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Published in: Sleep and Breathing 2/2019

01-06-2019 | Sleep Breathing Physiology and Disorders • Original Article

Obstructive sleep apnea negatively impacts objectively measured physical activity

Authors: Trent A. Hargens, Ryan A. Martin, Courtney L. Strosnider, Gabrielle Elam Williams Giersch, Christopher J. Womack

Published in: Sleep and Breathing | Issue 2/2019

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Abstract

Purpose

Obesity and obstructive sleep apnea (OSA) are frequent comorbid conditions. The impact of OSA on objectively measured physical activity (PA), independent of obesity, is not clear. The purpose of this study is to examine the effect of OSA on PA measured via accelerometer.

Methods

Overweight-to-obese individuals were recruited and screened for the presence of OSA via portable diagnostic device and divided into an OSA (n = 35) and control group (n = 24). Daytime sleepiness was assessed with the Epworth Sleepiness Scale. Body composition was assessed with dual-energy X-ray absorptiometry. Subjects wore an accelerometer (Actigraph GT3X+, Actigraph Corp., Pensacola, FL) for a minimum of 4 and maximum of 7 days, including at least one weekend day.

Results

There were no group differences in body mass index (BMI) or daytime sleepiness. Waist and neck circumference were higher in the OSA group. The OSA group was significantly older than the control group. The OSA group had fewer steps, moderate intensity minutes, moderate-to-vigorous minutes, number of PA bouts per day (≥ moderate intensity PA for ≥ 10 consecutive minutes), and total number of PA bouts. When adjusted for age, the PA bout data was no longer significant.

Conclusion

Individuals screened as likely possessing OSA were less physically active than individuals without OSA when measured through objective means. We found no group differences in daytime sleepiness, BMI, or percent fat, suggesting other mechanisms than obesity and sleepiness for this difference.
Literature
1.
go back to reference Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328(17):1230–1235CrossRef Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328(17):1230–1235CrossRef
2.
go back to reference Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM (2013) Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 177(9):1006–1014CrossRefPubMedPubMedCentral Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM (2013) Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 177(9):1006–1014CrossRefPubMedPubMedCentral
3.
go back to reference Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP, Schwartz AR, Smith PL (2002) Sleep-disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med 165(5):677–682CrossRefPubMed Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP, Schwartz AR, Smith PL (2002) Sleep-disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med 165(5):677–682CrossRefPubMed
4.
go back to reference Malhotra A, White DP (2002) Obstructive sleep apnoea. Lancet 360(9328):237–245CrossRef Malhotra A, White DP (2002) Obstructive sleep apnoea. Lancet 360(9328):237–245CrossRef
5.
go back to reference Dobrosielski DA, Papandreou C, Patil SP, Salas-Salvado J (2017) Diet and exercise in the management of obstructive sleep apnoea and cardiovascular disease risk. Eur Respir Rev 26(144):160110CrossRefPubMedPubMedCentral Dobrosielski DA, Papandreou C, Patil SP, Salas-Salvado J (2017) Diet and exercise in the management of obstructive sleep apnoea and cardiovascular disease risk. Eur Respir Rev 26(144):160110CrossRefPubMedPubMedCentral
6.
go back to reference Somers VK, White DP, Amin R, Abraham WT, Costa F, Culebras A, Daniels S, Floras JS, Hunt CE, Olson LJ, Pickering TG, Russell R, Woo M, Young T (2008) Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. J Am Coll Cardiol 52(8):686–717CrossRefPubMed Somers VK, White DP, Amin R, Abraham WT, Costa F, Culebras A, Daniels S, Floras JS, Hunt CE, Olson LJ, Pickering TG, Russell R, Woo M, Young T (2008) Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. J Am Coll Cardiol 52(8):686–717CrossRefPubMed
7.
go back to reference Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165(9):1217–1239CrossRefPubMed Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165(9):1217–1239CrossRefPubMed
8.
go back to reference Budhiraja R, Parthasarathy S, Quan SF (2007) Endothelial dysfunction in obstructive sleep apnea. J Clin Sleep Med 3(4):409–415PubMedPubMedCentral Budhiraja R, Parthasarathy S, Quan SF (2007) Endothelial dysfunction in obstructive sleep apnea. J Clin Sleep Med 3(4):409–415PubMedPubMedCentral
9.
go back to reference Suzuki YJ, Jain V, Park AM, Day RM (2006) Oxidative stress and oxidant signaling in obstructive sleep apnea and associated cardiovascular diseases. Free Radic Biol Med 40(10):1683–1692CrossRefPubMedPubMedCentral Suzuki YJ, Jain V, Park AM, Day RM (2006) Oxidative stress and oxidant signaling in obstructive sleep apnea and associated cardiovascular diseases. Free Radic Biol Med 40(10):1683–1692CrossRefPubMedPubMedCentral
10.
go back to reference Ryan S, Taylor CT, McNicholas WT (2005) Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation 112(17):2660–2667CrossRefPubMed Ryan S, Taylor CT, McNicholas WT (2005) Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation 112(17):2660–2667CrossRefPubMed
11.
go back to reference Ohga E, Tomita T, Wada H, Yamamoto H, Nagase T, Ouchi Y (2003) Effects of obstructive sleep apnea on circulating ICAM-1, IL-8, and MCP-1. J Appl Physiol (1985) 94 (1):179–184 Ohga E, Tomita T, Wada H, Yamamoto H, Nagase T, Ouchi Y (2003) Effects of obstructive sleep apnea on circulating ICAM-1, IL-8, and MCP-1. J Appl Physiol (1985) 94 (1):179–184
13.
go back to reference Quan SF, O'Connor GT, Quan JS, Redline S, Resnick HE, Shahar E, Siscovick D, Sherrill DL (2007) Association of physical activity with sleep-disordered breathing. Sleep Breath 11(3):149–157CrossRefPubMed Quan SF, O'Connor GT, Quan JS, Redline S, Resnick HE, Shahar E, Siscovick D, Sherrill DL (2007) Association of physical activity with sleep-disordered breathing. Sleep Breath 11(3):149–157CrossRefPubMed
14.
go back to reference Peppard PE, Young T (2004) Exercise and sleep-disordered breathing: an association independent of body habitus. Sleep 27(3):480–484CrossRefPubMed Peppard PE, Young T (2004) Exercise and sleep-disordered breathing: an association independent of body habitus. Sleep 27(3):480–484CrossRefPubMed
15.
go back to reference Simpson L, McArdle N, Eastwood PR, Ward KL, Cooper MN, Wilson AC, Hillman DR, Palmer LJ, Mukherjee S (2015) Physical inactivity is associated with moderate-severe obstructive sleep apnea. J Clin Sleep Med 11(10):1091–1099CrossRefPubMedPubMedCentral Simpson L, McArdle N, Eastwood PR, Ward KL, Cooper MN, Wilson AC, Hillman DR, Palmer LJ, Mukherjee S (2015) Physical inactivity is associated with moderate-severe obstructive sleep apnea. J Clin Sleep Med 11(10):1091–1099CrossRefPubMedPubMedCentral
16.
go back to reference Batool-Anwar S, Goodwin JL, Drescher AA, Baldwin CM, Simon RD, Smith TW, Quan SF (2014) Impact of CPAP on activity patterns and diet in patients with obstructive sleep apnea (OSA). J Clin Sleep Med 10(5):465–472PubMedPubMedCentral Batool-Anwar S, Goodwin JL, Drescher AA, Baldwin CM, Simon RD, Smith TW, Quan SF (2014) Impact of CPAP on activity patterns and diet in patients with obstructive sleep apnea (OSA). J Clin Sleep Med 10(5):465–472PubMedPubMedCentral
18.
go back to reference Bamberga M, Rizzi M, Gadaleta F, Grechi A, Baiardini R, Fanfulla F (2015) Relationship between energy expenditure, physical activity and weight loss during CPAP treatment in obese OSA subjects. Respir Med 109(4):540–545CrossRefPubMed Bamberga M, Rizzi M, Gadaleta F, Grechi A, Baiardini R, Fanfulla F (2015) Relationship between energy expenditure, physical activity and weight loss during CPAP treatment in obese OSA subjects. Respir Med 109(4):540–545CrossRefPubMed
19.
go back to reference Verwimp J, Ameye L, Bruyneel M (2013) Correlation between sleep parameters, physical activity and quality of life in somnolent moderate to severe obstructive sleep apnea adult patients. Sleep Breath 17(3):1039–1046CrossRefPubMed Verwimp J, Ameye L, Bruyneel M (2013) Correlation between sleep parameters, physical activity and quality of life in somnolent moderate to severe obstructive sleep apnea adult patients. Sleep Breath 17(3):1039–1046CrossRefPubMed
20.
go back to reference Igelstrom H, Emtner M, Lindberg E, Asenlof P (2013) Physical activity and sedentary time in persons with obstructive sleep apnea and overweight enrolled in a randomized controlled trial for enhanced physical activity and healthy eating. Sleep Breath 17(4):1257–1266CrossRefPubMed Igelstrom H, Emtner M, Lindberg E, Asenlof P (2013) Physical activity and sedentary time in persons with obstructive sleep apnea and overweight enrolled in a randomized controlled trial for enhanced physical activity and healthy eating. Sleep Breath 17(4):1257–1266CrossRefPubMed
21.
go back to reference Chasens ER, Sereika SM, Houze MP, Strollo PJ (2011) Subjective and objective appraisal of activity in adults with obstructive sleep apnea. J Aging Res 2011:751819CrossRefPubMedPubMedCentral Chasens ER, Sereika SM, Houze MP, Strollo PJ (2011) Subjective and objective appraisal of activity in adults with obstructive sleep apnea. J Aging Res 2011:751819CrossRefPubMedPubMedCentral
22.
go back to reference Kline CE, Crowley EP, Ewing GB, Burch JB, Blair SN, Durstine JL, Davis JM, Youngstedt SD (2011) The effect of exercise training on obstructive sleep apnea and sleep quality: a randomized controlled trial. Sleep 34(12):1631–1640CrossRefPubMedPubMedCentral Kline CE, Crowley EP, Ewing GB, Burch JB, Blair SN, Durstine JL, Davis JM, Youngstedt SD (2011) The effect of exercise training on obstructive sleep apnea and sleep quality: a randomized controlled trial. Sleep 34(12):1631–1640CrossRefPubMedPubMedCentral
23.
go back to reference Igelstrom H, Emtner M, Lindberg E, Asenlof P (2013) Level of agreement between methods for measuring moderate to vigorous physical activity and sedentary time in people with obstructive sleep apnea and obesity. Phys Ther 93(1):50–59CrossRefPubMed Igelstrom H, Emtner M, Lindberg E, Asenlof P (2013) Level of agreement between methods for measuring moderate to vigorous physical activity and sedentary time in people with obstructive sleep apnea and obesity. Phys Ther 93(1):50–59CrossRefPubMed
24.
go back to reference Diamanti C, Manali E, Ginieri-Coccossis M, Vougas K, Cholidou K, Markozannes E, Bakakos P, Liappas I, Alchanatis M (2013) Depression, physical activity, energy consumption, and quality of life in OSA patients before and after CPAP treatment. Sleep Breath 17(4):1159–1168CrossRefPubMed Diamanti C, Manali E, Ginieri-Coccossis M, Vougas K, Cholidou K, Markozannes E, Bakakos P, Liappas I, Alchanatis M (2013) Depression, physical activity, energy consumption, and quality of life in OSA patients before and after CPAP treatment. Sleep Breath 17(4):1159–1168CrossRefPubMed
25.
go back to reference Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund U, Freedson PS, Gary RA, Richardson CR, Smith DT, Swartz AM, American Heart Association Physical Activity Committee of the Council on L, Cardiometabolic H, Cardiovascular ECR, Prevention Committee of the Council on Clinical C, Council (2013) Guide to the assessment of physical activity: clinical and research applications: a scientific statement from the American Heart Association. Circulation 128(20):2259–2279CrossRefPubMed Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund U, Freedson PS, Gary RA, Richardson CR, Smith DT, Swartz AM, American Heart Association Physical Activity Committee of the Council on L, Cardiometabolic H, Cardiovascular ECR, Prevention Committee of the Council on Clinical C, Council (2013) Guide to the assessment of physical activity: clinical and research applications: a scientific statement from the American Heart Association. Circulation 128(20):2259–2279CrossRefPubMed
26.
go back to reference Erman MK, Stewart D, Einhorn D, Gordon N, Casal E (2007) Validation of the ApneaLink for the screening of sleep apnea: a novel and simple single-channel recording device. J Clin Sleep Med 3(4):387–392PubMedPubMedCentral Erman MK, Stewart D, Einhorn D, Gordon N, Casal E (2007) Validation of the ApneaLink for the screening of sleep apnea: a novel and simple single-channel recording device. J Clin Sleep Med 3(4):387–392PubMedPubMedCentral
27.
go back to reference Berry RB, Gamaldo CE, Harding SM, Brooks R, Lloyd RM, Vaughn BV, Marcus CL (2015) AASM scoring manual version 2.2 updates: new chapters for scoring infant sleep staging and home sleep apnea testing. J Clin Sleep Med 11(11):1253–1254CrossRefPubMedPubMedCentral Berry RB, Gamaldo CE, Harding SM, Brooks R, Lloyd RM, Vaughn BV, Marcus CL (2015) AASM scoring manual version 2.2 updates: new chapters for scoring infant sleep staging and home sleep apnea testing. J Clin Sleep Med 11(11):1253–1254CrossRefPubMedPubMedCentral
28.
go back to reference Collop NA, Tracy SL, Kapur V, Mehra R, Kuhlmann D, Fleishman SA, Ojile JM (2011) Obstructive sleep apnea devices for out-of-center (OOC) testing: technology evaluation. J Clin Sleep Med 7(5):531–548PubMedPubMedCentral Collop NA, Tracy SL, Kapur V, Mehra R, Kuhlmann D, Fleishman SA, Ojile JM (2011) Obstructive sleep apnea devices for out-of-center (OOC) testing: technology evaluation. J Clin Sleep Med 7(5):531–548PubMedPubMedCentral
29.
go back to reference Pescatello LS, American College of Sports Medicine (2014) ACSM's guidelines for exercise testing and prescription, 9th edn. Wolters Kluwer/Lippincott Williams & Wilkins Health, Philadelphia Pescatello LS, American College of Sports Medicine (2014) ACSM's guidelines for exercise testing and prescription, 9th edn. Wolters Kluwer/Lippincott Williams & Wilkins Health, Philadelphia
30.
go back to reference Evenson KR, Wen F, Metzger JS, Herring AH (2015) Physical activity and sedentary behavior patterns using accelerometry from a national sample of United States adults. Int J Behav Nutr Phys Act 12:20CrossRefPubMedPubMedCentral Evenson KR, Wen F, Metzger JS, Herring AH (2015) Physical activity and sedentary behavior patterns using accelerometry from a national sample of United States adults. Int J Behav Nutr Phys Act 12:20CrossRefPubMedPubMedCentral
31.
go back to reference Freedson PS, Melanson E, Sirard J (1998) Calibration of the computer science and applications, Inc accelerometer. Med Sci Sports Exerc 30(5):777–781CrossRefPubMed Freedson PS, Melanson E, Sirard J (1998) Calibration of the computer science and applications, Inc accelerometer. Med Sci Sports Exerc 30(5):777–781CrossRefPubMed
32.
go back to reference Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M (2008) Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 40(1):181–188CrossRef Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M (2008) Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 40(1):181–188CrossRef
33.
go back to reference Tudor-Locke C, Craig CL, Thyfault JP, Spence JC (2013) A step-defined sedentary lifestyle index: <5000 steps/day. Appl Physiol Nutr Metab 38(2):100–114CrossRefPubMed Tudor-Locke C, Craig CL, Thyfault JP, Spence JC (2013) A step-defined sedentary lifestyle index: <5000 steps/day. Appl Physiol Nutr Metab 38(2):100–114CrossRefPubMed
34.
go back to reference Slater G, Pengo MF, Kosky C, Steier J (2013) Obesity as an independent predictor of subjective excessive daytime sleepiness. Respir Med 107(2):305–309CrossRefPubMed Slater G, Pengo MF, Kosky C, Steier J (2013) Obesity as an independent predictor of subjective excessive daytime sleepiness. Respir Med 107(2):305–309CrossRefPubMed
35.
go back to reference Pahwa P, Karunanayake CP, Hagel L, Gjevre JA, Rennie D, Lawson J, Dosman JA (2012) Prevalence of high Epworth Sleepiness Scale scores in a rural population. Can Respir J 19(2):e10–e14CrossRefPubMedPubMedCentral Pahwa P, Karunanayake CP, Hagel L, Gjevre JA, Rennie D, Lawson J, Dosman JA (2012) Prevalence of high Epworth Sleepiness Scale scores in a rural population. Can Respir J 19(2):e10–e14CrossRefPubMedPubMedCentral
36.
go back to reference Pamidi S, Knutson KL, Ghods F, Mokhlesi B (2011) Depressive symptoms and obesity as predictors of sleepiness and quality of life in patients with REM-related obstructive sleep apnea: cross-sectional analysis of a large clinical population. Sleep Med 12(9):827–831CrossRefPubMed Pamidi S, Knutson KL, Ghods F, Mokhlesi B (2011) Depressive symptoms and obesity as predictors of sleepiness and quality of life in patients with REM-related obstructive sleep apnea: cross-sectional analysis of a large clinical population. Sleep Med 12(9):827–831CrossRefPubMed
37.
go back to reference Healy GN, Wijndaele K, Dunstan DW, Shaw JE, Salmon J, Zimmet PZ, Owen N (2008) Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Diabetes Care 31(2):369–371CrossRefPubMed Healy GN, Wijndaele K, Dunstan DW, Shaw JE, Salmon J, Zimmet PZ, Owen N (2008) Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Diabetes Care 31(2):369–371CrossRefPubMed
38.
go back to reference Bradley TD, Floras JS (2009) Obstructive sleep apnoea and its cardiovascular consequences. Lancet 373(9657):82–93CrossRefPubMed Bradley TD, Floras JS (2009) Obstructive sleep apnoea and its cardiovascular consequences. Lancet 373(9657):82–93CrossRefPubMed
39.
go back to reference Coughlin SR, Mawdsley L, Mugarza JA, Calverley PM, Wilding JP (2004) Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J 25(9):735–741CrossRefPubMed Coughlin SR, Mawdsley L, Mugarza JA, Calverley PM, Wilding JP (2004) Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J 25(9):735–741CrossRefPubMed
40.
go back to reference Pellegrinelli V, Rouault C, Rodriguez-Cuenca S, Albert V, Edom-Vovard F, Vidal-Puig A, Clement K, Butler-Browne GS, Lacasa D (2015) Human adipocytes induce inflammation and atrophy in muscle cells during obesity. Diabetes 64(9):3121–3134CrossRefPubMed Pellegrinelli V, Rouault C, Rodriguez-Cuenca S, Albert V, Edom-Vovard F, Vidal-Puig A, Clement K, Butler-Browne GS, Lacasa D (2015) Human adipocytes induce inflammation and atrophy in muscle cells during obesity. Diabetes 64(9):3121–3134CrossRefPubMed
41.
go back to reference Langen RC, Schols AM, Kelders MC, Van Der Velden JL, Wouters EF, Janssen-Heininger YM (2002) Tumor necrosis factor-alpha inhibits myogenesis through redox-dependent and -independent pathways. Am J Phys Cell Phys 283(3):C714–C721CrossRef Langen RC, Schols AM, Kelders MC, Van Der Velden JL, Wouters EF, Janssen-Heininger YM (2002) Tumor necrosis factor-alpha inhibits myogenesis through redox-dependent and -independent pathways. Am J Phys Cell Phys 283(3):C714–C721CrossRef
43.
go back to reference Carrera M, Barbe F, Sauleda J, Tomas M, Gomez C, Santos C, Agusti AG (2004) Effects of obesity upon genioglossus structure and function in obstructive sleep apnoea. Eur Respir J 23(3):425–429CrossRefPubMed Carrera M, Barbe F, Sauleda J, Tomas M, Gomez C, Santos C, Agusti AG (2004) Effects of obesity upon genioglossus structure and function in obstructive sleep apnoea. Eur Respir J 23(3):425–429CrossRefPubMed
44.
go back to reference Petrof BJ, Hendricks JC, Pack AI (1996) Does upper airway muscle injury trigger a vicious cycle in obstructive sleep apnea? A hypothesis. Sleep 19(6):465–471CrossRefPubMed Petrof BJ, Hendricks JC, Pack AI (1996) Does upper airway muscle injury trigger a vicious cycle in obstructive sleep apnea? A hypothesis. Sleep 19(6):465–471CrossRefPubMed
45.
go back to reference Smirne S, Iannaccone S, Ferini-Strambi L, Comola M, Colombo E, Nemni R (1991) Muscle fibre type and habitual snoring. Lancet 337(8741):597–599CrossRefPubMed Smirne S, Iannaccone S, Ferini-Strambi L, Comola M, Colombo E, Nemni R (1991) Muscle fibre type and habitual snoring. Lancet 337(8741):597–599CrossRefPubMed
Metadata
Title
Obstructive sleep apnea negatively impacts objectively measured physical activity
Authors
Trent A. Hargens
Ryan A. Martin
Courtney L. Strosnider
Gabrielle Elam Williams Giersch
Christopher J. Womack
Publication date
01-06-2019
Publisher
Springer International Publishing
Published in
Sleep and Breathing / Issue 2/2019
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-018-1700-0

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