis, obstructive sleep apnea risk was positively associated with all chronic conditions and excessive daytime sleepiness in a dose-response manner (p for trend < 0.001). The healthy lifestyle was inversely associated with all chronic conditions (p for trend < 0.001) but not with excessive daytime sleepiness (p for trend = 0.379). Higher healthy lifestyle score was also associated with reduced odds of depression and cardiovascular disease. We found an inverse relationship between healthy lifestyle score with depression (p for trend < 0.001), cardiovascular disease (p for trend = 0.003) and stroke (p for trend = 0.025) among those who had high obstructive sleep apnea risk. In the survival analysis, we found an inverse association between healthy lifestyle and all-cause mortality for all categories of obstructive sleep apnea risk (moderate/high- and high-risk groups [p for trend < 0.001]). This study emphasises the crucial role of a healthy lifestyle in mitigating the effects of obstructive sleep apnea risk in individuals with an elevated obstructive sleep apnea risk.
(© 2023 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.)

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2009776 The National Health and Medical Research Council of Australia (NHMRC) Investigator Grant; MCRF18005 Mid-Career Research Fellowship from the Victorian Cancer Agency; 1196261 NHMRC Leadership Fellowship

Keywords: cardiovascular disease; depression; excessive daytime sleepiness; healthy lifestyle; mortality; sleep apnea

Date Created: 20231023 Date Completed: 20240715 Latest Revision: 20240715

20240716

10.1111/jsr.14069

37867414