title: Leisure-Time Physical Activity and Sedentary Behavior and Their Cross-Sectional Associations with Excessive Daytime Sleepiness in the French SU.VI.MAX-2 Study.
abstract: BACKGROUND
  The potential benefit of physical activity in terms of decreasing excessive daytime sleepiness (EDS) prevalence is unclear, especially in aging adults.
  
  
  OBJECTIVE
  We aimed to elucidate the associations among physical activity, sedentariness, and EDS in middle-aged and older adults.
  
  
  METHODS
  We conducted a cross-sectional analysis using data from a subsample of participants in the SU.VI.MAX-2 observational study (2007-2009; N = 4179; mean age = 61.9 years). EDS was defined as a score >10 on the Epworth Sleepiness Scale. Leisure-time physical activity and different types of sedentary behavior were assessed with the Modifiable Activity Questionnaire. The associations were examined with multivariable logistic regression models.
  
  
  RESULTS
  In the adjusted multivariable model, total leisure-time physical activity (modeled in quartiles, Q) was significantly, inversely associated with EDS (odds ratios (OR)Q4 vs Q1 = 0.70, 95 % confidence interval (CI) = 0.54-0.89). The association persisted in analyses restricted to individuals not taking sleep medication (ORQ4 vs Q1 = 0.72, 95 % CI = 0.54-0.95). In turn, time spent watching television and time spent reading appeared protective against EDS (ORQ4 vs Q1 = 0.73, 95 % CI = 0.57-0.94; ORQ4 vs Q1 = 0.76, 95 % CI = 0.60-0.97, respectively), whereas time spent on a computer appeared to confer an increased risk for EDS (ORQ4 vs Q1 = 1.30, 95 % CI = 1.05-1.62). When physical activity and sedentariness were modeled jointly, using WHO recommendation-based cutoffs for high/low levels, no significant associations were observed in the fully adjusted models.
  
  
  CONCLUSIONS
  The findings reinforce public health recommendations promoting behavior modification and specifically moderate-intensity exercise in middle-aged and older adults. The association of high physical activity/low sedentariness with EDS, which was not supported by the data, merits further investigation before firm conclusions could be drawn.
authors.affiliation: Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France.
authors.forename: Roland M
authors.initials: RM
authors.lastname: Andrianasolo
authors.affiliation: Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Menai
authors.affiliation: Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France.
authors.forename: Pilar
authors.initials: P
authors.lastname: Galan
authors.affiliation: Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France.|Département de Santé Publique, Hôpital Avicenne, 93017, Bobigny, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
authors.affiliation: Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France.|Université Pierre et Marie Curie - Paris 6, Service de Nutrition, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiométabolisme et Nutrition (ICAN), Paris, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Oppert
authors.affiliation: Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Kesse-Guyot
authors.affiliation: Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France. v.andreeva@eren.smbh.univ-paris13.fr.
authors.forename: Valentina A
authors.initials: VA
authors.lastname: Andreeva
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D015995:Prevalence; D012306:Risk; D057185:Sedentary Behavior; D012890:Sleep / Q000502:physiology*; D011795:Surveys and Questionnaires
keywords: Health behavior; Physical activity; Sedentariness; Sleepiness