Abstract
BackgroundNo studies investigated the whole effect of modifiable lifestyle factors on OSA risk. This study aimed to examine the individual and combined effects of lifestyle factors on OSA risk among Chinese adults.MethodsThis cross-sectional study included 9733 participants aged 35 to 74 years from the baseline survey of Guangzhou Heart Study. OSA was evaluated by Berlin Questionnaire. The healthy lifestyle score (HLS), representing the overall effect of lifestyles, was derived from seven lifestyle factors: active smoking, passive smoking, alcohol, diet, waist-hip ratio, leisure-time physical activity, and mental status. Odds ratio (OR) with 95% confidence interval (CI) was calculated using the multivariate logistic regression model.Results8107 participants were divided into the non-OSA group and 1626 participants into the OSA group. No passive smoking (OR 0.83, 95% CI 0.74–0.94), healthy waist-hip ratio (OR 0.67, 95% CI 0.58–0.77) and healthy mental status (OR 0.45, 95% CI 0. 29–0.73) were associated with a reduced risk of OSA after adjusting for confounders, while others not. Participants with higher HLS were negatively associated with OSA risk (P-trend < 0.001). In comparison to the participants with 0–3 HLS, the OR for participants with 4, 5, 6, and 7 HLS was 0.68 (95% CI 0.56–0.84), 0.71 (95% CI 0.59–0.86), 0.62 (95% CI 0.51–0.76) and 0.49 (95% CI 0.37–0.65) after adjusting for confounders. Every 1-score increment of HLS was associated with a 13% lower risk of OSA.ConclusionsThe results suggest that HLS reflecting the combined effect of multiple-dimensional lifestyle factors was inversely associated with OSA risk. Preventive strategies integrating multiple lifestyle factors may provide a more feasible approach for OSA prevention.
Highlights
No studies investigated the whole effect of modifiable lifestyle factors on Obstructive sleep apnea (OSA) risk
No passive smoking, healthy waist-hip ratio and healthy mental status were associated with a lower risk of OSA, while others not (Table 2)
When considering the overall effect of all healthy lifestyle factors after adjusting for potential confounders, a lower risk of OSA was significantly associated with an increment of healthy lifestyle score (HLS) (P-trend < 0.001) (Table 3)
Summary
No studies investigated the whole effect of modifiable lifestyle factors on OSA risk. This study aimed to examine the individual and combined effects of lifestyle factors on OSA risk among Chinese adults. One billion adults aged 30–69 years worldwide were estimated to have OSA with 425 million requiring treatment, generating a high economic and social burden [5]. Several risk factors have been demonstrated to be associated with the occurrence and development of OSA, especially overweight, male, older age, anomalies of craniofacial structure, and hereditary factors [6, 7]. Recent studies have shown that lifestyle factors, including aerobic physical activity, diet, smoking, and alcohol drinking, were correlated with the occurrence and severity of OSA. Independent of known risk factors for OSA, increased levels of physical activity, including walking, were associated with a prevalence of OSA [8]. Psychological status was found to play an important role in the occurrence and development of OSA [14, 15]; individuals with psychiatric disorders, especially major depressive disorder, were associated with elevated levels of OSA [15]
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