Abstract
BACKGROUND: Cardiovascular health (CVH), operationalized using the Life's Essential 8 (LE8) construct, has been linked to a myriad of health outcomes. Although there is a link between CVH and Obstructive Sleep Apnea (OSA), which has become a significant public health issue, a thorough investigation of this relationships has not been undertaken. METHODS: This study investigates the association between CVH, quantified according to the LE8 construct, and OSA using data from the National Health and Nutrition Examination Survey (NHANES). Based on data from the NHANES (2005-2008, 2015-2018), this study consisted of 9,350 adults aged 20-79 years. Logistic regression analysis is utilized to determine the association between LE8 scores and OSA. Two-sample Mendelian randomization (MR) is used to investigate the causal relationship between CVH and OSA with the inverse-variance weight (IVW) method being the primary source of analysis. RESULTS: The connection between CVH and OSA risk was affirmed, with individuals who had better CVH (high LE8 vs. low LE8), being at significantly lower risk for OSA than those with worse CVH (Odds Ratio [OR]: 0.23, 95% confidence interval [CI]: 0.18-0.30). Additionally, patients with higher LE8 scores experienced a decreased risk of OSA in a manner that was dose-dependent. The MR analysis also provided evidence of a positive correlation between BMI (genetically determined) and increased risk for OSA (OR for 1 Standard Deviation [SD] increase = 2, 95% CI: 1.81-2.21). Additionally, individuals who smoked less and exercised more showed decreased risk of OSA with respect to smoking (OR = 0.5, 95% CI: 0.32-0.79) and exercise (OR = 0.73, 95% CI: 0.54-0.99). CONCLUSIONS: This study highlights the importance of keeping CVH in good shape (as measured by the LE8 score) to lower the risk of developing OSA.