• Wenwei Zuo and Xuelian Yang.
• School of Gongli Hospital Medical Technology, University of Shanghai for Science and Technology, No.516, Jungong Road, Yangpu Area, Shanghai 200093, China.
• Prev Med. 2025 Jan 16: 108226108226.

ObjectiveThis study aimed to assess the relationship between the independent effects of dietary quality (DQ) (Healthy Eating Index [HEI]-2015) and physical activity (PA) and their joint effects and the risk of obstructive sleep apnea (OSA).MethodsThis cross-sectional study collected information on participants with complete DQ, PA, and OSA diagnostic data from the 2015 to 2020 National Health and Nutrition Examination Survey (NHANES). We used multivariate logistic regression modeling to explore the relationship between the independent and joint effects of DQ and PA and OSA. In addition, sensitivity analyses were conducted to further validate the robustness of the results.ResultsA total of 8050 participants were included in this study, 3930 males and 4120 females. After adjusting for confounders, qualified DQ and high-level PA were significantly associated with a lower risk of OSA, with an odd ratio (OR) of 0.860 (95 % CI: 0.759-0.974) and 0.849 (95 % CI: 0.751-0.961), respectively. In the combined analysis, qualified DQ and high-level PA significantly reduced the risk of OSA (OR: 0.705, 95 % CI: 0.591-0.842). The sensitivity analysis results were consistent with the original results, further validating our findings.ConclusionsThe results of this study demonstrated that the combination of qualified DQ and high-level PA was significantly associated with a reduced risk of OSA. This finding emphasized the importance of a healthy lifestyle in the prevention of OSA.Copyright © 2025. Published by Elsevier Inc.

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