Obstructive sleep apnea risk is associated with poor physical performance: a cross-sectional analysis of the U.S. health and retirement study

Rajani Khanal; Kimberley S van Schooten; Ronaldo Piovezan; Robert Adams; Kelly Sansom; Andrew Vakulin

doi:10.1007/s44470-026-00070-2

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Obstructive sleep apnea risk is associated with poor physical performance: a cross-sectional analysis of the U.S. health and retirement study

Journal article

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Peer reviewed

Obstructive sleep apnea risk is associated with poor physical performance: a cross-sectional analysis of the U.S. health and retirement study

Rajani Khanal, Kimberley S van Schooten, Ronaldo Piovezan, Robert Adams, Kelly Sansom and Andrew Vakulin

Journal of clinical sleep medicine, Vol.22(1), 46

2026

DOI: https://doi.org/10.1007/s44470-026-00070-2

PMID: 41946820

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Abstract

Accidental Falls - statistics & numerical data

Aged

Cross-Sectional Studies

Female

Hand Strength - physiology

Humans

Male

Middle Aged

Physical Functional Performance

Postural Balance - physiology

Risk Factors

Sleep Apnea, Obstructive - complications

Sleep Apnea, Obstructive - epidemiology

Sleep Apnea, Obstructive - physiopathology

Surveys and Questionnaires

United States - epidemiology

Study objectives Obstructive sleep apnoea (OSA) may be linked to poor physical performance and fall risk, yet this association remains underexplored. This study examined associations between OSA risk, balance, gait speed and handgrip strength (HGS) in community living adults across age-groups and sexes. Methods Cross-sectional data from the 2016 Health and Retirement Study were analysed. Probable OSA was estimated with an adapted STOP-Bang questionnaire. Poor balance was defined as the inability to hold a semi-tandem stance for 10 s; slow gait speed as walking < 0.8 m/s over 2.5 m; and weak HGS as HGS-to-body mass index ratio < 1.00 m2 for males and < 0.56m2 for females. Results 6,918 participants (mean age 66 ± 11 years; 57% female) were included. Probable OSA was associated with higher odds of: (i) poor balance in the overall sample (OR:1.23, 95% bootstrapped confidence interval (BCI):1.07–1.39, p = 0.002), 50–64 years (OR: 1.41, BCI: 1.15- 1.72, p < 0.001) and females (OR: 1.30, BCI: 1.10–1.56, p = 0.004); (ii) slow gait speed in the overall sample (OR:1.29, BCI:1.07–1.57, p = 0.007), 80 + years (OR:1.61, BCI:1.07–2.42, p = 0.028) and females (OR:1.39, BCI:1.03–1.91, p = 0.024); and (iii) weak HGS in the overall sample (OR:2.22, BCI:1.90–2.63, p = 0.001), 50–64 years (OR:3.40, BCI: 2.58–4.61, p < 0.001), 65–79 years (OR: 1.93, BCI:1.52- 2.47, p < 0.001), males (OR = 1.87, BCI:1.49–2.35, p < 0.001) and females (OR = 2.67, BCI 2.15–3.33, p < 0.001). Conclusions Poor balance, slow gait speed and weak HGS are common among older adults at high risk of OSA. Further research should evaluate causality and assess co-screening to potentially enable early detection of fall risk in older adults.

Details

Title: Obstructive sleep apnea risk is associated with poor physical performance: a cross-sectional analysis of the U.S. health and retirement study
Authors/Creators: Rajani Khanal - Adelaide Institute for Sleep Health
Kimberley S van Schooten - Neuroscience Research Australia
Ronaldo Piovezan - Queen Elizabeth Hospital
Robert Adams - Adelaide Institute for Sleep Health
Kelly Sansom - Murdoch University, Centre for Healthy Ageing
Andrew Vakulin - Adelaide Institute for Sleep Health
Publication Details: Journal of clinical sleep medicine, Vol.22(1), 46
Publisher: Springer Nature
Number of pages: 11
Identifiers: 991005877052307891
Murdoch Affiliation: Centre for Healthy Ageing
Language: English
Resource Type: Journal article

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