The impact of comprehensive healthy lifestyles on obstructive sleep apnea and the mediating role of BMI: insights from NHANES 2005–2008 and 2015–2018

Abstract Objective In 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. Methods A total...

Full description

Saved in:
Bibliographic Details
Main Authors: Jinsong Mou, Haishan Zhou, Shiya Huang, Zhangui Feng
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Pulmonary Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12890-024-03404-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846137339975303168
author Jinsong Mou
Haishan Zhou
Shiya Huang
Zhangui Feng
author_facet Jinsong Mou
Haishan Zhou
Shiya Huang
Zhangui Feng
author_sort Jinsong Mou
collection DOAJ
description Abstract Objective In 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. Methods A 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. Results Participants 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. Conclusions This 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.
format Article
id doaj-art-33c9e6c9156d4ea6b3317ad68f08cf49
institution Kabale University
issn 1471-2466
language English
publishDate 2024-12-01
publisher BMC
record_format Article
series BMC Pulmonary Medicine
spelling doaj-art-33c9e6c9156d4ea6b3317ad68f08cf492024-12-08T12:17:18ZengBMCBMC Pulmonary Medicine1471-24662024-12-0124111310.1186/s12890-024-03404-zThe impact of comprehensive healthy lifestyles on obstructive sleep apnea and the mediating role of BMI: insights from NHANES 2005–2008 and 2015–2018Jinsong Mou0Haishan Zhou1Shiya Huang2Zhangui Feng3Pingshan District Maternal & Child Healthcare Hospital of ShenzhenPingshan District Maternal & Child Healthcare Hospital of ShenzhenPingshan District Maternal & Child Healthcare Hospital of ShenzhenPingshan District Maternal & Child Healthcare Hospital of ShenzhenAbstract Objective In 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. Methods A 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. Results Participants 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. Conclusions This 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.https://doi.org/10.1186/s12890-024-03404-zObstructive sleep apneaHealthy lifestyleBody Mass IndexElderly PopulationMediation analysisPublic Health
spellingShingle Jinsong Mou
Haishan Zhou
Shiya Huang
Zhangui Feng
The impact of comprehensive healthy lifestyles on obstructive sleep apnea and the mediating role of BMI: insights from NHANES 2005–2008 and 2015–2018
BMC Pulmonary Medicine
Obstructive sleep apnea
Healthy lifestyle
Body Mass Index
Elderly Population
Mediation analysis
Public Health
title The impact of comprehensive healthy lifestyles on obstructive sleep apnea and the mediating role of BMI: insights from NHANES 2005–2008 and 2015–2018
title_full The impact of comprehensive healthy lifestyles on obstructive sleep apnea and the mediating role of BMI: insights from NHANES 2005–2008 and 2015–2018
title_fullStr The impact of comprehensive healthy lifestyles on obstructive sleep apnea and the mediating role of BMI: insights from NHANES 2005–2008 and 2015–2018
title_full_unstemmed The impact of comprehensive healthy lifestyles on obstructive sleep apnea and the mediating role of BMI: insights from NHANES 2005–2008 and 2015–2018
title_short The impact of comprehensive healthy lifestyles on obstructive sleep apnea and the mediating role of BMI: insights from NHANES 2005–2008 and 2015–2018
title_sort impact of comprehensive healthy lifestyles on obstructive sleep apnea and the mediating role of bmi insights from nhanes 2005 2008 and 2015 2018
topic Obstructive sleep apnea
Healthy lifestyle
Body Mass Index
Elderly Population
Mediation analysis
Public Health
url https://doi.org/10.1186/s12890-024-03404-z
work_keys_str_mv AT jinsongmou theimpactofcomprehensivehealthylifestylesonobstructivesleepapneaandthemediatingroleofbmiinsightsfromnhanes20052008and20152018
AT haishanzhou theimpactofcomprehensivehealthylifestylesonobstructivesleepapneaandthemediatingroleofbmiinsightsfromnhanes20052008and20152018
AT shiyahuang theimpactofcomprehensivehealthylifestylesonobstructivesleepapneaandthemediatingroleofbmiinsightsfromnhanes20052008and20152018
AT zhanguifeng theimpactofcomprehensivehealthylifestylesonobstructivesleepapneaandthemediatingroleofbmiinsightsfromnhanes20052008and20152018
AT jinsongmou impactofcomprehensivehealthylifestylesonobstructivesleepapneaandthemediatingroleofbmiinsightsfromnhanes20052008and20152018
AT haishanzhou impactofcomprehensivehealthylifestylesonobstructivesleepapneaandthemediatingroleofbmiinsightsfromnhanes20052008and20152018
AT shiyahuang impactofcomprehensivehealthylifestylesonobstructivesleepapneaandthemediatingroleofbmiinsightsfromnhanes20052008and20152018
AT zhanguifeng impactofcomprehensivehealthylifestylesonobstructivesleepapneaandthemediatingroleofbmiinsightsfromnhanes20052008and20152018