Validity And Reliability Of Two Brief Physical Activity Questionnaires In Adults With Obstructive Sleep Apnea

Abstract

Efforts to encourage the medical community to prescribe exercise for disease prevention and management have increased significantly in recent years. In patients with obstructive sleep apnea (OSA), it is encouraging that exercise has been shown to improve sleep efficiency, daytime sleepiness, and disease severity. However, in order to better understand the dose-response relationship between exercise and OSA-related outcomes, accurate and reliable methods for assessing physical activity habits are needed. PURPOSE: To determine the validity and reliability of two self-report physical activity questionnaires [Physical Activity Vital Sign (PAVS); International Physical Activity Questionnaire-Short Form (IPAQ-SF)] in an OSA population. METHODS: 39 adults diagnosed with moderate-to-severe OSA [64% female; mean age (SD)=51.5 (9.5) yr; body mass index (BMI)= 39.1 (8.8) kg/m2; apnea hypopnea index (AHI)=40.4 (29.4)] wore an accelerometer for 7 consecutive days and completed the PAVS and IPAQ-SF twice within 10 days. Criterion validity was evaluated using Pearson (r) correlation coefficients comparing the total number of min/wk of moderate-vigorous physical activity (MVPA) from PAVS and IPAQ-SF to accelerometry. Spearman rank correlation coefficients (ρ) were calculated to determine construct validity against self-reported measures (quality of life, daytime sleepiness, and treatment adherence) and BMI. RESULTS: PAVS and IPAQ-SF scores were reported as total min/wk of moderate-vigorous physical activity (MVPA). Test-retest reliability for MVPA was excellent for PAVS (ICC=0.98, p<0.01) and good for IPAQ-SF (ICC=0.77, p<0.01). Levels of MVPA from accelerometry strongly correlated with PAVS (r = 0.80; p<0.001) and moderately with IPAQ-SF (r = 0.57; p<0.001). Both PAVS (ρ = -0.273; p=0.05) and IPAQ-SF (ρ = -0.268; p=0.05) were significantly related to BMI, but no other variables. CONCLUSIONS: This study provides preliminary evidence that the PAVS and IPAQ-SF questionnaires have acceptable reliability and validity to assess physical activity levels in adults with OSA.