{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T16:49:40Z","timestamp":1775580580154,"version":"3.50.1"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001785","name":"Flinders University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001785","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Clin Sleep Med"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study objectives<\/jats:title>\n                    <jats:p>Obstructive sleep apnoea (OSA) may be linked to poor physical performance and fall risk, yet this association remains underexplored. This study examined associations between OSA risk, balance, gait speed and handgrip strength (HGS) in community living adults across age-groups and sexes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Cross-sectional data from the 2016 Health and Retirement Study were analysed. Probable OSA was estimated with an adapted STOP-Bang questionnaire. Poor balance was defined as the inability to hold a semi-tandem stance for 10\u00a0s; slow gait speed as walking\u2009&lt;\u20090.8\u00a0m\/s over 2.5\u00a0m; and weak HGS as HGS-to-body mass index ratio\u2009&lt;\u20091.00 m\n                      <jats:sup>2<\/jats:sup>\n                      for males and\u2009&lt;\u20090.56m\n                      <jats:sup>2<\/jats:sup>\n                      for females.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      6,918 participants (mean age 66\u2009\u00b1\u200911\u00a0years; 57% female) were included. Probable OSA was associated with higher odds of: (i) poor balance in the overall sample (OR:1.23, 95% bootstrapped confidence interval (BCI):1.07\u20131.39,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), 50\u201364\u00a0years (OR: 1.41, BCI: 1.15- 1.72,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and females (OR: 1.30, BCI: 1.10\u20131.56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004); (ii) slow gait speed in the overall sample (OR:1.29, BCI:1.07\u20131.57,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), 80\u2009+\u2009years (OR:1.61, BCI:1.07\u20132.42, p\u2009=\u20090.028) and females (OR:1.39, BCI:1.03\u20131.91,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024); and (iii) weak HGS in the overall sample (OR:2.22, BCI:1.90\u20132.63,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), 50\u201364\u00a0years (OR:3.40, BCI: 2.58\u20134.61,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), 65\u201379\u00a0years (OR: 1.93, BCI:1.52- 2.47,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), males (OR\u2009=\u20091.87, BCI:1.49\u20132.35, p\u2009&lt;\u20090.001) and females (OR\u2009=\u20092.67, BCI 2.15\u20133.33,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Poor balance, slow gait speed and weak HGS are common among older adults at high risk of OSA. Further research should evaluate causality and assess co-screening to potentially enable early detection of fall risk in older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Brief summary<\/jats:title>\n                    <jats:p>\n                      <jats:bold>Study Rationale:<\/jats:bold>\n                      OSA is a common but often undiagnosed condition that may contribute to accelerated age-related physical decline and increased fall risk. Despite known links between diagnosed OSA and motor deficits, little is known about how undiagnosed OSA relates to fall-related physical performance measures in large, community-based populations.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>Study Impact:<\/jats:bold>\n                      This study suggests that individuals at high risk of OSA are more likely to have poor balance, slow gait speed, and weak handgrip strength, which are key predictors of fall risk. The observation of these associations in adults as young as 50\u00a0years of age warrants future research to evaluate causality and determine if co-screening of OSA and fall risk can help identify those most vulnerable.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s44470-026-00070-2","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T15:51:10Z","timestamp":1775577070000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Obstructive sleep apnea risk is associated with poor physical performance: a cross-sectional analysis of the U.S. health and retirement study"],"prefix":"10.1007","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6141-6379","authenticated-orcid":false,"given":"Rajani","family":"Khanal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberley S.","family":"van Schooten","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronaldo","family":"Piovezan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Adams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Sansom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Vakulin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"issue":"Suppl 2","key":"70_CR1","doi-asserted-by":"publisher","first-page":"i3","DOI":"10.1136\/injuryprev-2019-043286","volume":"26","author":"SL James","year":"2020","unstructured":"James SL, et al. The global burden of falls: global, regional and national estimates of morbidity and mortality from the Global Burden of Disease Study 2017. Inj Prev. 2020;26(Suppl 2):i3-11. https:\/\/doi.org\/10.1136\/injuryprev-2019-043286.","journal-title":"Inj Prev."},{"key":"70_CR2","unstructured":"World Health Organization. Fact sheets: falls. 2021. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/falls. Cited 3\/05\/2025."},{"issue":"5","key":"70_CR3","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.gerinurse.2015.08.006","volume":"36","author":"C Enderlin","year":"2015","unstructured":"Enderlin C, et al. Summary of factors contributing to falls in older adults and nursing implications. Geriatr Nurs. 2015;36(5):397\u2013406. https:\/\/doi.org\/10.1016\/j.gerinurse.2015.08.006.","journal-title":"Geriatr Nurs."},{"issue":"5","key":"70_CR4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0285530","volume":"18","author":"T Pham","year":"2023","unstructured":"Pham T, et al. Longitudinal association between handgrip strength, gait speed and risk of serious falls in a community-dwelling older population. PLoS One. 2023;18(5): e0285530. https:\/\/doi.org\/10.1371\/journal.pone.0285530.","journal-title":"PLoS One"},{"issue":"3","key":"70_CR5","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1519\/JPT.0b013e31822938ac","volume":"34","author":"TE Shubert","year":"2011","unstructured":"Shubert TE. Evidence-based exercise prescription for balance and falls prevention: a current review of the literature. J Geriatr Phys Ther. 2011;34(3):100\u20138. https:\/\/doi.org\/10.1519\/JPT.0b013e31822938ac.","journal-title":"J Geriatr Phys Ther"},{"key":"70_CR6","doi-asserted-by":"publisher","DOI":"10.3389\/978-2-88966-964-6","volume-title":"Balance and ageing","author":"K Van Schooten","year":"2021","unstructured":"Van Schooten K, Bruijn SM. Balance and ageing. Frontiers Media SA; 2021. https:\/\/doi.org\/10.3389\/978-2-88966-964-6."},{"issue":"4","key":"70_CR7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-051085","volume":"11","author":"KS Van Schooten","year":"2021","unstructured":"Van Schooten KS, et al. Protocol of a 12-month multifactorial eHealth programme targeting balance, dual-tasking and mood to prevent falls in older people: the StandingTall+ randomised controlled trial. BMJ Open. 2021;11(4): e051085. https:\/\/doi.org\/10.1136\/bmjopen-2021-051085.","journal-title":"BMJ Open"},{"issue":"12","key":"70_CR8","doi-asserted-by":"publisher","first-page":"2450","DOI":"10.1093\/gerona\/glaa014","volume":"75","author":"D Stevens","year":"2020","unstructured":"Stevens D, et al. The impact of obstructive sleep apnea on balance, gait, and falls risk: a narrative review of the literature. J Gerontol A Biol Sci Med Sci. 2020;75(12):2450\u201360. https:\/\/doi.org\/10.1093\/gerona\/glaa014.","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"1","key":"70_CR9","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1186\/s12877-023-04008-8","volume":"23","author":"W Jeong","year":"2023","unstructured":"Jeong W, Moon JY, Kim J-H. Association of absolute and relative hand grip strength with all-cause mortality among middle-aged and old-aged people. BMC Geriatr. 2023;23(1):321. https:\/\/doi.org\/10.1186\/s12877-023-04008-8.","journal-title":"BMC Geriatr"},{"issue":"2","key":"70_CR10","doi-asserted-by":"publisher","first-page":"43","DOI":"10.22540\/JFSF-06-043","volume":"6","author":"SG Neri","year":"2021","unstructured":"Neri SG, et al. Poor handgrip strength determined clinically is associated with falls in older women. J Frailty, Sarcopenia Falls. 2021;6(2):43. https:\/\/doi.org\/10.22540\/JFSF-06-043.","journal-title":"J Frailty, Sarcopenia Falls"},{"key":"70_CR11","doi-asserted-by":"publisher","unstructured":"Senaratna CV, et al. Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev. 2017;34:70\u201381.\u00a0https:\/\/doi.org\/10.1016\/j.smrv.2016.07.002.","DOI":"10.1016\/j.smrv.2016.07.002"},{"issue":"1","key":"70_CR12","doi-asserted-by":"publisher","first-page":"83","DOI":"10.5603\/PJNNS.a2019.0059","volume":"54","author":"T Demir","year":"2020","unstructured":"Demir T, Aslan K, Demirkiran M. Evaluation of postural balance in patients with obstructive sleep apnoea syndrome. Neurol Neurochir Pol. 2020;54(1):83\u20139. https:\/\/doi.org\/10.5603\/PJNNS.a2019.0059.","journal-title":"Neurol Neurochir Pol"},{"issue":"6","key":"70_CR13","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1136\/thoraxjnl-2015-207490","volume":"71","author":"F Degache","year":"2016","unstructured":"Degache F, et al. Sleep-disordered breathing and daytime postural stability. Thorax. 2016;71(6):543\u20138. https:\/\/doi.org\/10.1136\/thoraxjnl-2015-207490.","journal-title":"Thorax"},{"issue":"4","key":"70_CR14","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1111\/jsr.12516","volume":"26","author":"A Micarelli","year":"2017","unstructured":"Micarelli A, et al. Integrating postural and vestibular dimensions to depict impairment in moderate\u2010to\u2010severe obstructive sleep apnea syndrome patients. J Sleep Res. 2017;26(4):487\u201394. https:\/\/doi.org\/10.1111\/jsr.12516.","journal-title":"J Sleep Res"},{"issue":"3","key":"70_CR15","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1111\/ggi.12885","volume":"17","author":"M Kanezaki","year":"2017","unstructured":"Kanezaki M, Ogawa T. Sleep apnea and lateral balance instability in older adults. Geriatr Gerontol Int. 2017;17(3):511\u20133. https:\/\/doi.org\/10.1111\/ggi.12885.","journal-title":"Geriatr Gerontol Int"},{"issue":"4","key":"70_CR16","doi-asserted-by":"publisher","first-page":"1961","DOI":"10.1007\/s11325-021-02322-2","volume":"25","author":"G Yilmaz Gokmen","year":"2021","unstructured":"Yilmaz Gokmen G, et al. Postural stability and fall risk in patients with obstructive sleep apnea: a cross-sectional study. Sleep Breath. 2021;25(4):1961\u20137. https:\/\/doi.org\/10.1007\/s11325-021-02322-2.","journal-title":"Sleep Breath"},{"key":"70_CR17","doi-asserted-by":"publisher","first-page":"631","DOI":"10.2147\/NSS.S502204","volume":"17","author":"J Jiang","year":"2025","unstructured":"Jiang J, et al. Gait characteristics and neuroanatomical alterations in obstructive sleep apnea-hypopnea syndrome. Nat Sci Sleep. 2025;17:631\u201347. https:\/\/doi.org\/10.2147\/NSS.S502204.","journal-title":"Nat Sci Sleep"},{"key":"70_CR18","doi-asserted-by":"publisher","first-page":"e118","DOI":"10.1016\/j.rehab.2016.07.268","volume":"59","author":"S Baillieul","year":"2016","unstructured":"Baillieul S, et al. Impaired control of gait in patients with severe obstructive sleep apnea is reversed by continuous positive airway pressure treatment. Ann Phys Rehabil Med. 2016;59:e118\u20139. https:\/\/doi.org\/10.1016\/j.rehab.2016.07.268.","journal-title":"Ann Phys Rehabil Med"},{"key":"70_CR19","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.resp.2014.06.012","volume":"201","author":"G Allali","year":"2014","unstructured":"Allali G, et al. Gait abnormalities in obstructive sleep apnea and impact of continuous positive airway pressure. Respir Physiol Neurobiol. 2014;201:31\u20133. https:\/\/doi.org\/10.1016\/j.resp.2014.06.012.","journal-title":"Respir Physiol Neurobiol"},{"key":"70_CR20","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.maturitas.2022.06.009","volume":"164","author":"RD Piovezan","year":"2022","unstructured":"Piovezan RD, et al. Associations of indicators of sleep impairment and disorders with low muscle strength in middle-aged and older adults: the HypnoLaus cohort study. Maturitas. 2022;164:52\u20139. https:\/\/doi.org\/10.1016\/j.maturitas.2022.06.009.","journal-title":"Maturitas"},{"key":"70_CR21","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S276932","author":"D Stevens","year":"2020","unstructured":"Stevens D, et al. Associations of OSA and nocturnal hypoxemia with strength and body composition in community dwelling middle aged and older men. Nat Sci Sleep. 2020. https:\/\/doi.org\/10.2147\/NSS.S276932.","journal-title":"Nat Sci Sleep"},{"issue":"9","key":"70_CR22","doi-asserted-by":"publisher","first-page":"1665","DOI":"10.1111\/j.1532-5415.2008.01846.x.","volume":"56","author":"T-T Dam","year":"2008","unstructured":"Dam T-T, et al. Association between sleep and physical function in older men: the Osteoporotic Fractures in Men Sleep Study. J Am Geriatr Soc. 2008;56(9):1665\u201373. https:\/\/doi.org\/10.1111\/j.1532-5415.2008.01846.x.","journal-title":"J Am Geriatr Soc"},{"issue":"02","key":"70_CR23","doi-asserted-by":"publisher","first-page":"049","DOI":"10.1055\/s-2002-32318","volume":"6","author":"V Kapur","year":"2002","unstructured":"Kapur V, et al. Underdiagnosis of sleep apnea syndrome in US communities. Sleep Breath. 2002;6(02):049\u201354. https:\/\/doi.org\/10.1055\/s-2002-32318.","journal-title":"Sleep Breath"},{"issue":"2","key":"70_CR24","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1093\/ije\/dyu067","volume":"43","author":"A Sonnega","year":"2014","unstructured":"Sonnega A, et al. Cohort profile: the Health and Retirement Study (HRS). Int J Epidemiol. 2014;43(2):576\u201385. https:\/\/doi.org\/10.1093\/ije\/dyu067.","journal-title":"Int J Epidemiol"},{"issue":"1","key":"70_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/workar\/wax032","volume":"4","author":"GG Fisher","year":"2017","unstructured":"Fisher GG, Ryan LH. Overview of the health and retirement study and introduction to the special issue. Work Aging Retire. 2017;4(1):1\u20139. https:\/\/doi.org\/10.1093\/workar\/wax032.","journal-title":"Work Aging Retire"},{"key":"70_CR26","unstructured":"Crimmins E, et al. Documentation of physical measures, anthropometrics and blood pressure in the health and retirement study. HRS Documentation Report DR-011. 2008 Feb;14(1-2):47\u201359. https:\/\/hrs.isr.umich.edu."},{"issue":"3","key":"70_CR27","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1378\/chest.15-0903","volume":"149","author":"F Chung","year":"2016","unstructured":"Chung F, Abdullah HR, Liao P. STOP-Bang questionnaire: a practical approach to screen for obstructive sleep apnea. Chest. 2016;149(3):631\u20138. https:\/\/doi.org\/10.1378\/chest.15-0903.","journal-title":"Chest"},{"issue":"4","key":"70_CR28","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.5664\/jcsm.9832","volume":"18","author":"MM Shieu","year":"2022","unstructured":"Shieu MM, et al. The association between obstructive sleep apnea risk and cognitive disorders: a population-based study. J Clin Sleep Med. 2022;18(4):1177\u201385. https:\/\/doi.org\/10.5664\/jcsm.9832.","journal-title":"J Clin Sleep Med"},{"key":"70_CR29","doi-asserted-by":"publisher","DOI":"10.2147\/copd.s496086","author":"Y Wang","year":"2025","unstructured":"Wang Y, et al. Dynamic risk status of OSA and its association with COPD incidence and progression to oxygen therapy: insights from a US national cohort. Int J Chron Obstruct Pulmon Dis. 2025. https:\/\/doi.org\/10.2147\/copd.s496086.","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"70_CR30","doi-asserted-by":"publisher","unstructured":"Braley TJ, et al. Sex-specific dementia risk in known or suspected obstructive sleep apnea: a 10-year longitudinal population-based study. SLEEP Advances, 2024;5(1):zpae077. https:\/\/doi.org\/10.1093\/sleepadvances\/zpae077.","DOI":"10.1093\/sleepadvances\/zpae077"},{"issue":"09","key":"70_CR31","doi-asserted-by":"publisher","first-page":"951","DOI":"10.5664\/jcsm.4022","volume":"10","author":"F Chung","year":"2014","unstructured":"Chung F, et al. Alternative scoring models of STOP-bang questionnaire improve specificity to detect undiagnosed obstructive sleep apnea. J Clin Sleep Med. 2014;10(09):951\u20138. https:\/\/doi.org\/10.5664\/jcsm.4022.","journal-title":"J Clin Sleep Med"},{"key":"70_CR32","doi-asserted-by":"publisher","unstructured":"Tu R, et al. Association between subjective cognitive complaints, balance impairment and disability among middle-aged and older adults: evidence from a population-based cohort study. Geriatr Gerontol Int. 2022;22(12):1025\u201331.\u00a0https:\/\/doi.org\/10.1111\/ggi.14501.","DOI":"10.1111\/ggi.14501"},{"key":"70_CR33","doi-asserted-by":"publisher","unstructured":"Stephan Y, et al. Balance, strength, and risk of dementia: findings from the health and retirement study and the english longitudinal study of ageing. J Gerontol: Series A. 2024;79(8). https:\/\/doi.org\/10.1093\/gerona\/glae165.","DOI":"10.1093\/gerona\/glae165"},{"key":"70_CR34","doi-asserted-by":"publisher","unstructured":"Montero-Odasso M, et al. World guidelines for falls prevention and management for older adults: a global initiative. Age and Ageing, 2022;51(9): afac205. https:\/\/doi.org\/10.1093\/ageing\/afac205.","DOI":"10.1093\/ageing\/afac205"},{"issue":"5","key":"70_CR35","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1097\/MCO.0000000000000202","volume":"18","author":"RW Bohannon","year":"2015","unstructured":"Bohannon RW. Muscle strength: clinical and prognostic value of hand-grip dynamometry. Curr Opin Clin Nutr Metab Care. 2015;18(5):465\u201370. https:\/\/doi.org\/10.1097\/MCO.0000000000000202.","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"70_CR36","doi-asserted-by":"publisher","unstructured":"Studenski, et al. The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol Series A: Biomed Sci Med Sci. 2014;69(5):547\u2013558. https:\/\/doi.org\/10.1093\/gerona\/glu010.","DOI":"10.1093\/gerona\/glu010"},{"issue":"2","key":"70_CR37","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1370\/afm.1363","volume":"10","author":"AL Huntley","year":"2012","unstructured":"Huntley AL, et al. Measures of multimorbidity and morbidity burden for use in primary care and community settings: a systematic review and guide. Ann Fam Med. 2012;10(2):134\u201341. https:\/\/doi.org\/10.1370\/afm.1363.","journal-title":"Ann Fam Med"},{"issue":"2","key":"70_CR38","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1123\/jpah.2011-0281","volume":"11","author":"M Wen","year":"2014","unstructured":"Wen M, Li L, Su D. Physical activity and mortality among middle-aged and older adults in the United States. J Phys Act Health. 2014;11(2):303\u201312. https:\/\/doi.org\/10.1123\/jpah.2011-0281.","journal-title":"J Phys Act Health"},{"key":"70_CR39","unstructured":"Angelo Canty BR, Brazzale AR. Boot: Bootstrap Functions. 2025. Available from: https:\/\/CRAN.R-project.org\/package=boot.\u00a0Cited 2025."},{"issue":"2","key":"70_CR40","doi-asserted-by":"publisher","first-page":"714","DOI":"10.14336\/AD.2024.0124-1","volume":"16","author":"J Wang","year":"2024","unstructured":"Wang J, et al. Age-related dysfunction in balance: a comprehensive review of causes, consequences, and interventions. Aging Dis. 2024;16(2):714\u201337. https:\/\/doi.org\/10.14336\/AD.2024.0124-1.","journal-title":"Aging Dis"},{"issue":"1","key":"70_CR41","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1177\/0165025414533223","volume":"39","author":"ME Lachman","year":"2015","unstructured":"Lachman ME, Teshale S, Agrigoroaei S. Midlife as a pivotal period in the life course: balancing growth and decline at the crossroads of youth and old age. Int J Behav Dev. 2015;39(1):20\u201331. https:\/\/doi.org\/10.1177\/0165025414533223.","journal-title":"Int J Behav Dev"},{"key":"70_CR42","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2021.101344","volume":"68","author":"N Shur","year":"2021","unstructured":"Shur N, et al. Age-related changes in muscle architecture and metabolism in humans: the likely contribution of physical inactivity to age-related functional decline. Ageing Res Rev. 2021;68: 101344. https:\/\/doi.org\/10.1016\/j.arr.2021.101344.","journal-title":"Ageing Res Rev"},{"issue":"6","key":"70_CR43","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s12276-019-0233-3","volume":"51","author":"E-J Yeo","year":"2019","unstructured":"Yeo E-J. Hypoxia and aging. Exp Mol Med. 2019;51(6):1\u201315. https:\/\/doi.org\/10.1038\/s12276-019-0233-3.","journal-title":"Exp Mol Med"},{"key":"70_CR44","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0030-2019","author":"MR Bonsignore","year":"2019","unstructured":"Bonsignore MR, Saaresranta T, Riha RL. Sex differences in obstructive sleep apnoea. Eur Respir Rev. 2019. https:\/\/doi.org\/10.1183\/16000617.0030-2019.","journal-title":"Eur Respir Rev"},{"key":"70_CR45","doi-asserted-by":"publisher","first-page":"31806","DOI":"10.3402\/ecrj.v3.31806","volume":"3","author":"U Anttalainen","year":"2016","unstructured":"Anttalainen U, et al. Prolonged partial upper airway obstruction during sleep - an underdiagnosed phenotype of sleep-disordered breathing. Eur Clin Respir J. 2016;3:31806. https:\/\/doi.org\/10.3402\/ecrj.v3.31806.","journal-title":"Eur Clin Respir J"},{"issue":"8","key":"70_CR46","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1016\/j.molmed.2017.06.006","volume":"23","author":"LS Gaspar","year":"2017","unstructured":"Gaspar LS, et al. Obstructive sleep apnea and hallmarks of aging. Trends Mol Med. 2017;23(8):675\u201392. https:\/\/doi.org\/10.1016\/j.molmed.2017.06.006.","journal-title":"Trends Mol Med"},{"key":"70_CR47","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.smrv.2018.09.001","volume":"42","author":"S Besnard","year":"2018","unstructured":"Besnard S, et al. The balance of sleep: role of the vestibular sensory system. Sleep Med Rev. 2018;42:220\u20138. https:\/\/doi.org\/10.1016\/j.smrv.2018.09.001.","journal-title":"Sleep Med Rev"},{"key":"70_CR48","doi-asserted-by":"publisher","first-page":"631","DOI":"10.2147\/NSS.S502204","volume":"17","author":"J Jiang","year":"2025","unstructured":"Jiang J, et al. Gait characteristics and neuroanatomical alterations in obstructive sleep apnea-hypopnea syndrome. Nat Sci Sleep. 2025;17:631\u201347. https:\/\/doi.org\/10.2147\/NSS.S502204.","journal-title":"Nat Sci Sleep"},{"issue":"1","key":"70_CR49","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1164\/ajrccm.159.1.9709051","volume":"159","author":"P Mayer","year":"1999","unstructured":"Mayer P, et al. Peripheral neuropathy in sleep apnea. A tissue marker of the severity of nocturnal desaturation. Am J Respir Crit Care Med. 1999;159(1):213\u20139. https:\/\/doi.org\/10.1164\/ajrccm.159.1.9709051.","journal-title":"Am J Respir Crit Care Med"},{"key":"70_CR50","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2466-14-140","volume":"14","author":"S Celle","year":"2014","unstructured":"Celle S, et al. Sleep-related breathing disorders and gait variability: a cross-sectional preliminary study. BMC Pulm Med. 2014;14:1\u20136. https:\/\/doi.org\/10.1186\/1471-2466-14-140.","journal-title":"BMC Pulm Med"},{"key":"70_CR51","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2024.102007","volume":"78","author":"T Cho","year":"2024","unstructured":"Cho T, Yan E, Chung F. The STOP-Bang questionnaire: a narrative review on its utilization in different populations and settings. Sleep Med Rev. 2024;78: 102007. https:\/\/doi.org\/10.1016\/j.smrv.2024.102007.","journal-title":"Sleep Med Rev"}],"container-title":["Journal of Clinical Sleep Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44470-026-00070-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s44470-026-00070-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44470-026-00070-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T15:51:12Z","timestamp":1775577072000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s44470-026-00070-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":51,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["70"],"URL":"https:\/\/doi.org\/10.1007\/s44470-026-00070-2","relation":{},"ISSN":["1550-9389","1550-9397"],"issn-type":[{"value":"1550-9389","type":"print"},{"value":"1550-9397","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"assertion":[{"value":"4 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 February 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 February 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 April 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Health and Retirement Study is approved by University of Michigan Institutional Review Board (IRB0000921). All participants provided written consent for anonymous use of their public survey data.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"N\/A (No identifiable individual data are presented).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"AV\u2019s research is supported by NHMRC and MRFF funding unrelated to this work, and has received competitive research funding and equipment from ResMed, Philips Respironics, Withings and NeuroFlex for research unrelated to and outside the submitted work.RJA declares research funding and\/or in kind support from the National Health and Medical Research Council, the Medical Research Future Fund, the Hospital Research Foundation, Flinders Foundation, Safework SA,\u00a0Sydney Trains, Withings, ResMed Foundation, Philips, Neuroflex\u00a0and the Lifetime Support Authority for research related to sleep.RK\u2019s PhD stipend is provided by ResMed foundation and they have no role in the submitted work.Other authors have no conflicts to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"46"}}