Why the study?
The contribution of lifestyle behaviors, specifically eating mechanics and psychological eating cues, to disease severity in obstructive sleep apnea accompanied by metabolic syndrome remains unclear.
Are dietary behaviors and physical activity associated with metabolic syndrome, severe OSA, and poor sleep quality in patients with obstructive sleep apnea?
Are dietary behaviors and physical activity associated with metabolic syndrome, severe OSA, and poor sleep quality in patients with obstructive sleep apnea?
In patients with obstructive sleep apnea, metabolic syndrome and severe OSA are independently associated with specific dietary behaviors (such as reward eating and eating speed) and physical activity levels.
Does not support changing OSA care; leaves open whether targeting reward eating and activity improves metabolic outcomes.
Background/Objectives: Obstructive sleep apnea (OSA) is often accompanied by metabolic syndrome (MetS), forming a high-risk phenotype with elevated cardiometabolic burden. The contribution of lifestyle behaviors—particularly eating mechanics and psychological eating cues—to disease severity remains unclear. This study examined independent associations of dietary behaviors and physical activity (PA) with OSA severity, sleep quality, and metabolic health. Methods: Forty-four OSA patients (mean age 38.3 ± 9.1 years; 89% male) underwent attended polysomnography, dual-energy X-ray absorptiometry, and metabolic profiling. Validated questionnaires assessed dietary behaviors, PA, and sleep quality. Hierarchical logistic regression identified predictors of MetS, severe OSA, and poor sleep quality. Results: The prevalence of MetS was 45%. Compared with those with OSA alone, participants with MetS demonstrated significantly greater central adiposity and more severe nocturnal hypoxemia, despite similar apnea–hypopnea indexes. In multivariable models, MetS was independently associated with higher body mass index (adjusted odds ratio [aOR] = 1.64; p = 0.008) and reward eating (aOR = 3.34; p = 0.041), whereas higher total PA was associated with reduced odds (aOR = 0.96; p = 0.026). Poor subjective sleep quality was significantly associated with younger age (aOR = 0.91; p = 0.037). For severe OSA, slow chewing was associated with significantly reduced odds (aOR = 0.24; p = 0.038), while emotional eating was associated with increased odds (aOR = 2.40; p = 0.048). Conclusions: This hypothesis-generating study identifies a high-risk OSA phenotype marked by metabolic dysfunction and hypoxemia. Eating speed (a proxy for mindful eating), emotional and reward-driven eating, and PA independently shape metabolic and respiratory outcomes. These findings support incorporating behavioral nutrition into multidisciplinary OSA management.
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Lee et al. (2026) studied this question.
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