Excessive daytime sleepiness with snoring or witnessed apnea is associated with handgrip strength: a population-based study

Abstract

Abstract Background Sarcopenia is emerging as an important public health problem, and evidences have determined that poor sleep is associated with muscle strength, but the potential effects of excessive daytime sleepiness (EDS), snoring and witnessed apnea on handgrip strength have not been evaluated. Aim We aimed to examine the association between EDS, snoring, witnessed apnea and muscle strength in an adult population. Design Cross-sectional study. Methods This cross-sectional study comprised 19 434 adults. Handgrip strength was measured using a handheld digital dynamometer. EDS was assessed by Epworth Sleepiness Scale, snoring and witnessed apnea during sleep were reported through simple yes/no questions. Analysis of covariance was carried out to determine the association between EDS with snoring or witnessed apnea and muscle strength. Results The means (95% confidence interval) for average handgrip strength/body weight (kg/kg) across symptoms categories were 0.396 (0.333–0.472), 0.393 (0.330–0.467), 0.396 (0.333–0.471) and 0.386 (0.325–0.460) (P < 0.0001), respectively. Similar results were observed with maximal handgrip strength/body weight (kg/kg). Conclusions Self-reported EDS accompanied with snoring or apnea is associated with lowest handgrip strength, independently of confounding factors. Whether improvement of EDS, snoring and apnea, can ameliorate age-associated decline in muscle strength warrants further studies.