Obstructive Sleep Apnea Syndrome (OSAS) is a sleep disorder with high prevalence in general population, but alarmingly low in clinicians' differential diagnosis. We reviewed the literature on PubMed and Scopus from June 1980–2021 in order to describe the altered systematic pathophysiologic mechanisms in OSAS patients as well as to propose an exercise program for these patients. Exercise prevents a dysregulation of both daytime and nighttime cardiovascular autonomic function, reduces body weight, halts the onset and progress of insulin resistance, while it ameliorates excessive daytime sleepiness, cognitive decline, and mood disturbances, contributing to an overall greater sleep quality and quality of life.
Patients with obstructive sleep apnea syndrome (OSAS) exhibit low cardio-fitness impact, attributed to fragmented sleep architecture and associated pathophysiological sequelae. The purpose of our study was to investigate fitness indicators during 6-min walk test (6MWT) and oxidative stress markers in apnea-hypopnea index (AHI) in OSAS patients stratified by severity. A total of 37 newly diagnosed patients, comorbidity-free, were divided into two groups: (Moderate OSAS (n = 12), defined as ≥ 15 AHI < 30 events per hour; Age: 50.7 ± 7.2 years, BMI: 32.5 ± 4.0 kg/m2 vs. Severe OSAS (n = 25), defined as AHΙ ≥ 30 events per hour; Age: 46.3 ± 10.4 years, BMI: 33.3 ± 7.9 kg/m2). Measurements included demographics, anthropometric characteristics, body composition, blood sampling for reactive oxygen metabolites’ levels (d-ROM) and plasma antioxidant capacity (PAT), and followed by a 6MWT. AHI was significantly associated with d-ROMs levels, chest circumference in maximal inhalation and exhalation (Δchest), neck circumference, as well as 6MWT-derived indices. In conclusion, our study determines bidirectional interrelationships between OSAS severity and anthropometrics, body composition, and fitness metrics. These findings indicate that the impact of OSAS should be evaluated well beyond polysomnography-derived parameters.
Background and objective The aim of this study was to investigate whether the maximum inspiratory and expiratory pressure are correlated with the apnea-hypopnea index (AHI) in patients with obstructive sleep apnea syndrome (OSAS). Methods Fifty-two patients with OSAS were divided into two groups (AHI, events/hours: <30, n=28, versus ≥30, n=24). For each patient, anthropometric characteristics, spirometry parameters, maximum inspiratory (MIP) and expiratory pressure (MEP), and cardiopulmonary function (CPF) parameters (oxygen uptake at rest (VO 2 ), carbon dioxide output (VCO 2 ), heart rate (HR), minute ventilation (V E ), tidal volume at inspiratory (TVin) and expiratory (TVex), breath frequency ( f β ), end-tidal carbon dioxide pressure (P ET CO 2 ), end-tidal oxygen pressure (P ET O 2 ), and mean arterial pressure (MAP)) in sitting position for three minutes were recorded. The independent t-test was used to measure the differences between groups (events/hours <30 versus ≥30) and Pearson correlation analysis was used for statistical comparison between parameters. Results Results showed differences between groups (AHI, events/h ≥30 versus <30) in MIP (102.0±18.3 versus 91.1±12.1 % of predicted, p=0.013) and CPF parameters TVin (0.8±0.2 versus 0.7±0.1, L, p=0.047), P ET CO 2 (34.6±4.2 versus 31.4±3.7, mmHg, p=0.007), and MAP (88.4±6.5 versus 82.9±6.2, mmHg, p=0.003). Pearson correlation analysis between respiratory muscle strength (MIP and MEP) and polysomnography (PSG) parameters, MIP is related to AHI (r=.332, p=0.016) and desaturation index (r=.439, p=0.001), as well as MEP to percent of REM sleep stage (r=-.564, p<0.001). Conclusion The data from the present study support that maximal inspiratory pressure relates to the severity of AHI and intermittent breath-holding during sleep increases the inspiratory muscle strength.
The aim of the study was to investigate the effect of sleep quality in cognitive domains of perceptual ability after exhausting exercise in adolescent and adult athletes. Eighty-six male professional soccer players were included in our study and divided into two groups: adolescents (age: 17.3 ± 0.2 yrs, body mass: 68.9 ± 7.9 kg, body fat: 9.9 ± 3.6 %) versus adults (age: 26.3 ± 5.2 yrs, body mass: 76.5 ± 7.2 kg, body fat: 10.3 ± 3.1 %). For each athlete, prior to cardiopulmonary exercise testing (CPET), anthropometric and morphological characteristics were recorded and Pittsburgh Sleep Quality Index (PSQI) questionnaire was answered. Immediately after CPET, all athletes underwent the perceptual ability test (PATest) for 30 sec and the sum of hits (rep/30 sec) and the time between a visual stimulus and the following stimulus (mean reaction time; RT, sec) were recorded. Oxygen uptake in maximal effort and in anaerobic threshold showed differences between hits ( P = 0.037 ) and RT ( P = 0.025 ). The variable of PSQI questionnaire “had bad dreams” showed correlation with hits ( P = 0.021 ) and RT ( P = 0.011 ) and the RT showed correlation with variables “cannot breathe comfortably” ( P = 0.041 ) and “...enthusiasm to get things done” ( P = 0.041 ). Adolescents showed poorer sleep quality (PSQI score: 5.7 ± 3.6 vs. 2.4 ± 2.6) compared to adults and slower reaction time (0.9 ± 0.1 vs. 0.8 ± 0.1 sec, P = 0.029 ) compared to adolescent athletes with PSQI score ≥5.5. The variable of PSQI score in adolescents is related to HR in maximal effort (r = −0.364, P = 0.032 ) and in adults is related to speed (r = −0.335, P = 0.016 ). Perceptual ability, which requires sustained attention, vigilance, and motor coordination, is often negatively affected by restricted sleep, especially in adolescents.
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