CPAP increases exercise tolerance in obese subjects with obstructive sleep apnea

Pendharkar, Sachin R.; Tsai, Willis H.; Eves, Neil D.; Ford, Gordon; Davidson, Warren

doi:10.1016/j.rmed.2011.06.007

Cited by 15 publications

(14 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, few studies have documented increases in VO 2peak [48,49] and HRR [49] following CPAP treatment similar to the present study's findings, and others have failed to note VO 2peak improvements with CPAP use [38,50]. As the effects of CPAP on SNS hyperactivity are dependent upon compliance [51] and lost with CPAP withdrawal [52], exercise training may be a beneficial adjunct therapy to promote cardiovascular health in adults with OSA.…”

Section: Discussionsupporting

confidence: 77%

Blunted heart rate recovery is improved following exercise training in overweight adults with obstructive sleep apnea

Kline

Crowley

Ewing

et al. 2013

International Journal of Cardiology

View full text Add to dashboard Cite

Background Obstructive sleep apnea (OSA) predisposes individuals to cardiovascular morbidity, and cardiopulmonary exercise test (CPET) markers prognostic for cardiovascular disease have been found to be abnormal in adults with OSA. Due to the persistence of OSA and its cardiovascular consequences, whether the cardiovascular adaptations normally conferred by exercise are blunted in adults not utilizing established OSA treatment is unknown. The aims of this study were to document whether OSA participants have abnormal CPET responses and determine whether exercise modifies these CPET markers in individuals with OSA. Methods The CPET responses of 43 sedentary, overweight adults (body mass index [BMI]>25) with untreated OSA (apnea-hypopnea index [AHI]≥15) were compared against matched non-OSA controls (n=9). OSA participants were then randomized to a 12-week exercise training (n=27) or stretching control treatment (n=16), followed by a post-intervention CPET. Measures of resting, exercise, and post-exercise recovery heart rate (HRR), blood pressure, and ventilation, as well as peak oxygen consumption (VO2peak), were obtained. Results OSA participants had blunted HRR compared to non-OSA controls at 1 (P=.03), 3 (P=.02), and 5 min post-exercise (P=.03). For OSA participants, exercise training improved VO2peak (P=.04) and HRR at 1 (P=.03), 3 (P<.01), and 5 min post-exercise (P<.001) compared to control. AHI change was associated with change in HRR at 5-min post-exercise (r=−.30, P<.05), but no other CPET markers. Conclusions These results suggest that individuals with OSA have autonomic dysfunction, and that exercise training, by increasing HRR and VO2peak, may attenuate autonomic imbalance and improve functional capacity independent of OSA severity reduction.

show abstract

Section: Discussionsupporting

confidence: 77%

Blunted heart rate recovery is improved following exercise training in overweight adults with obstructive sleep apnea

Kline

Crowley

Ewing

et al. 2013

International Journal of Cardiology

View full text Add to dashboard Cite

show abstract

“…Several studies have examined this question but provide conflicting results. Although an improvement in maximal exercise performance has been observed after varying treatment durations from 1 week to 8 months [48][49][50][51], other studies have not reported enhanced V′O 2 peak after 1-3 months of continuous positive airway pressure (CPAP) treatment [10,52,53]. These inconsistencies may be due to differences in treatment adherence, disease severity or physical activity levels.…”

Section: Potential Physiological Mechanismsmentioning

confidence: 99%

Maximal exercise capacity in patients with obstructive sleep apnoea syndrome: a systematic review and meta-analysis

Mendelson¹,

Marillier²,

Bailly³

et al. 2018

Eur Respir J

View full text Add to dashboard Cite

Maximal aerobic capacity is a strong health predictor and peak oxygen consumption (') is considered a reflection of total body health. No systematic reviews or meta-analyses to date have synthesised the existing data regarding ' in patients with obstructive sleep apnoea (OSA).A systematic review of English and French articles using PubMed/MEDLINE and Embase included studies assessing ' in OSA patients either in mL·kg·min compared with controls or in % predicted. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence.Mean ' expressed in mL·kg·min was significantly lower in patients with OSA than in controls (mean difference -2.7 mL·kg·min; p<0.001; n=850). This reduction in ' was found to be larger in non-obese patients (body mass index <30 kg·m). Mean ' % pred was 89.9% in OSA patients (n=643).OSA patients have reduced maximal aerobic capacity, which can be associated with increased cardiovascular risks and reduced survival in certain patient subgroups. Maximal exercise testing can be useful to characterise functional limitation and to evaluate health status in OSA patients.

show abstract

“…Indeed, it may be bidirectional. CPAP therapy increased exercise tolerance in obese individuals with OSA, 38 suggesting that OSA may exert a physiological influence that blunts capacity to engage in vigorous exercise activity. Conversely, longitudinal data suggest that exercise independently decreases the incidence of moderate-severe OSA.…”

mentioning

confidence: 99%

Physical Inactivity Is Associated with Moderate-Severe Obstructive Sleep Apnea

Simpson

McArdle

Eastwood

et al. 2015

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

Study Objectives: To investigate whether low levels of physical activity were associated with an increased occurrence of obstructive sleep apnea (OSA), OSA-related symptoms, and cardiometabolic risk. Methods: A case-control study design was used. OSA cases were patients referred to a sleep clinic for suspected OSA (n = 2,340). Controls comprised participants from the Busselton community (n = 1,931). Exercise and occupational activity were derived from questionnaire data. Associations were modelled using logistic and linear regression and adjusted for confounders. Results: In comparison with moderate exercise, the high, low, and nil exercise groups had an odds ratio (OR) for moderate-severe OSA of 0.6 (95% CI 0.5-0.8), 1.6 (95% CI 1.2-2.0), and 2.7 (95% CI 1.9-3.7), respectively. Relative to men in heavy activity occupations, men in medium, light and sedentary occupations had an OR for moderate-severe OSA of 1.7 (95% CI 1.1-2.5), 2.1 (95% CI 1.4-3.2), and 1.8 (95% CI 1.2-2.8), respectively. Relative to women in medium activity occupations, women in light and sedentary occupations had an OR for moderate-severe OSA of 4.2 (95% CI 2.6-7.2) and 3.5 (2.0-6.0). OSA patients who adequately exercised had lower: levels of doctor-diagnosed depression (p = 0.047); symptoms of fatigue (p < 0.0001); systolic (p = 0.015) and diastolic blood pressure (p = 0.015); and C-reactive protein (CRP) (p = 0.003). Conclusions: Low levels of physical activity were associated with moderate-severe OSA. Exercise in individuals with OSA is associated with lower levels of depression, fatigue, blood pressure and CRP.

show abstract

CPAP increases exercise tolerance in obese subjects with obstructive sleep apnea

Cited by 15 publications

References 34 publications

Blunted heart rate recovery is improved following exercise training in overweight adults with obstructive sleep apnea

Blunted heart rate recovery is improved following exercise training in overweight adults with obstructive sleep apnea

Maximal exercise capacity in patients with obstructive sleep apnoea syndrome: a systematic review and meta-analysis

Physical Inactivity Is Associated with Moderate-Severe Obstructive Sleep Apnea

Contact Info

Product

Resources

About