Abstract
Background
We evaluated 1) the independent and combined influence of obstructive sleep apnea (OSA) risk and a healthy lifestyle on typical OSA outcomes [excessive daytime sleepiness (EDS), depression, cardiovascular disease (CVD), and stroke]; and 2) the impact of a healthy lifestyle on survival in individuals presenting a heightened risk of OSA.
Method
We utilized data from 13,694 adults (median age 46 years; 50% men) for both cross-sectional and longitudinal analyses (15 years). A healthy lifestyle score ranging from 0 (most unhealthy) to 5 (most healthy) was computed based on diet, alcohol consumption, physical activity levels, smoking habits, and body mass index.
Results
A dose-response relationship was found between OSA risk and all examined chronic conditions and EDS (p for trend < 0.001). A healthy lifestyle was found to be inversely related to all chronic conditions (p for trend < 0.001), except EDS (p for trend = 0.379). A higher healthy lifestyle score correlated with lower odds of depression and CVD. An inverse relationship was found between healthy lifestyle score and depression (P for trend < 0.001), CVD (P for trend = 0.003), and stroke (P for trend = 0.025) in those with high OSA risk. An inverse relationship was observed between a healthy lifestyle and all-cause mortality in general, and in the moderate/high and high OSA risk groups (p for trend < 0.001).
Discussion
This study highlights the role of a healthy lifestyle in reducing chronic conditions and in enhancing survival rates in individuals with a heightened risk of OSA.