The effects of exercise training on vascular function among overweight adults with obstructive sleep apnea

Abstract

Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity due, in part, to impaired vascular function. Exercise confers cardioprotection by improving vascular health. Yet, whether OSA severity affects the vascular improvements conferred with exercise training is not known. Overweight (body mass index (BMI) >27 kg/m2) adults were evaluated for OSA and enrolled in a 6‐week exercise intervention. Baseline assessments of brachial artery flow‐mediated dilation (BAFMD), central augmentation index (AIx), and pulse wave velocity (PWV) were repeated post‐training. Fifty‐one participants (25 men; 26 women) completed the study. Despite improved aerobic capacity (P = .0005) and total fat mass (P = .0005), no change in vascular function was observed. Participants were divided into two severity groups according to their baseline total apnea‐hypopnea index (AHI) as either 5 to 14.9 events per hour (n = 21; Age = 48 ± 7 years; BMI = 33.7 ± 4.6 kg•m−2) or ≥15 events per hour (n = 30; Age = 56 ± 13 years; BMI = 34.3 ± 4.2 kg•m−2). No effect of OSA group was observed for BAFMD (P = .82), AIx (P = .37) or PWV (P = .44), suggesting that OSA severity does not influence the effect of exercise on vascular function. The vascular effects of extended exercise programs of greater intensity in overweight OSA patients should be examined.

Influence of cardiorespiratory fitness and body composition on resting and post-exercise indices of vascular health in young adults

“…Assessments were performed by a single experienced sonographer using previously published methodology. 37 , 38 Brachial artery diameter and pulse-wave Doppler velocity signals were acquired simultaneously using a high-resolution ultrasound (GE Logiq, GE Healthcare Products, USA) equipped with a 7.5–12 ​MHz linear array transducer. For all FMD measurements, the participants rested in a supine position for 10 ​min.…”

Impacts of exercise on inflammatory markers in individuals with OSA: more questions than answers

“…In this issue of Sleep and Biological Rhythms, Dobrosielski and colleagues examined whether the effects of exercise training on inflammation differed based on baseline OSA severity [11]. In secondary analyses from a single-arm experimental trial focused on vascular function [12] The authors found no changes in inflammatory markers as a result of the exercise intervention in either the no/ mild OSA or moderate/severe OSA groups. As the authors noted, the lack of observed change may have been due to the exercise intervention being of insufficient duration and/ or volume.…”

“…Dobrosielski and colleagues state that, in theory, the cardiovascular adaptations conferred by exercise may be blunted in those with underlying OSA. To date, their work has not supported this hypothesis when investigating outcomes of inflammation [11], vascular function [12], and executive function [14]. This area of research remains in its infancy though, and future research should attempt to more comprehensively address (in larger and diverse samples) whether individuals with OSA should expect similar cardiovascular adaptations from exercise training as those without OSA.…”