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Physical activity in sleep apnea and obesity: personal incentives, challenges, and facilitators for success
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Educational Sciences, Department of Education.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
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2012 (English)In: Behavioural Sleep Medicine, ISSN 1540-2002, E-ISSN 1540-2010, Vol. 10, no 2, 122-137 p.Article in journal (Refereed) Published
Abstract [en]

Background:

Physical activity combined with changes in eating habits is recommended for weight reduction in obstructive sleep apnea (OSA). Studies of how to enhance such health behaviours in persons with OSA and obesity are scarce.

Aim:

To explore aspects associated with engagement in physical activity in individuals with OSA and obesity.

Method:

7 women and 8 men with moderate or severe OSA (apnea-hypopnea index >15) and obesity (mean BMI 38.2) were selected from the Sleep clinic at Uppsala University Hospital, Sweden. Using semi-structured interviews, following content areas were covered: 1) health perceptions and susceptibility, 2) outcome expectations, and 3) facilitating and hindering factors for physical activity. Transcribed data were analysed according to content analysis using researcher triangulation.

Results:

Two comprehensive themes evolved exploring influences on engagement: 1) Incentives strong enough, and 2) Facilitators for success and challenges to overcome. Five categories reflected the meaning of theme 1: Consequences of OSA and obesity, Reasons to devote oneself to physical activity, Perceived benefits, Perceived disadvantages, and Ambivalence. Three categories reflected theme 2: Cognitions, Context, and Disease and physical symptoms.

Conclusion:

What constitutes strong incentives to change seems crucial for the understanding of how physical activity is initiated and maintained. Identified challenges and facilitators concerned a broad spectrum of cognitions and contextual aspects and were not only related to disease and physical symptoms. Future interventions aiming at enhanced physical activity may benefit from integrating these aspects.

Place, publisher, year, edition, pages
2012. Vol. 10, no 2, 122-137 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-153826DOI: 10.1080/15402002.2011.574763ISI: 000304277100004PubMedID: 22468930OAI: oai:DiVA.org:uu-153826DiVA: diva2:418040
Available from: 2011-05-19 Created: 2011-05-19 Last updated: 2017-12-11Bibliographically approved
In thesis
1. Physical Activity and Eating Behaviour Changes in Patients with Obstructive Sleep Apnea Syndrome
Open this publication in new window or tab >>Physical Activity and Eating Behaviour Changes in Patients with Obstructive Sleep Apnea Syndrome
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis aimed at developing and evaluating a tailored behavioural sleep medicine intervention for enhanced physical activity and healthy eating in patients with obstructive sleep apnea syndrome (OSAS) and overweight.

Participants with moderate or severe OSAS (apnea-hypopnea index ≥15) and obesity (Studies I-II) or overweight (Studies III-IV), treated with continuous positive airway pressure (CPAP) (Studies I-II) or admitted to CPAP treatment (Studies III-IV), were recruited from the sleep clinic at Uppsala University Hospital, Sweden. Semi-structured individual interviews were analysed using qualitative content analysis (Study I). Data on moderate-to-vigorous physical activity (MVPA) and sedentary time were collected with three measurement methods and analysed regarding the level of measurement agreement (Study II). Potential disease-related and psychological correlates for the amount of MVPA, daily steps and sedentary time were explored using multiple linear regression (Study III). Physical activity and eating behaviour changes were examined after a six month behaviour change trial (Study IV). A tailored behavioural sleep medicine intervention targeting physical activity and healthy eating in combination with first- time CPAP treatment was compared with CPAP treatment and advice on the association between weight and OSAS.

According to participants’ conceptions, a strong incentive is needed for a change in physical activity and bodily symptoms, external circumstances and thoughts and feelings influence physical activity engagement (Study I). Compared with accelerometry, the participants overestimated the level of MVPA and underestimated sedentary time when using self-reports (Study II). The participants spent 11 hours 45 minutes (71.6% of waking hours) while sedentary. Fear of movement contributed to the variation in steps and sedentary time. Body mass index was positively correlated to MVPA (Study III). The experimental group increased intake of fruit and fish and reduced more weight and waist circumference compared with controls. There were no changes in physical activity (Study IV).

The novel tailored behavioural sleep medicine intervention combined with first-time CPAP facilitated eating behaviour change, with subsequent effects on anthropometrics, but it had no effects on physical activity and sedentary time. Fear of movement may be a salient determinant of sedentary time, which has to be further explored in this population. The results confirm sedentary being a construct necessary to separate from the lower end of a physical activity continuum and highlight the need of developing interventions targeting sedentary behaviours specifically.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 64 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 885
Keyword
Obstructive sleep apnea, physical activity, eating behaviour, sedentary time, health behaviour change
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-197595 (URN)978-91-554-8638-9 (ISBN)
Public defence
2013-05-17, Universitetshuset, sal IX, Övre Slottsgatan 2, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2013-04-24 Created: 2013-03-29 Last updated: 2013-08-30Bibliographically approved

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Igelström, HelenaMartin, CathrinEmtner, MargaretaLindberg, EvaÅsenlöf, Pernilla

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