Sleep apnea: Exercise and cutting TV time reduce risk

Obstructive sleep apnea (OSA) is a sleep disorder that affects 10–20% of the adult population in the United States.
OSA is associated with an increased risk of certain chronic diseases.
A new study concludes that being more active and spending less time watching television are linked to a lower risk of developing OSA.

OSA involves repeated, intermittent upper airway blockage during sleep. This blockage reduces or halts airflow to the lungs and may increase the risk of serious conditions, including cancer, cardiovascular disease, and type 2 diabetes, among others.

OSA occurs when the throat muscles temporarily relax during sleep, causing partial or complete blockage of the airway.

Snoring is a common indicator of OSA. Interrupted sleep and inadequate nighttime oxygenation may result in daytime sleepiness, headaches, mood swings, and high blood pressure, among other adverse effects.

The role of physical activity

Previous research has shown that low levels of physical activity during the day, or increased sedentary behavior, may be linked to a higher risk of experiencing OSA.

Mediators of these adverse effects may include excess body fat, chronic low level inflammation, insulin resistance, and fluid retention.

Investigators at Brigham and Women’s Hospital and Harvard Medical School in Boston, MA, Johns Hopkins Bloomberg School of Public Health in Baltimore, MA, and other institutions collaborated on a new study, which examined “the potential role of maintaining an active lifestyle in reducing [OSA] incidence.”

The results appear in the European Respiratory Journal.

The authors concluded that being more active and spending less time sitting while watching television are behaviors linked to a lower risk of developing OSA.

The study also attempted to tease out each factor’s influence on OSA risk.

The investigation

The investigators examined data from 137,917 participants enrolled in the Nurses’ Health Study (NHS), Nurses’ Health Study II (NHSII), and the Health Professionals Follow-up Study (HPFS).

Medical News Today spoke with Tianyi Huang, an assistant professor of medicine at Harvard Medical School and one of the authors of the study.

According to Huang, these large, long-term, ongoing studies provide an especially reliable source of health-related information, as the participants are all healthcare professionals.

Among the general public, “OSA is highly underdiagnosed,” Huang said. He noted that healthcare professionals are presumably more likely to recognize and report symptoms of OSA.

The results

For their analysis, the investigators accounted for the time that the participants spent sitting at work. Physical activity included all the time that they spent moving, including walking, running, lap swimming, and weightlifting.

Overall, the team found that individuals who were less active were more likely to report OSA. For example, the participants with more sedentary jobs had a 49% higher risk of OSA than those with the least sedentary occupations.

Also, those who watched more than 4 hours of TV each day had a 78% higher risk of OSA than the participants with the least sedentary lifestyles.

Maintaining an active lifestyle and avoiding excessive sedentary behavior are associated with a lower risk of developing OSA. This, in turn, may be linked to a reduced risk of developing various potentially serious conditions, including cardiovascular disease and obesity.

A two-way relationship

Due to the nature of the study, it was not possible to discern cause and effect, so the researchers could not determine whether inactivity and TV watching promote OSA or whether the health effects of OSA encourage sedentary behavior.

Although it may be unsurprising that sedentary behaviors and watching TV, which also involves sitting for extended periods, may be linked to OSA, Huang speculates that the effects of TV watching on OSA may be due to obesity.

“TV watching most strongly correlated with sleep apnea,” said Huang. “TV watching is also correlated with obesity, type 2 diabetes, and cardiovascular disease.”

Dr. Albert A. Rizzo, M.D., who is chief medical officer for the American Lung Association and was not involved with the study, spoke with MNT. “It makes sense,” Rizzo said, “to look at the relationships between OSA, sedentary behavior, and TV watching.”

“It struck me, though, that this is a chicken-or-the-egg type of situation […] Many people with obesity have OSA, but does obesity lead to OSA, or does OSA contribute to obesity? I think you could argue either way.”

He remained equivocal regarding the relationship. “I thought [the study] was an interesting way to look at it, but I think it probably occurs both ways.”

Written by Dale Kiefer on August 3, 2021 — Fact checked by Hannah Flynn, MS

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