The purpose of this study was to investigate the prevalence of locomotive syndrome (LS) in patients with obstructive sleep apnea syndrome (OSAS), and to compare the health-related quality of life (HRQOL) among patients with and without LS as classified by age and sex. A total of 1173 patients with OSAS (1013 males and 160 females) who were treated with continuous positive airway pressure (CPAP) therapy were enrolled in this cross-sectional study. Male participants were divided into 6 groups (30–39 years, 40–49 years, 50–59 years, 60–69 years, 70–79 years, and 80–89 years) and female participants were divided into 5 groups (40–49 years, 50–59 years, 60–69 years, 70–79 years, and 80–89 years). LS was evaluated using a “loco-check” established by the Japanese Orthopedic Association. HRQOL was evaluated using the EuroQol 5-dimensional questionnaire (EQ-5D). The prevalence of LS among the different age and sex groups was 19.6–79.4% in males and 27.0–95.5% in females and increased with age. In males aged 30–39 and 70–79 years, and in females aged 50–59 years, the EQ-5D scores were significantly lower in OSAS patients with LS than in OSAS patients without LS, even after adjusting for confounding factors. In OSAS patients, LS was closely linked to HRQOL. Preventing and improving the outcomes of LS would be beneficial for improving the HRQOL in OSAS patients.
Obstructive sleep apnea syndrome Locomotive syndrome Prevalence rate Health-related quality of life
This is a preview of subscription content, log in to check access.
This research was supported in part by research grants form Nankaiikueikai, Japan.
Compliance with ethical standards
Conflict of interest
The authors declare that there were no means of financial support or relationships that could pose a conflict of interest.
The research ethics committee of KKR Takamatsu Hospital approved this cross-sectional study (Ethics ID E111).
Coughlin SR, Mawdsley L, Mugarza JA, Calverley PM, Wilding JP. Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J. 2004;25:735–41.CrossRefGoogle Scholar
Kyzer S, Charuzi I. Obstructive sleep apnea in the obese. World J Surg. 1998;22:998–1001.CrossRefGoogle Scholar
Redline S, Young T. Epidemiology and natural history of obstructive sleep apnea. Ear Nose Throat J. 1993;72(20–1):24–6.Google Scholar
Punjabi NM, Caffo BS, Goodwin JL, Gottlieb DJ, Newman AB, O’Connor GT, et al. Sleep-disordered breathing and mortality: a prospective cohort study. PLoS Med. 2009;6:e1000132.CrossRefGoogle Scholar
Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, Nieto FJ, et al. Eighteen-year follow-up of the Wisconsin sleep cohort. Sleep. 2008;31:1071–8.CrossRefGoogle Scholar
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–5.CrossRefGoogle Scholar
Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000;342:1378–84.CrossRefGoogle Scholar
Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Nieto FJ, et al. Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med. 2001;163:19–25.CrossRefGoogle Scholar
Peppard PE. Young T, Palta M, Dempsey J, Skatrud J. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA. 2000;284:3015–21.CrossRefGoogle Scholar
Kataoka H, Miyatake N, Ichikawa H, Arakawa Y, Mori Y. Relationship of locomotive syndrome to health-related quality of life in patients with obstructive sleep apnea syndrome. J Phys Ther Sci. 2017;29:1129–33.CrossRefGoogle Scholar
Nakamura K. A “super-aged” society and the “locomotive syndrome”. J Orthop Sci. 2008;13:1–2.CrossRefGoogle Scholar
Sasaki E, Ishibashi Y, Tsuda E, Ono A, Yamamoto Y, Inoue R, et al. Evaluation of locomotive disability using loco-check: a cross-sectional study in the Japanese general population. J Orthop Sci. 2013;18:121–9.CrossRefGoogle Scholar
Takegami M, Suzukamo Y, Wakita T, Noguchi H, Chin K, Kadotani H, et al. Development of a Japanese version of the Epworth sleepiness Scale (JESS) based on item response therapy. Sleep Med. 2009;10:556–65.CrossRefGoogle Scholar
Schwab RJ, Badr SM, Epstein LJ, Gay PC, Gozal D, Kohler M, et al. An official American Thoracic Society statement: continuous positive airway pressure adherence tracking systems. The optimal monitoring strategies and outcome measures in adults. Am J Respir Crit Care Med. 2013;188:613–20.CrossRefGoogle Scholar
Nakamura K. The concept and treatment of locomotive syndrome: its acceptance and spread in Japan. J Orthop Sci. 2011;16:489–91.CrossRefGoogle Scholar
Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33:337–43.CrossRefGoogle Scholar
Katayama A, Miyatake N, Nishi H, Uzike K, Sakano N, Hashimoto H, et al. Evaluation of physical activity and its relationship to health-related quality of life in patients in chronic hemodialysis. Environ Health Prev Med. 2014;19:220–25.CrossRefGoogle Scholar
Asakura R, Miyatake N, Mochimasu KD, Kurato R, Kuwana S. Comparison of health-related quality of life between type 2 diabetic patients with and without locomotive syndrome. Environ Health Prev Med. 2016;21:356–60.CrossRefGoogle Scholar
Nakamura M, Kobayashi Y, Hashizume H, Oka H, Kono R, Nomura S, et al. Locomotive syndrome is associated with body composition and cardiometabolic disorders in elderly Japanese women. BMC Geriatr. 2016;16:166.CrossRefGoogle Scholar
Iizuka Y, Iizuka H, Mieda T, Tajika T, Yamamoto A, Takagishi K. Association between “loco-check” and EuroQol, a comprehensive instrument for assessing health-related quality of life: a study of the Japanese general population. J Orthop Sci. 2014;19:786–91.CrossRefGoogle Scholar
Hirano K, Imagama S, Hasegawa Y, Ito Z, Muramoto A, Ishiguro N. The influence of locomotive syndrome on health-related quality of life in a community-living population. Mod Rheumatol. 2013;23:939–44.CrossRefGoogle Scholar
Katayama A, Miyatake N, Nishi H, Hashimoto H, Uzike H, Sakano N, et al. Evaluation of psychological distress using K6 in patients on chronic hemodialysis. Environ Health Prev Med. 2015;20:102–7.CrossRefGoogle Scholar
Young T, Shahar E, Nieto FJ, Redline S, Newman AB, Gottlieb DJ, et al. Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med. 2002;162:893–900.CrossRefGoogle Scholar
Kobayashi M, Namba K, Tsuiki S, Matsuo A, Sugiura T, Inoue Y. Clinical characteristics in two subgroups of obstructive sleep apnea syndrome in the elderly: comparison between cases with elderly and middle-age onset. Chest. 2010;137:1310–5.CrossRefGoogle Scholar