Association between diet quality and sleep apnea in the Multi-Ethnic Study of Atherosclerosis

Michelle Reid, Janice E. Maras, Steven Shea, Alexis C. Wood, Cecilia Castro-Diehl, Dayna A. Johnson, Tianyi Huang, David R. Jacobs, Allison Crawford, Marie Pierre St-Onge, Susan Redline

Research output: Contribution to journalArticle

3 Scopus citations


Rationale Although short sleep duration has been linked to unhealthy dietary patterns, little is known about the association of obstructive sleep apnea (OSA), a disorder characterized by sleep fragmentation and diet. Study Objectives Investigate associations between diet quality and OSA in the Multi-Ethnic Study of Atherosclerosis and assess whether reductions in slow-wave sleep (stage N3) and rapid eye movement (REM) sleep are potential mediators for these associations. Methods A diverse population (N = 1813) completed a food frequency questionnaire and underwent Type 2 in-home polysomnography, which included measurement of N3 and REM sleep and apnea-hypopnea index (AHI). Moderate-to-more severe OSA was defined as having an AHI > 15 events/hr. Results Participants were 53.9% female with a mean age of 68.3 (SD 9.1) years. Approximately 33.8% were categorized as having moderate-to-more severe OSA. In adjusted analyses, OSA was associated with lower intakes of whole grains, (β = -0.200, SE = 0.072, p < 0.01), higher intakes of red/processed meat, (β = -0.440, SE = 0.136, p < 0.01), and lower overall diet quality (β = -1.286, SE = 0.535, p = 0.02). Stage N3 sleep partially explained the associations between red/processed meat and overall diet quality score with OSA. Conclusions Moderate-to-more severe OSA is associated with a less healthy dietary profile that is partially explained by reduced N3 sleep. These findings suggest the opportunity to target sleep quality in interventions aimed at improving cardio-metabolic risk factors in patients with OSA.

Original languageEnglish (US)
Article numberzsy194
Issue number1
StatePublished - Jan 1 2019


  • Alternative Health Eating Index
  • OSA
  • diet quality
  • slow-wave sleep

Fingerprint Dive into the research topics of 'Association between diet quality and sleep apnea in the Multi-Ethnic Study of Atherosclerosis'. Together they form a unique fingerprint.

  • Cite this

    Reid, M., Maras, J. E., Shea, S., Wood, A. C., Castro-Diehl, C., Johnson, D. A., Huang, T., Jacobs, D. R., Crawford, A., St-Onge, M. P., & Redline, S. (2019). Association between diet quality and sleep apnea in the Multi-Ethnic Study of Atherosclerosis. Sleep, 42(1), [zsy194].