Aerobic and Anaerobic Exercise Capacities in Obstructive Sleep Apnea and Associations with Subcutaneous Fat Distributions

Abstract

Obesity is a strong risk factor for the development and progression of sleep apnea. Responses to exercise by patients with obstructive sleep apnea syndrome (OSAS) are clinically relevant to reducing body weight and cardiovascular risk factors. This study aimed to clarify the aerobic and anaerobic exercise capacities and their possible relationships with other findings in patients with OSAS. Forty patients (30 males, 10 females) and 40 controls (30 males, 10 females) were enrolled in this study. Questionnaires (excessive daytime sleepiness, daytime tiredness, morning headache, waking unrefreshed, and imbalance), overnight polysomnography, indirect laryngoscopy, and aerobic and anaerobic exercise tests were performed. Triceps, subscapular, abdomen, and thigh skinfold thicknesses were measured. Subcutaneous abdominal fat (abdomen skinfold) was significantly higher in OSAS patients than in controls. Maximal anaerobic power and anaerobic capacity were not different significantly between the patients and controls. We found that aerobic capacity was significantly lower in OSAS patients than in controls. Aerobic capacity was negatively correlated with upper-body subcutaneous fat (triceps and subscapular skinfolds) but not correlated with subcutaneous abdominal fat in OSAS patients. In multivariate analyses using all patients, the apnea-hypopnea index remained a significant independent predictor of aerobic capacity after controlling for a variety of potential confounders including body mass index. Our data confirm that central obesity (subcutaneous abdominal fat) is prominent in patients with OSAS. Our results suggest that lower aerobic exercise capacity in patients with OSAS might be due to daily physical activity that is restricted by OSA itself. This study also suggests that the degree of subcutaneous abdominal fat cannot be used for predicting aerobic capacity level. We think that upper-body subcutaneous fat might be suitable for determining the physical fitness of patients with OSAS.

Obstructive Sleep Apnea Is Associated with Impaired Exercise Capacity: A Cross-Sectional Study

“…[8][9][10] The impact of OSA on exercise capacity remains unclear. Prior studies examining exercise capacity in OSA patients have yielded confl icting results, with some demonstrating reduced exercise capacity [11][12][13][14][15][16] and others suggesting exercise capacity is not impaired. [8][9][10]17,18 These studies have several methodological limitations that make reconciling their fi ndings challenging.…”

“…After adjusting for baseline differences, this association remained signifi cant (p < 0.01). AHI alone explained 16.1% of the variability observed in percent predicted peak O 2 (p = 0.02). Conclusions: OSA is associated with impaired exercise capacity.…”

Exercise capacity and heart rate recovery response to exercise in morbidly obese female patients with obstructive sleep apnoea syndrome.

“…However, these results conflict with many other reports that have described higher maximal V'O2 in non-OSA than in 6,22). Reinforcing this last observation, some studies have shown that AHI is inversely correlated with peak V'O2 during CPET (3,5,22,23). Nevertheless, other factors have also been implicated in the exercise capacity of patients with OSA, such as age, BMI, body weight and sex (2,10,22-24).…”

Respiratory Variables During Wakefulness in Patients with Obstructive Sleep Apnea and Associations with Anthropometric Measurements

“…Ucok et al (27) found that aerobic capacity was significantly lower in OSAS patients than in controls. These findings in the literature mentioned above (25)(26)(27) might be interpreted that the aerobic capacity was lower and the anaerobic metabolism was more developed in the patients with OSAS than normal subjects. Lactic acid, a product of anaerobic metabolism, largely is broken down with using O 2 during non rapid muscle activity.…”