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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #358947
Title: Association between diet quality and sleep apnea in the Multi-Ethnic Study of Atherosclerosis

Author
item REID, MICHELLE - BRIGHAM & WOMEN'S HOSPITAL
item MARAS, JANICE - NORTHEASTERN UNIVERSITY
item SHEA, STEVEN - COLUMBIA UNIVERSITY - NEW YORK
item WOOD, ALEXIS - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)
item CASTRO-DIEHL, CECILIA - BOSTON UNIVERSITY
item JOHNSON, DAYNA - BRIGHAM & WOMEN'S HOSPITAL
item HUANG, TIANYI - BRIGHAM & WOMEN'S HOSPITAL
item JACOBS, JR., DAVID - UNIVERSITY OF MINNESOTA
item CRAWFORD, ALLISON - COLUMBIA UNIVERSITY - NEW YORK
item ST-ONGE, MARIE - COLUMBIA UNIVERSITY - NEW YORK
item REDLINE, SUSAN - BRIGHAM & WOMEN'S HOSPITAL

Submitted to: Sleep
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/27/2018
Publication Date: 10/22/2018
Citation: Reid, M., Maras, J.E., Shea, S., Wood, A.C., Castro-Diehl, C., Johnson, D.A., Huang, T., Jacobs, Jr., D.R., Crawford, A., St-Onge, M.P., Redline, S. 2018. Association between diet quality and sleep apnea in the Multi-Ethnic Study of Atherosclerosis. Sleep. https://doi.org/10.1093/sleep/zsy194.
DOI: https://doi.org/10.1093/sleep/zsy194

Interpretive Summary: Short sleep duration has been linked to unhealthy dietary patterns, but little is known about whether obstructive sleep apnea (OSA), a disorder of poor sleep quantity and quality characterized by sleep fragmentation, is associated with a poorer diet. We examined this question in a large multi-ethnic sample of US adults ages 45-90 years. Using self-reported diet, and in-home polysomnography (an objective assessment of sleep quality and quantity), we found that OSA was associated with lower intakes of whole grains, higher intakes of red/processed meat and lower overall diet quality. The association between OSA and higher red/processed meat intake was partially due to reductions in a specific stage of sleep known as N3 sleep. Our study suggested that OSA is associated with a less healthy dietary profile that is partially explained by N3 sleep. These findings may be useful to clinicians who have to counsel individuals with OSA, and for researchers through the suggestion that targeting diet in interventions may improve sleep quality and/or vice versa.

Technical Abstract: While 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. Our objectives were to 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. A diverse population (N=1,813) 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/hour. 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, (Beta=-0.200, SE=0.072, P<0.01), higher intakes of red/processed meat, (Beta=-0.440, SE=0.136, P<0.01) and lower overall diet quality, (Beta=-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. 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.