Association Between Eating Habits and Risk of Obstructive Sleep Apnea: A Population-Based Study

Figures & data

Table 1 Basic Characteristics of the Study Subjects

	Total (n=9733)	Non-OSA (N=8475)	OSA (N=1258)	P value
Age, year, mean (S.D.)	55.99 (9.88)	55.76 (9.96)	57.51 (9.14)	<0.001*
Body mass index, kg/m^2, mean (S.D.)	24.01 (3.52)	23.60 (3.24)	26.77 (4.03)	<0.001*
Leisure-time physical activity, MET-h/week, mean (S.D.)	45.75 (34.64)	45.15 (34.74)	43.06 (33.88)	0.003*
Neck circumference, cm, mean (S.D.)	34.58 (3.24)	34.24 (3.07)	36.86 (3.46)	<0.001*
Waist-hip ratio, mean (S.D.)	0.88 (0.07)	0.87 (0.07)	0.92 (0.07)	<0.001*
Gender, male, N (%)	3273 (33.63)	2623 (30.95)	650 (51.67)	<0.001^†
Marital status, married, N (%)	8575 (88.10)	7426 (87.62)	1149 (91.34)	<0.001^†
Educational status, N (%)
Primary school and lower	3469 (35.64)	3020 (35.63)	449 (35.69)	0.003^†
Junior high school	2478 (25.46)	2162 (25.51)	316 (25.12)
Senior high school	2505 (25.74)	2142 (25.27)	363 (28.86)
College and above	1281 (13.16)	1151 (13.58)	130 (10.33)
Cigarette smoking, N (%)
Never	7765 (79.78)	6889 (81.29)	876 (69.63)	<0.001^†
Occasion	461 (4.74)	352 (4.15)	109 (8.66)
Frequent	1507 (15.48)	1234 (14.56)	273 (21.70)
Alcohol drinking, N (%)
Never	7572 (77.80)	6690 (78.94)	882 (70.11)	<0.001^†
Occasion	1573 (16.16)	1331 (15.71)	242 (19.24)
Frequent	588 (6.04)	454 (5.36)	134 (10.65)
Retirement, yes, N (%)	4901 (50.35)	4236 (49.98)	665 (52.86)	0.061^†
Hypertension, yes, N (%)	2816 (28.93)	1774 (20.93)	1042 (82.83)	<0.001^†
Dyslipidemia, yes, N (%)	6822 (70.09)	5868 (69.24)	954 (75.83)	<0.001^†
Diabetes, yes, N (%)	778 (7.99)	636 (7.50)	142 (11.29)	<0.001^†

Notes: *P-value from t-test between subjects with and without OSA. ^†P-value from Chi-square test with Yates’ continuity correction between subjects with OSA and without OSA.

Abbreviations: OSA, obstructive sleep apnea; MET-h/week, metabolic equivalent -hours per week.

Figure 1 Distribution of scores of three eating patterns.

Table 2 The Association Between Food and Dietary Supplements Consumption and Risk of OSA

Food & Dietary Supplements	N (Non-OSA/OSA)*	Crude OR1 (95% CI)^†	Adjusted OR2 (95% CI)^‡	Adjusted OR3 (95% CI)^§
Rice
≤3/week	362/65	1.00	1.00	1.00
4–6/week	285/55	1.07 (0.73, 1.59)	1.05 (0.66, 1.69)	1.12 (0.69, 1.81)
≥1/day	7828/1138	0.81 (0.62, 1.07)	0.87 (0.63, 1.21)	0.87 (0.62, 1.21)
P for trend		0.036	0.244	0.198
Vegetables
≤3/week	126/29	1.00	1.00	1.00
4–6/week	172/26	0.66 (0.37, 1.17)	0.95 (0.47, 1.92)	0.97 (0.48, 1.98)
≥1/day	8177/1203	0.64 (0.43, 0.98)	0.79 (0.48, 1.34)	0.76 (0.45, 1.29)
P for trend		0.053	0.258	0.172
Fruits
≤3/week	1664/326	1.00	1.00	1.00
4–6/week	1304/204	0.80 (0.66, 0.96)	0.81 (0.64, 1.01)	0.79 (0.63, 1.00)
≥1/day	5507/728	0.67 (0.59, 0.78)	0.74 (0.62, 0.88)	0.72 (0.60, 0.86)
P for trend		< 0.001	0.001	< 0.001
Fried food
<1/month	5666/769	1.00	1.00	1.00
1–3/month	2227/348	1.15 (1.00, 1.32)	1.16 (0.99, 1.37)	1.12 (0.95, 1.32)
≥1/week	582/141	1.79 (1.46, 2.17)	1.77 (1.37, 2.27)	1.63 (1.25, 2.11)
P for trend		< 0.001	< 0.001	0.001
Wheat and its products
<1/week	1755/247	1.00	1.00	1.00
1–3/week	2786/414	1.06 (0.89, 1.25)	1.10 (0.90, 1.34)	1.07 (0.87, 1.31)
≥4/week	3934/597	1.08 (0.92, 1.27)	1.10 (0.91, 1.33)	1.11 (0.91, 1.35)
P for trend		0.369	0.409	0.294
Coarse grain
<1/week	3800/627	1.00	1.00	1.00
1–3/week	3013/419	0.84 (0.74, 0.96)	0.96 (0.82, 1.13)	0.95 (0.81, 1.12)
≥4/week	1662/212	0.77 (0.65, 0.91)	0.98 (0.81, 1.20)	1.00 (0.81, 1.23)
P for trend		0.001	0.787	0.865
Beans and soy products
<1/week	5024/791	1.00	1.00	1.00
1–3/week	2739/374	0.87 (0.76, 0.99)	0.98 (0.84, 1.15)	0.99 (0.84, 1.17)
≥4/week	712/93	0.83 (0.66, 1.04)	1.09 (0.83, 1.43)	1.12 (0.84, 1.47)
P for trend		0.018	0.754	0.609
Red meat
<1/week	426/55	1.00	1.00	1.00
1–3/week	1452/219	1.17 (0.86, 1.61)	1.38 (0.96, 2.00)	1.44 (0.99, 2.12)
≥4/week	6597/984	1.16 (0.87, 1.56)	1.26 (0.90, 1.78)	1.34 (0.95, 1.91)
P for trend		0.530	0.681	0.455
Poultry meat
<1/week	1125/172	1.00	1.00	1.00
1–3/week	3636/510	0.92 (0.76, 1.11)	0.99 (0.80, 1.24)	1.01 (0.81, 1.26)
≥4/week	3714/576	1.01 (0.85, 1.22)	1.02 (0.82, 1.27)	1.03 (0.83, 1.29)
P for trend		0.454	0.797	0.729
Fish and aquatic product
<1/week	882/125	1.00	1.00	1.00
1–3/week	3078/430	0.99 (0.80, 1.22)	0.91 (0.71, 1.16)	0.94 (0.73, 1.22)
≥4/week	4515/703	1.10 (0.90, 1.35)	0.95 (0.75, 1.21)	0.96 (0.76, 1.23)
P for trend		0.130	0.968	0.956
Eggs
<1/week	1713/287	1.00	1.00	1.00
1–3/week	3631/526	0.86 (0.74, 1.01)	0.99 (0.83, 1.19)	1.02 (0.84, 1.23)
≥4/week	3131/445	0.85 (0.72, 1.00)	1.02 (0.84, 1.24)	1.04 (0.85, 1.26)
P for trend		0.062	0.781	0.720
Animal innards
<1/week	7732/1139	1.00	1.00	1.00
1–3/week	639/98	1.04 (0.83, 1.29)	1.17 (0.89, 1.53)	1.24 (0.94, 1.62)
≥4/week	104/21	1.37 (0.83, 2.15)	1.06 (0.58, 1.87)	1.09 (0.60, 1.92)
P for trend		0.272	0.343	0.208
Salted food
<1/week	7543/1075	1.00	1.00	1.00
1–3/week	734/136	1.30 (1.07, 1.57)	1.32 (1.04, 1.66)	1.21 (0.95, 1.53)
≥4/week	198/47	1.67 (1.19, 2.28)	1.17 (0.78, 1.74)	1.13 (0.74, 1.71)
P for trend		< 0.001	0.046	0.164
Nuts
<1/week	5009/741	1.00	1.00	1.00
1–3/week	2237/336	1.02 (0.88, 1.16)	1.02 (0.86, 1.20)	1.01 (0.85, 1.20)
≥4/week	1229/181	1.00 (0.83, 1.18)	1.01 (0.82, 1.24)	1.00 (0.81, 1.24)
P for trend		0.969	0.869	0.960
Non-fermented milk
<1/week	4989/831	1.00	1.00	1.00
1–3/week	1659/209	0.76 (0.64, 0.89)	0.98 (0.81, 1.19)	1.02 (0.84, 1.25)
≥4/week	1827/218	0.72 (0.61, 0.84)	0.89 (0.73, 1.08)	0.93 (0.76, 1.13)
P for trend		< 0.001	0.267	0.540
Fermented milk
<1/week	6006/974	1.00	1.00	1.00
1–3/week	1509/175	0.72 (0.60, 0.85)	0.87 (0.71, 1.06)	0.87 (0.70, 1.07)
≥4/week	960/109	0.70 (0.57, 0.86)	0.87 (0.68, 1.12)	0.86 (0.66, 1.10)
P for trend		< 0.001	0.143	0.121
Carbonated beverages
<1/week	8087/1174	1.00	1.00	1.00
1–3/week	295/61	1.42 (1.06, 1.88)	1.34 (0.93, 1.90)	1.25 (0.86, 1.79)
≥4/week	93/23	1.70 (1.05, 2.65)	1.42 (0.78, 2.50)	1.47 (0.79, 2.63)
P for trend		0.001	0.058	0.090
Non-carbonated beverages
<1/week	7676/1122	1.00	1.00	1.00
1–3/week	383/59	1.05 (0.79, 1.38)	1.06 (0.75, 1.49)	1.08 (0.75, 1.52)
≥4/week	416/77	1.27 (0.98, 1.62)	1.31 (0.96, 1.78)	1.26 (0.91, 1.73)
P for trend		0.071	0.093	0.147
Vitamin supplement
<1/week	7780/1179	1.00	1.00	1.00
1–3/week	222/28	0.83 (0.55, 1.22)	1.01 (0.62, 1.59)	1.04 (0.64, 1.65)
≥4/week	473/51	0.71 (0.52, 0.95)	0.83 (0.58, 1.16)	0.85 (0.59, 1.20)
P for trend		0.016	0.317	0.419
Mineral supplement
<1/week	7352/1118	1.00	1.00	1.00
1–3/week	342/49	0.94 (0.69, 1.27)	1.14 (0.79, 1.61)	1.16 (0.80, 1.66)
≥4/week	781/91	0.77 (0.61, 0.96)	0.91 (0.69, 1.17)	0.93 (0.71, 1.22)
P for trend		0.022	0.611	0.793
Healthcare products
<1/week	7837/1164	1.00	1.00	1.00
1–3/week	190/21	0.74 (0.46, 1.14)	1.11 (0.63, 1.86)	1.17 (0.66, 1.99)
≥4/week	448/73	1.10 (0.84, 1.41)	1.14 (0.83, 1.53)	1.18 (0.86, 1.60)
P for trend		0.745	0.388	0.264
Fish oil
<1/week	7651/1129	1.00	1.00	1.00
1–3/week	202/32	1.07 (0.72, 1.54)	1.34 (0.85, 2.08)	1.31 (0.81, 2.04)
≥4/week	622/97	1.06 (0.84, 1.31)	1.16 (0.89, 1.51)	1.17 (0.89, 1.53)
P for trend		0.579	0.177	0.182

Notes: *N represents the sample size for non-OSA group or OSA group. ^†OR₁, without any adjustment. ^‡OR₂, adjustment for age, sex, marital status, educational status, retirement, smoking, drinking, leisure-time physical activity, neck circumference, waist–hip ratio, hypertension, dyslipidemia, and diabetes. ^§OR₃, adjustment for body mass index as well as covariates in OR₂.

Table 3 The Association of Eating Patterns with Risk of OSA

	N (Non-OSA/OSA)*	Crude OR1 (95% CI)^†	Adjusted OR2 (95% CI)^‡	Adjusted OR3 (95% CI)^§	Adjusted OR4 (95% CI)^ll
Pattern I
Tertile 1	2748/497	1.00	1.00	1.00	1.00
Tertile 2	2852/397	0.77 (0.67, 0.89)	0.98 (0.82, 1.16)	0.98 (0.82, 1.17)	0.97 (0.81, 1.17)
Tertile 3	2875/364	0.70 (0.61, 0.81)	0.96 (0.79, 1.16)	0.99 (0.82, 1.21)	0.98 (0.79, 1.21)
P for trend		< 0.001	0.653	0.970	0.849
Every-1 score increment		0.95 (0.93, 0.97)	0.99 (0.96, 1.02)	0.99 (0.97, 1.02)	0.98 (0.93, 1.03)
Pattern II
Tertile 1	2834/422	1.00	1.00	1.00	1.00
Tertile 2	2810/444	1.06 (0.92, 1.22)	1.08 (0.91, 1.28)	1.07 (0.90, 1.27)	1.05 (0.88, 1.25)
Tertile 3	2831/392	0.93 (0.80, 1.08)	0.95 (0.80, 1.13)	0.95 (0.79, 1.14)	0.92 (0.76, 1.11)
P for trend		0.222	0.409	0.443	0.271
Every-1 score increment		0.97 (0.94, 1.00)	0.98 (0.95, 1.02)	0.98 (0.95, 1.02)	0.98 (0.91, 1.05)
Pattern III
Tertile 1	2867/396	1.00	1.00	1.00	1.00
Tertile 2	2862/384	0.97 (0.84, 1.13)	1.10 (0.92, 1.31)	1.07 (0.89, 1.28)	1.08 (0.90, 1.29)
Tertile 3	2746/478	1.26 (1.09, 1.45)	1.30 (1.09, 1.55)	1.22 (1.02, 1.46)	1.25 (1.03, 1.50)
P for trend		< 0.001	0.003	0.027	0.016
Every-1 score increment		1.08 (1.04, 1.12)	1.09 (1.04, 1.14)	1.07 (1.02, 1.12)	1.09 (1.00, 1.20)

Notes: *N represents the sample size for non-OSA group or OSA group. ^†OR₁, without any adjustment. ^‡OR₂, adjustment for age, sex, marital status, educational status, retirement, smoking, drinking, leisure-time physical activity, neck circumference, waist–hip ratio, hypertension, dyslipidemia, and diabetes. ^§OR₃, adjustment for covariates in OR₂ as well as body mass index. ^llOR₄, adjustment for covariates in OR2 as well as three patterns.