The role of lifestyle habits in the developmenet and management of obstructive sleep apnea in adults

Obstructive sleep apnea (OSA) is a chronic disease characterized by recurrent episodes of partial or complete collapse of the upper airway during sleep, leading to pauses of breathing and arousals. Although previously considered as an exclusive respiratory disorder, it is nowadays recognized as an important cause of morbidity and mortality. OSA is strongly associated with various chronic and metabolic diseases, including hypertension, cardiovascular diseases and diabetes mellitus, while obesity, in particular central obesity, seems to play a central role in the pathogenesis of the disease. Therefore, the modification of lifestyle habits, e.g. in terms of nutrition and physical activity, is currently explored as a mean of preventing and managing the disease in combination with current first line treatment (continuous positive airway pressure during sleep). The purpose of this review is to summarize the existing data regarding the role of lifestyle habits in the development and management of OSA in adults. Regarding the development of the disease, the existing data are limited and not sufficient to demonstrate causal associations; however, it has been shown that patients with OSA have a preference for foods high in fat and low in fiber, while physical activity level has been inversely associated with both the presence and the severity of the disease. In terms of the disease management, several interventional studies have so far investigated the effect of lifestyle changes on the treatment of OSA, focusing primarily on weight loss. The available data support that weight loss effectively reduces the severity of the disease and improves the associated cardiometabolic disorders in overweight patients.