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Physical activity and sedentary time in persons with obstructive sleep apnea and overweight enrolled in a randomized controlled trial for enhanced physical activity and healthy eating
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. (Behavioural medicine and physiotherapy)
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.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. (Behavioural medicine and physiotherapy)
2013 (English)In: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 17, no 4, 1257-1266 p.Article in journal (Refereed) Published
Abstract [en]

Background

The aim of the study was to describe the amount of physical activity and sedentary time in patients with obstructive sleep apnea syndrome (OSAS) and overweight, and to explore potential disease-related and psychological correlates.

Methods

A descriptive and correlational study was performed. Prospective data of physical activity and sedentary time were collected through accelerometry, and a one-point measurement of body mass index (BMI), daytime sleepiness, exercise self-efficacy, fear of movement, and depressive symptoms. Seventy-three participants with overweight (mean BMI 35kg/m2 SD 5) and moderate/severe OSAS (Apnea-Hypopnea Index >15) were consecutively recruited. Multivariate associations were determined through multiple linear regression analysis.

Results

The participants took a daily average of 7734 (SD 3528) steps, spent an average of 77 (SD 54) minutes in moderate-to-vigorous physical activity (MVPA), and spent 11h 45 min (SD 2h 8 min) sedentary. BMI, daytime sleepiness, exercise self-efficacy, fear of movement, and depressive symptoms did not explain variance in MVPA or steps, but explained 22.9% of variance in sedentary time. In backward selection analysis, BMI contributed to the explanatory degree of MVPA with 9% whereas, fear of movement explained 6.3% of the variance in steps and 14.3% of the variance in sedentary time.

Conclusions

An important implication for future physical activity interventions is that both physical activity and sedentary behaviors should be targeted, and fear of movement may be an important determinant for change in patients with OSAS and overweight.

Place, publisher, year, edition, pages
2013. Vol. 17, no 4, 1257-1266 p.
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
URN: urn:nbn:se:uu:diva-197191DOI: 10.1007/s11325-013-0831-6ISI: 000326928000020OAI: oai:DiVA.org:uu-197191DiVA: diva2:611789
Available from: 2013-03-18 Created: 2013-03-18 Last updated: 2017-12-06Bibliographically 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, HelenaEmtner, MargaretaLindberg, EvaÅsenlöf, Pernilla

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