ArticleBMC pulmonary medicine2024
The impact of comprehensive healthy lifestyles on obstructive sleep apnea and the mediating role of BMI: insights from NHANES 2005-2008 and 2015-2018.
Article in BMC pulmonary medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Gut Microbiome-Sleep Crosstalk: Mechanistic Pathways, Dysbiosis Signatures, and Microbiome-Based Interventions.Brain and behavior · 2026Review
- Review
- Body mass index and diet-related inflammation as predictors of sleep disorders: A cross-sectional study.Medicine · 2026Article
- Association of serum uric acid-to-high-density lipoprotein cholesterol ratio with obstructive sleep apnea: a cross-sectional study.Lipids in health and disease · 2025Article
- Association between pollinosis and obstructive sleep apnea hypopnea syndrome in the US population: evidence from the NHANES database 2005-2018.BMC pulmonary medicine · 2025Article
- The association between speech impairments and depression in Chinese adults aged 45 and older: insights from the CHARLS database.BMC psychiatry · 2025Article
- Mediating Role of BMI in the Association Between Obstructive Sleep Apnea and Nonalcoholic Fatty Liver Disease: A Cross-Sectional Mediation Analysis.Canadian respiratory journal · 2025Article
- Comparative impact of different weight loss strategies on obstructive sleep apnea: an integrated review of surgical, pharmacological, and lifestyle interventions.Frontiers in neurology · 2025Review
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4 authors.
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Abstract
objectiveIn this study, the associations between healthy lifestyles and obstructive sleep apnea (OSA) in middle-aged and elderly adults were investigated via data from the National Health and Nutrition Examination Survey (NHANES) for the periods of 2005-2008 and 2015-2018.
methodsA total of 6,406 participants aged 40 years and older were included in the analysis. Healthy lifestyle behaviors were assessed through diet quality, physical activity, sleep duration, alcohol consumption, smoking status, and body mass index (BMI). A composite healthy lifestyle score (ranging from 0 to 6) was created and categorized into insufficient (0-2), intermediate (3-4), and optimal (5-6) health groups. Weighted logistic regression models were used to examine the association between these lifestyle scores and OSA, adjusting for some demographic, socioeconomic, and clinical covariates. Additionally, mediation analysis was conducted to evaluate the role of BMI as a mediator in the relationship between the composite healthy lifestyle score and OSA, determining the proportion of the total effect mediated by BMI.
resultsParticipants were classified into insufficient (17.81%), intermediate (56.82%), and optimal (25.37%) lifestyle groups. Higher dietary quality (OR: 0.81, 95% CI: 0.66-0.99) and adequate weight (OR: 0.09, 95% CI: 0.07-0.11) were statistically associated with reduced OSA odds after adjustments, whereas the variables were not. Each one-point increase in the healthy lifestyle score was linked to a 33% reduction in OSA odds (OR: 0.67, 95% CI: 0.63-0.71). A significant linear trend was observed, with better adherence to healthy lifestyle correlating with lower odds of OSA (p for trend < 0.001). Compared with insufficient lifestyle, intermediate lifestyle was linked to a 27% reduction in OSA (OR: 0.73, 95% CI: 0.58-0.91), whereas optimal lifestyle was associated with a 74% reduction (OR: 0.26, 95% CI: 0.21-0.33). Mediation analysis revealed that BMI significantly mediated the relationship between healthy lifestyle score and OSA, accounting for approximately 59.2% of the total effect (P < 0.001). The direct effect of the healthy lifestyle score on OSA remained significant even when controlling for BMI (P < 0.001). Subgroup analyses confirmed consistent benefits across different demographic groups.
conclusionsThis study revealed that adherence to healthy lifestyles significantly reduces the odds of OSA, with optimal lifestyles leading to a marked decrease in the odds of OSA. Notably, BMI plays a critical mediating role in this relationship. These findings emphasize the importance of promoting healthy lifestyle interventions as a key strategy for the prevention and management of OSA.
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