Key takeaways:

• Six factors made up an individual’s healthy lifestyle score.
• The odds for OSA went down by 33% as the healthy lifestyle score went up by one point.

The likelihood for obstructive sleep apnea went down by 74% among adults with optimal vs. insufficient healthy lifestyle behaviors, according to results published in BMC Pulmonary Medicine.

“Our study revealed that adopting a combination of healthy lifestyle behaviors — high dietary quality, active physical activity, optimal sleep, never smoking, moderate or less drinking and maintaining a healthy weight — was adversely associated with a lower odd[s] of OSA,” Jinsong Mou, researcher at Shenzhen Pingshan Maternal and Child Health Hospital in China, and colleagues wrote.

Using 2005 to 2008 and 2015 to 2018 National Health and Nutrition Examination Survey data, Mou and colleagues evaluated 6,406 adults aged at least 40 years (mean age, 58 years; 51.11% men; 76.43% white) to determine how healthy lifestyle — scored based on “diet quality, physical activity, sleep duration, alcohol consumption, smoking status and BMI” — is linked to the odds for OSA.

Within the total cohort, over half (56.82%; 63.09% aged 40-59 years; 54.41% men; 76.42% white) of adults had a composite healthy lifestyle score of 3 to 4 out of 6 points, signaling an intermediate healthy lifestyle. Following, 25.37% (62.96% aged 40-59 years; 40.27% men; 79.15% white) of adults had a score of 5 to 6, indicating an optimal healthy lifestyle, and 17.81% (75.25% aged 40-59 years; 55.67% men; 72.37% white) had a score of 0 to 2, signaling an insufficient healthy lifestyle.

In a demographic, socioeconomic and clinical covariate-adjusted model, researchers found a significant link between two of the six healthy lifestyle variables and lower odds for OSA: higher diet quality (adjusted OR = 0.81; 95% CI, 0.66-0.99) and adequate weight (aOR = 0.09; 95% CI, 0.07-0.11).

Notably, the odds for OSA went down by 33% (aOR = 0.67; 95% CI, 0.63-0.71) as the healthy lifestyle score went up by one point, according to the study.

Researchers further reported that “better adherence to healthy lifestyle” was significantly linked to a decreased likelihood for OSA.

The odds for OSA went down by 74% (aOR = 0.26; 95% CI, 0.21-0.33) with an optimal vs. insufficient lifestyle. Additionally, the odds for OSA also fell with an intermediate vs. insufficient lifestyle but to a lesser degree (27%; aOR = 0.73; 95% CI, 0.58-0.91), according to the study.

During mediation analysis, researchers found that 59.2% of the total effect in the healthy lifestyle score and OSA link was mediated by BMI. Despite this finding, the study reported that controlling for BMI still resulted in a significant direct effect of the healthy lifestyle score on OSA.

When divided based on various demographics — age, sex, ethnicity, education, family income to poverty ratio, marital status and family size — results from the main analysis continued to be seen, with a reduced likelihood for OSA among those with an optimal vs. insufficient healthy lifestyle, as well as among those with an intermediate vs. insufficient healthy lifestyle in all but the Hispanic and Mexican American ethnicity subgroups.

“These findings emphasize the importance of promoting healthy lifestyle changes for OSA prevention and control, suggesting that public health strategies should prioritize these modifiable factors,” Mou and colleagues wrote.

“Future research should focus on elucidating the underlying mechanisms driving these associations, as well as assessing the effectiveness of targeted lifestyle interventions in diverse populations,” they continued.