Poor diet, poor sleep in sleep apnea: which is the cart and which is the horse?

摘要

With interest, I read the manuscript “Association between Diet Quality and Sleep Apnea in the Multi-Ethnic Study of Atherosclerosis” by Reid et al. [1]. The authors studied a large cohort with a high prevalence of obstructive sleep apnea (OSA). Compared to those mild or no OSA, those with moderate to severe OSA had poorer eating habits and decreased amount of N3 sleep. “A formal mediation analysis showed that N3 sleep duration explained approximately 6% to 9% of the association between AHI and red/processed meat score and total AHEI-10 score” (dietary inventory). “These associations suggest the importance of poor sleep quality as a contributor to unhealthy eating patterns in individuals with OSA, and possibly secondarily, as a risk factor for obesity and cardiovascular disease in those patients.” The authors concluded: “ 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.”