{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T02:46:29Z","timestamp":1786934789370,"version":"build-2736575974"},"reference-count":57,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,10,22]],"date-time":"2023-10-22T00:00:00Z","timestamp":1697932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["2009776"],"award-info":[{"award-number":["2009776"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>We assessed: (1) the independent and joint association of obstructive sleep apnea risk and healthy lifestyle with common consequences (excessive daytime sleepiness, depression, cardiovascular disease and stroke) of obstructive sleep apnea; and (2) the effect of healthy lifestyle on survival in people with increased obstructive sleep apnea risk. Data from 13,694 adults (median age 46\u2009years; 50% men) were used for cross\u2010sectional and survival analyses (mortality over 15\u2009years). A healthy lifestyle score with values from 0 (most unhealthy) to 5 (most healthy) was determined based on diet, alcohol intake, physical activity, smoking and body mass index. In the cross\u2010sectional analysis, obstructive sleep apnea risk was positively associated with all chronic conditions and excessive daytime sleepiness in a dose\u2013response manner (<jats:italic>p<\/jats:italic> for trend &lt;\u20090.001). The healthy lifestyle was inversely associated with all chronic conditions (<jats:italic>p<\/jats:italic> for trend &lt;\u20090.001) but not with excessive daytime sleepiness (<jats:italic>p<\/jats:italic> for trend\u2009=\u20090.379). Higher healthy lifestyle score was also associated with reduced odds of depression and cardiovascular disease. We found an inverse relationship between healthy lifestyle score with depression (<jats:italic>p<\/jats:italic> for trend &lt;\u20090.001), cardiovascular disease (<jats:italic>p<\/jats:italic> for trend\u2009=\u20090.003) and stroke (<jats:italic>p<\/jats:italic> for trend\u2009=\u20090.025) among those who had high obstructive sleep apnea risk. In the survival analysis, we found an inverse association between healthy lifestyle and all\u2010cause mortality for all categories of obstructive sleep apnea risk (moderate\/high\u2010 and high\u2010risk groups [<jats:italic>p<\/jats:italic> for trend &lt;\u20090.001]). This study emphasises the crucial role of a healthy lifestyle in mitigating the effects of obstructive sleep apnea risk in individuals with an elevated obstructive sleep apnea risk.<\/jats:p>","DOI":"10.1111\/jsr.14069","type":"journal-article","created":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T05:45:20Z","timestamp":1698039920000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Healthy lifestyle is associated with reduced cardiovascular disease, depression and mortality in people at elevated risk of sleep apnea"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3051-7313","authenticated-orcid":false,"given":"Yohannes Adama","family":"Melaku","sequence":"first","affiliation":[{"name":"FHMRI Sleep (Adelaide Institute for Sleep Health), College of Medicine and Public Health Flinders University, Bedford Park  Adelaide South Australia Australia"},{"name":"Cancer Epidemiology Division Cancer Council Victoria  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7292-9714","authenticated-orcid":false,"given":"Sarah","family":"Appleton","sequence":"additional","affiliation":[{"name":"FHMRI Sleep (Adelaide Institute for Sleep Health), College of Medicine and Public Health Flinders University, Bedford Park  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9534-8699","authenticated-orcid":false,"given":"Amy C.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"FHMRI Sleep (Adelaide Institute for Sleep Health), College of Medicine and Public Health Flinders University, Bedford Park  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger L.","family":"Milne","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Division Cancer Council Victoria  Melbourne Victoria Australia"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health The University of Melbourne  Melbourne Victoria Australia"},{"name":"Precision Medicine, School of Clinical Sciences at Monash Health Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigid M.","family":"Lynch","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Division Cancer Council Victoria  Melbourne Victoria Australia"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health The University of Melbourne  Melbourne Victoria Australia"},{"name":"Physical Activity Laboratory, Baker Heart and Diabetes Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3503-2363","authenticated-orcid":false,"given":"Danny J.","family":"Eckert","sequence":"additional","affiliation":[{"name":"FHMRI Sleep (Adelaide Institute for Sleep Health), College of Medicine and Public Health Flinders University, Bedford Park  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Adams","sequence":"additional","affiliation":[{"name":"FHMRI Sleep (Adelaide Institute for Sleep Health), College of Medicine and Public Health Flinders University, Bedford Park  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3945\/an.115.009258"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-006-0024-x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-2600(19)30198-5"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-015-1155-5"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12824"},{"key":"e_1_2_10_7_1","volume-title":"National Health and nutrition examination survey","author":"Center for Disease Control and Prevention","year":"2020"},{"key":"e_1_2_10_8_1","unstructured":"Center for Disease Control and Prevention. 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