Associations of OSA and nocturnal hypoxemia with strength and body composition in community dwelling middle aged and older men

David Stevens, Sarah Appleton, Andrew D. Vincent, Yohannes Melaku, Sean Martin, Tiffany Gill, Catherine Hill, Andrew Vakulin, Robert Adams, Gary Wittert

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Reduced hand grip strength (HGS) is associated with poorer health in chronic conditions, yet there has been little research examining the association with hand grip strength and obstructive sleep apnea (OSA). Further, these studies have not examined, nor adjusted, for muscle mass. The aim of this study was to determine associations between OSA indices, HGS, muscle mass, and fat mass. Participants and Methods: A total of 613 participants (age range 41–88, BMI 28.6 ± 4.3) from the population-based Men Androgen Inflammation Lifestyle Environment and Stress Study underwent in-home overnight polysomnography, assessment of dominant and non-dominant HGS, and dual x-ray absorptiometry to determine whole body muscle mass and fat mass. Linear models determined cross-sectional associations of polysomnographic-derived OSA indices with hand grip strength, muscle mass, and fat mass, whilst adjusting for lifestyle information (income, smoking status, diet, self-reported physical activity), blood sample derived testosterone and systemic inflammation (C-reactive protein), cardiometabolic health (cardiovascular disease, hypertension, type 2 diabetes), and depression. Results: In adjusted models, reduced dominant HGS was associated with lower oxygen nadir (unstandardised β [B] = 0.19, 95% confidence interval [CI] 0.08 to 0.29), greater time spent below 90% oxygen saturation (B = −0.08, 95% CI −0.14 to −0.02), and increased apnea duration (B = −0.3, 95% CI −0.23 to −0.02). By contrast, there were no associations between HGS and both AHI and REM AHI. Fat mass was consistently associated with worsening OSA indices, whereas muscle mass demonstrated no associations with any OSA index. Conclusion: Our findings suggest impairments in HGS may be related to fat infiltration of muscle, hypoxemia-induced reductions in peripheral neural innervation, or even endothelial dysfunction, which is a common outcome of hypoxemia. Longitudinal data are needed to further examine these hypotheses and establish if reduced grip strength in patients with OSA is associated with long-term adverse health outcomes.

Original languageEnglish
Pages (from-to)959-968
Number of pages10
JournalNature and Science of Sleep
Volume12
DOIs
Publication statusPublished or Issued - 2020

Keywords

  • Grip strength
  • Intermittent hypoxemia
  • Muscle mass
  • Myosteatosis

ASJC Scopus subject areas

  • Applied Psychology
  • Behavioral Neuroscience

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