Michelle Reid1, Janice E Maras2, Steven Shea3,4, Alexis C Wood5, Cecilia Castro-Diehl6, Dayna A Johnson1,7, Tianyi Huang8, David R Jacobs9, Allison Crawford4, Marie-Pierre St-Onge4,10, Susan Redline1,7,11. 1. Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA. 2. Department of Health Sciences, Northeastern University, Boston, MA. 3. Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY. 4. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. 5. USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX. 6. Section of Preventive Medicine and Epidemiology, Boston University, Boston, MA. 7. Department of Sleep Medicine, Harvard Medical School, Boston, MA. 8. Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA. 9. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN. 10. Institute of Human Nutrition, Columbia University Vagelos College of Physicians and Surgeons, New York, NY. 11. Department of Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
Abstract
Rationale: Although short sleep duration has been linked to unhealthy dietary patterns, little is known about the association of obstructive sleep apnea (OSA), a disorder characterized by sleep fragmentation and diet. Study Objectives: Investigate associations between diet quality and OSA in the Multi-Ethnic Study of Atherosclerosis and assess whether reductions in slow-wave sleep (stage N3) and rapid eye movement (REM) sleep are potential mediators for these associations. Methods: A diverse population (N = 1813) completed a food frequency questionnaire and underwent Type 2 in-home polysomnography, which included measurement of N3 and REM sleep and apnea-hypopnea index (AHI). Moderate-to-more severe OSA was defined as having an AHI > 15 events/hr. Results: Participants were 53.9% female with a mean age of 68.3 (SD 9.1) years. Approximately 33.8% were categorized as having moderate-to-more severe OSA. In adjusted analyses, OSA was associated with lower intakes of whole grains, (β = -0.200, SE = 0.072, p < 0.01), higher intakes of red/processed meat, (β = -0.440, SE = 0.136, p < 0.01), and lower overall diet quality (β = -1.286, SE = 0.535, p = 0.02). Stage N3 sleep partially explained the associations between red/processed meat and overall diet quality score with OSA. Conclusions: Moderate-to-more severe OSA is associated with a less healthy dietary profile that is partially explained by reduced N3 sleep. These findings suggest the opportunity to target sleep quality in interventions aimed at improving cardio-metabolic risk factors in patients with OSA.
Rationale: Although short sleep duration has been linked to unhealthy dietary patterns, little is known about the association of obstructive sleep apnea (OSA), a disorder characterized by sleep fragmentation and diet. Study Objectives: Investigate associations between diet quality and OSA in the Multi-Ethnic Study of Atherosclerosis and assess whether reductions in slow-wave sleep (stage N3) and rapid eye movement (REM) sleep are potential mediators for these associations. Methods: A diverse population (N = 1813) completed a food frequency questionnaire and underwent Type 2 in-home polysomnography, which included measurement of N3 and REM sleep and apnea-hypopnea index (AHI). Moderate-to-more severe OSA was defined as having an AHI > 15 events/hr. Results: Participants were 53.9% female with a mean age of 68.3 (SD 9.1) years. Approximately 33.8% were categorized as having moderate-to-more severe OSA. In adjusted analyses, OSA was associated with lower intakes of whole grains, (β = -0.200, SE = 0.072, p < 0.01), higher intakes of red/processed meat, (β = -0.440, SE = 0.136, p < 0.01), and lower overall diet quality (β = -1.286, SE = 0.535, p = 0.02). Stage N3 sleep partially explained the associations between red/processed meat and overall diet quality score with OSA. Conclusions: Moderate-to-more severe OSA is associated with a less healthy dietary profile that is partially explained by reduced N3 sleep. These findings suggest the opportunity to target sleep quality in interventions aimed at improving cardio-metabolic risk factors in patients with OSA.
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