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The following is a summary of “Impact of comprehensive healthy lifestyles on obstructive sleep apnea and the mediating role of BMI: insights from NHANES 2005–2008 and 2015–2018,” published in the December 2024 issue of Pulmonology by Mou et al. 

Researchers conducted a retrospective study to evaluate the associations between healthy lifestyles and obstructive sleep apnea (OSA) in middle-aged and elderly adults employing data from the National Health and Nutrition Examination Survey (NHANES) for 2005–2008 and 2015–2018.  

They analyzed data from 6,406 participants aged 40 and older. Healthy lifestyle behaviors, including diet quality, physical activity, sleep duration, alcohol consumption, smoking status, and body mass index (BMI), were assessed. A composite 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 investigated the relationship between lifestyle scores and OSA, adjusting for demographic, socioeconomic, and clinical covariates. Mediation analysis evaluated BMI as a mediator in the relationship between the composite healthy lifestyle score and OSA, determining the proportion of the effect mediated by BMI.  

The results showed the 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 linked to reduced odds of OSA, a one-point increase in the healthy lifestyle score was associated with a 33% reduction in OSA odds (OR: 0.67, 95% CI: 0.63–0.71). A significant linear trend showed that better lifestyle adherence correlated with lower OSA odds (P for trend < 0.001). Intermediate lifestyle reduced OSA odds by 27% (OR: 0.73, 95% CI: 0.58–0.91), and optimal lifestyle reduced them by 74% (OR: 0.26, 95% CI: 0.21–0.33) compared with insufficient lifestyle. Mediation analysis revealed that BMI mediated 59.2% of the total effect (P < 0.001). The direct effect of the healthy lifestyle score on OSA remained significant after controlling for BMI (P < 0.001). Subgroup analyses proved constant benefits across demographic groups.  

Investigators concluded the adherence to healthy lifestyles, particularly optimal BMI, significantly lowered the risk of OSA, highlighting the potential of lifestyle interventions in preventing and managing this condition. 

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-03404-z