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Physical activity and eating behaviour in sleep disorders
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. (Fysioterapi)
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Description
Abstract [en]

Sleep-disordered breathing and insomnia are common sleep disorders and associated with an increased risk of morbidity. The aim of this thesis was to study the contribution of a behavioural sleep medicine perspective on sleep-disordered breathing and insomnia. More specific, factors considered important for changing eating behaviour and the impact of physical activity were studied.

Methods: In study I, semi-structured interviews of participants with obstructive sleep apnoea and obesity (n = 15) were analysed using a qualitative content analysis. A population-based female cohort was followed prospectively over ten years in study II and III using a postal questionnaire on two occasions (n = 4,851 and n = 5062, respectively). In study IV, a series of five experimental single-case studies was conducted testing how an aerobic exercise intervention affected selected typical snores, following an A1B1A2B2A3 design over nine days and nights (n = 5).

Results:  Facilitators and barriers towards eating behaviour change were identified. A low level of self-reported leisure-time physical activity was a risk factor among women for future habitual snoring complaints, independent of weight, weight gain alcohol dependence or smoking. Maintaining higher levels or increasing levels of leisure-time physical activity over the ten-year period partly protected from snoring complaints (study II). Further, a low level of self-reported leisure-time physical activity is a risk factor for future insomnia among women. Maintaining higher levels or increasing levels of leisure-time physical activity over the ten-year period partly protect against self-reported insomnia, independent of psychological distress, age, change in body mass index, smoking, alcohol dependence, snoring status or level of education (study III). Single bouts of aerobic exercise did not produce an acute effect on snoring the following nights in the studied individuals. A pronounced night-to-night variation in snoring was identified (study IV).

Conclusion: Women with sleep disorders would benefit from a behavioural sleep medicine perspective targeting their physical activity in the prevention and management of snoring and insomnia. This is motivated by the protective effects of physical activity confirmed by this thesis.

Knowledge was added about facilitators and barriers for future eating behaviour change interventions.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2016. , p. 63
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1283
Keyword [en]
Health behaviour, obesity, sleep-disordered breathing, sleep disorders, public health, diet, physical activity, snoring, insomnia, risk factors, epidemiology
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-308395ISBN: 978-91-554-9771-2 (print)OAI: oai:DiVA.org:uu-308395DiVA, id: diva2:1049571
Public defence
2017-01-13, Gunnesalen, Psykiatriens hus ingång 10, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2016-12-21 Created: 2016-11-25 Last updated: 2016-12-21
List of papers
1. Facilitators and barriers for eating behaviour changes in obstructive sleep apnoea and obesity: a qualitative content analysis
Open this publication in new window or tab >>Facilitators and barriers for eating behaviour changes in obstructive sleep apnoea and obesity: a qualitative content analysis
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2013 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 1, p. 74-81Article in journal (Refereed) Published
Abstract [en]

Purpose:

Obesity is a major risk factor for obstructive sleep apnoea syndrome, a condition known causing lack of sleep continuity and daytime sleepiness. Weight loss interventions are recommended, however knowledge on what facilitate and impede eating behaviour change is lacking for this particular population. The aim of this study was to identify personal conceptions of prerequisites for eating behaviour change.

Method:

A qualitative study on 15 patients with obstructive sleep apnoea syndrome (OSAS; apnoea-hypopnoea index >15) and obesity (Mean body mass index 38.2). Semi-structured interviews were conducted and data were transcribed and analysed using qualitative content analysis with researcher triangulation for trustworthiness.

Results:

Data were organised according to barriers and facilitators for changing eating behaviour. Identified barriers were desire and reward, cravings and emotional control, low self-confidence, insufficient support, taxing behaviours, cost, lack of knowledge about healthy eating strategies, perceived helplessness and low susceptibility. Identified facilitators were positive expectations, fear of negative consequences, experience of success, support and follow-up, accessibility, applied skills for healthy eating, personal involvement and challenged self-image.

Conclusion:

This study adds knowledge on important barriers and facilitators of eating behaviour change according to individuals with obesity and OSAS. Information used to inform a tailored behavioural medicine intervention targeting eating behaviours. Implications for Rehabilitation Patients with obstructive sleep apnoea syndrome (OSAS) benefit from weight loss and eating behaviour changes are recommended. Patients' views on prerequisites for eating behaviour change are important to plan, conduct and tailor behaviour change interventions. These aspects have hitherto not been elaborated in patients with OSAS. Considerations on patient's self-image and perceived susceptibility along with providing strategies for controlling the desire and rewarding feeling associated with eating are emphasised.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-208962 (URN)10.3109/09638288.2013.782354 (DOI)000328335300010 ()23651128 (PubMedID)
Available from: 2013-10-11 Created: 2013-10-11 Last updated: 2017-12-06Bibliographically approved
2. Leisure-time physical activity predicts complaints of snoring in women: a prospective cohort study over 10 years
Open this publication in new window or tab >>Leisure-time physical activity predicts complaints of snoring in women: a prospective cohort study over 10 years
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2014 (English)In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 15, no 4, p. 415-421Article in journal (Refereed) Published
Abstract [en]

Objective

We aimed to assess the impact of self-reported physical activity on incidence and remission of snoring complaints in women.

Methods

A population-based sample of 4851 women aged >20 years responded to questionnaires in years 2000 and 2010. Based on the responses, the women were categorized into low, medium, or high level of physical activity at baseline and at follow-up.

Results

The prevalence of habitual snoring complaints increased from 7.6% at baseline to 9.2% in 2010 (P<.0001). After adjusting for age, body mass index (BMI), waist and neck circumference, weight gain, smoking status, alcohol dependence, and snoring status at baseline, reported physical activity level at baseline had a protective effect on habitual snoring complaints at follow-up. The adjusted odds ratio (OR) (95% confidence intervals]) for complaints of habitual snoring was 0.7 (0.5–0.9) for the reported medium physical activity level and 0.5 (0.4–0.8) for the high activity level. When subdividing the population by changes in reported physical activity level over the follow-up period, an increase in physical activity was followed by a decrease in the complaint of snoring. Similarly a high level of reported physical activity only had a protective effect on snoring in participants who remained at a high or medium level.

Conclusions

A low level of self-reported physical activity is a risk factor for future habitual snoring complaints in women, independent of weight, weight gain, alcohol dependence, and smoking. Increased physical activity can modify the risk.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-212697 (URN)10.1016/j.sleep.2013.09.020 (DOI)000333762500007 ()
Available from: 2013-12-13 Created: 2013-12-13 Last updated: 2017-12-06Bibliographically approved
3. High or increasing levels of physical activity protect women from future insomnia
Open this publication in new window or tab >>High or increasing levels of physical activity protect women from future insomnia
2017 (English)In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 32, p. 22-27Article in journal (Refereed) Published
Abstract [en]

Objective: There is a lack of evidence about the impact of physical activity on insomnia based on representative samples with a long-term follow-up. The aim of this study was to assess the impact of physical activity on insomnia incidence, as well as the impact of changes in leisure-time physical activity on insomnia in women. Method: The study included a population-based sample of 5062 women aged >20 years who responded to questionnaires in 2000 and 2010. Insomnia was defined as experiencing severe or very severe problems in falling asleep, maintaining sleep, or experiencing early morning awakenings, together with daytime sleepiness or fatigue. Physical activity was categorized as low, medium, or high level at baseline and at follow-up. Results: After adjusting for age, body mass index, smoking, alcohol dependence, snoring status, level of education, and psychological distress, the adjusted odds ratio (OR) (95% confidence interval) for incident insomnia in women who increased from a low to a medium or high level of physical activity was 0.53 (0.3 e0.94) and 0.17 (0.03e0.81), respectively, as compared to women with a low activity level on both occasions. Women remaining on a medium activity level or increasing to a high activity level had an OR of 0.53 (0.35 e0.83) and 0.36 (0.21e0.64) and the OR of those decreasing from a high level to a medium level or remaining on a high activity level on both occasions was 0.37 (0.21e0.66) and 0.3 (0.16e0.54) respectively. Conclusion: Women maintaining higher levels or increasing their level of leisure-time physical activity over the 10-year period were partly protected from self-reported insomnia.

Place, publisher, year, edition, pages
Elsevier, 2017
National Category
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-281463 (URN)10.1016/j.sleep.2016.03.017 (DOI)000400211300005 ()28366337 (PubMedID)
Available from: 2016-03-24 Created: 2016-03-24 Last updated: 2017-06-20Bibliographically approved
4. The effects of aerobic exercise and individual variations on snoring over nine nights: five experimental single-case studies.
Open this publication in new window or tab >>The effects of aerobic exercise and individual variations on snoring over nine nights: five experimental single-case studies.
Show others...
(English)Manuscript (preprint) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-308393 (URN)
Available from: 2016-11-25 Created: 2016-11-25 Last updated: 2016-11-25

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