Leisure-Time Physical Activity and Sedentary Behavior and Their Cross-Sectional Associations with Excessive Daytime Sleepiness in the French SU.VI.MAX-2 Study
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The potential benefit of physical activity in terms of decreasing excessive daytime sleepiness (EDS) prevalence is unclear, especially in aging adults.
We aimed to elucidate the associations among physical activity, sedentariness, and EDS in middle-aged and older adults.
We conducted a cross-sectional analysis using data from a subsample of participants in the SU.VI.MAX-2 observational study (2007–2009; N = 4179; mean age = 61.9 years). EDS was defined as a score >10 on the Epworth Sleepiness Scale. Leisure-time physical activity and different types of sedentary behavior were assessed with the Modifiable Activity Questionnaire. The associations were examined with multivariable logistic regression models.
In the adjusted multivariable model, total leisure-time physical activity (modeled in quartiles, Q) was significantly, inversely associated with EDS (odds ratios (OR)Q4 vs Q1 = 0.70, 95 % confidence interval (CI) = 0.54–0.89). The association persisted in analyses restricted to individuals not taking sleep medication (ORQ4 vs Q1 = 0.72, 95 % CI = 0.54–0.95). In turn, time spent watching television and time spent reading appeared protective against EDS (ORQ4 vs Q1 = 0.73, 95 % CI = 0.57–0.94; ORQ4 vs Q1 = 0.76, 95 % CI = 0.60–0.97, respectively), whereas time spent on a computer appeared to confer an increased risk for EDS (ORQ4 vs Q1 = 1.30, 95 % CI = 1.05–1.62). When physical activity and sedentariness were modeled jointly, using WHO recommendation-based cutoffs for high/low levels, no significant associations were observed in the fully adjusted models.
The findings reinforce public health recommendations promoting behavior modification and specifically moderate-intensity exercise in middle-aged and older adults. The association of high physical activity/low sedentariness with EDS, which was not supported by the data, merits further investigation before firm conclusions could be drawn.
KeywordsHealth behavior Physical activity Sedentariness Sleepiness
The study was funded by the French National Research Agency (no. ANR-05-PNRA-010) and the French Ministry of Health (DGS). The funding bodies did not have any involvement in the design/conduct of the research, or in data analysis/interpretation, or in writing/approval of the manuscript. The authors wish to thank Nathalie Arnault and Laurent Bourhis (statisticians) who coordinated data management of the SU.VI.MAX study. The SU.VI.MAX trial is registered at www.clinicaltrials.gov under # NCT00272428.
Conflict of Interest
The authors declare that they have no conflict of interest.
Compliance with Ethical Standards
All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
PG, SH, and EKG were responsible for developing the concept, design, and protocol of the study and for coordinating data collection; JMO was involved with the physical activity and sedentary behavior data collection; RMA and MM performed the literature review; RMA led the writing; RMA and MM performed the statistical analyses; VAA and EKG provided methodological guidance; MM, PG, SH, JMO, EKG, and VAA were involved in interpreting the results and editing the manuscript for important intellectual content. All authors read and approved the final version of the manuscript.
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