title: Sitting and television viewing: novel risk factors for sleep disturbance and apnea risk? results from the 2013 National Sleep Foundation Sleep in America Poll.
abstract: BACKGROUND
  Excess sitting is emerging as a novel risk factor for cardiovascular disease, diabetes, mental illness, and all-cause mortality. Physical activity, distinct from sitting, is associated with better sleep and lower risk for OSA, yet relationships among sitting behaviors and sleep/OSA remain unknown. We examined whether total sitting time and sitting while viewing television were associated with sleep duration and quality, OSA risk, and sleepiness.
  
  
  METHODS
  The 2013 National Sleep Foundation Sleep in America Poll was a cross-sectional study of 1,000 adults aged 23 to 60 years. Total sitting time, time watching television while sitting, sleep duration and quality, OSA risk, and daytime sleepiness were assessed.
  
  
  RESULTS
  After adjusting for confounding factors (including BMI and physical activity), each additional hour per day of total sitting was associated with greater odds of poor sleep quality (OR [95% CI] = 1.06 [1.01, 1.11]) but not with other sleep metrics (including sleep duration), OSA risk, or daytime sleepiness. For television viewing while sitting, each additional hour per day was associated with greater odds of long sleep onset latency (≥ 30 min) (OR = 1.15 [1.04, 1.27]), waking up too early in the morning (OR = 1.12 [1.03, 1.23]), poor sleep quality (OR = 1.12 [1.02, 1.24]), and "high risk" for OSA (OR = 1.15 [1.04, 1.28]). Based upon an interaction analysis, regular physical activity was protective against OSA risk associated with television viewing (P = .04).
  
  
  CONCLUSIONS
  Excess sitting was associated with relatively poor sleep quality. Sitting while watching television was associated with relatively poor sleep quality and OSA risk and may be an important risk factor for sleep disturbance and apnea risk.
authors: School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ. Electronic address: matthew.buman@asu.edu.
authors: Matthew P
authors: MP
authors: Buman
authors: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: Christopher E
authors: CE
authors: Kline
authors: School of Nutrition and Health Promotion, College of Nursing and Health Innovation, Arizona State University, Phoenix VA Health Care System, Phoenix, AZ.
authors: Shawn D
authors: SD
authors: Youngstedt
authors: Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kentucky College of Medicine, Lexington, KY.
authors: Barbara
authors: B
authors: Phillips
authors: Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
authors: Marco
authors: M
authors: Tulio de Mello
authors: Sleep Center, Michael E. DeBakey Veterans Affairs Medical Center and Department of Medicine, Baylor College of Medicine, Houston, TX.
authors: Max
authors: M
authors: Hirshkowitz
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D012307:Risk Factors; D057185:Sedentary Behavior; D012891:Sleep Apnea Syndromes / Q000453:epidemiology* / Q000503:physiopathology; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013690:Television; D014481:United States / Q000453:epidemiology
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