Does obstructive sleep apnea affect exercise capacity and the hemodynamic response to exercise? An individual patient data and aggregate meta-analysis

Berger, Mathieu; Kline, Christopher E.; Cepeda, Felipe X.; Rizzi, Camila F.; Chapelle, Céline; Laporte, Silvy; Hupin, David; Raffin, Jérémy; Costes, Frédéric; Hargens, Trent A.; Barthélémy, Jean‐Claude; Roche, Frédéric

doi:10.1016/j.smrv.2019.03.002

Cited by 25 publications

(23 citation statements)

References 66 publications

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“…Speakers in the "Exercise and sleep: from impaired function to new therapeutic strategies" symposium discussed the interactions between sleep and exercise from health-to-disease. Prof. Ludger Grote outlined the available data on reduced exercise capacity in OSA patients, a finding that was confirmed by recent meta-analyses [4,5]. In this perspective, Elbehairy et al [6] have shown that OSA-associated resting systemic vascular dysfunction and pulmonary gasexchange abnormalities during exercise are possible contributors for reduced exercise capacity and exertional dyspnoea.…”

Section: Assembly 2: Respiratory Intensive Care (Noel Britton)mentioning

confidence: 91%

European Respiratory Society International Congress 2020: highlights from best-abstract awardees

Britton

Elbehairy

Mensink‐Bout

et al. 2020

Breathe

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During the 2020 European Respiratory Society (ERS) International Congress, the author of the best abstract (highest average score of abstract reviewers and only those who had not applied or were not eligible for a sponsored award) of every Assembly was awarded “a best-abstract certificate”. Best-abstract awardees were invited to write a short summary about their virtual Congress experience and their view on the evolving field of research in light of their respective ERS Assembly. The purpose of this article is to give the readers a quick overview of some of the Congress highlights and to give the stage to the promising best-abstract awardees as they are the future of the ERS.

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Section: Assembly 2: Respiratory Intensive Care (Noel Britton)mentioning

confidence: 91%

European Respiratory Society International Congress 2020: highlights from best-abstract awardees

Britton

Elbehairy

Mensink‐Bout

et al. 2020

Breathe

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“…As expected, the value of the peak oxygen consumption reported in this study was within the reference range (29.6 ± 6 mL/kg/min) for the OSA population reported previously (Daiana Mortari et al, 2014). Systematic reviews showed that the reduction in VO 2peak was found to be larger in non-obese patients (body mass index < 30 kg/m 2 ) such as our participant group (Berger et al, 2019;Mendelson et al, 2018).…”

Section: Discussionmentioning

confidence: 67%

“…Previous studies on OSA have reported that the presence of OSA negatively in uences the aerobic capacity as measured by the maximal oxygen uptake (VO 2 max) (Berger et al, 2019;Lin et al, 2006;Nanas et al, 2010;Ucok et al, 2009;Vanhecke et al, 2008;Vanuxem et al, 1997a). Likewise, OSA severity is associated with an attenuated rate of oxygen consumption, when calculated using a nomogram based on age, sex, and baseline activity level, and high post-exercise blood pressure (Mansukhani et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Energy Cost of Walking and Functional Aerobic Capacity During Moderate Intensity Exercise in Adults with Obstructive Sleep Apnea: A Cross-Sectional Study

Aldhahi

Puri

Jain

et al. 2020

Preprint

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Background: Autonomic dysregulation associated with obstructive sleep apnea (OSA) may limit cardiopulmonary responses to exercise which, in turn, may impair functional aerobic capacity (FAC) and walking economy. We aimed to characterize walking economy and FAC in OSA patients compared with healthy adults (non-OSA) and examine their relationship with OSA severity (apnea-hypopnea index [AHI]). Participants: In this cross-sectional study, a total of 26 adults (OSA: n=13; non-OSA: n=13) participated in the study. In this study, the participants with OSA were adults between the ages of 25 and 60 with a body mass index between 25 kg/m2 and 39 kg/m2 who had undergone a recent third-party sleep study with an AHI of 5 or greater. Methods: Participant completed a maximal integrated cardiopulmonary exercise test, three separate exercise bouts of a constant work rate (CWR) treadmill test at 85% of anaerobic threshold (AT), and a 10-minute walk test (10MWT). Multiple linear regression corrected for weight, age, and BMI was conducted to examine the associations. Results: There were significant differences between OSA and Non-OSA participants in VO2peak (29.7±5.6mL/kg/min vs. 37.5±6.5mL/kg/min, p=0.03) and in Net VO2 during CWR (12.7±5 vs.19±6mL/kg/min, p=0.02). The 10MWT speed, distance, and energy expenditure were significantly lower in the OSA group (all p<0.001). The AHI scores associated with 10MWT distance (R2=0.85, p<0.001), energy cost of walking (R2=87, p<0.001), VO2 at anaerobic threshold (R2=0.92, p<0.001). Conclusions: The findings of this study show that patients with OSA have reduced FAC and have a higher energy cost of walking. AHI explained 87% of the variance in the energy cost of walking during the 10MWT. The results suggest that individuals with more severe obstructive sleep apnea experience greater impairment in functional performance.

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“…CPET is a valuable cardiovascular instrument for risk stratification and prognosis assessment, helping to establish a personalized exercise training program for OSA patients. Current literature [14] offers conflicting results regarding CPET results in OSA patients and the role of CPAP in improving exercise performance. As such, the purpose of this study is to evaluate the impact of short-term (8 weeks) CPAP therapy on exercise capacity of patients with moderate-severe OSA and cardiometabolic comorbidities.…”

Section: Introductionmentioning

confidence: 99%

CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities

et al. 2020

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Background and Objectives: Obstructive sleep apnea (OSA) is associated with daytime somnolence, cognitive impairment and high cardiovascular morbidity and mortality. Obesity, associated cardiovascular comorbidities, accelerated erythropoiesis and muscular mitochondrial energetic dysfunctions negatively influence exercise tolerance in moderate-severe OSA patients. The cardiopulmonary exercise testing (CPET) offers an integrated assessment of the individual's aerobic capacity and helps distinguish the main causes of exercise limitation. The purpose of this study is to evaluate the aerobic capacity of OSA patients, before and after short-term continuous positive airway pressure (CPAP). Materials and Methods: Our prospective study included 64 patients with newly diagnosed moderate-severe OSA (apnea hypopnea index (AHI) 39.96 ± 19.04 events/h) who underwent CPET before and after CPAP. Thirteen patients were unable to tolerate CPAP or were lost during follow-up. Results: 49.29% of our patients exhibited a moderate or severe decrease in functional capacity (Weber C or D). CPET performance was influenced by gender but not by apnea severity. Eight weeks of CPAP induced significant improvements in maximal exercise load (∆ = 14.23 W, p = 0.0004), maximum oxygen uptake (∆ = 203.87 mL/min, p = 0.004), anaerobic threshold (∆ = 316.4 mL/min, p = 0.001), minute ventilation (∆ = 5.1 L/min, p = 0.01) and peak oxygen pulse (∆ = 2.46, p = 0.007) as well as a decrease in basal metabolic rate (BMR) (∆ = −8.3 kCal/24 h, p = 0.04) and average Epworth score (∆ = −4.58 points, p < 0.000001). Conclusions: Patients with moderate-severe OSA have mediocre functional capacity. Apnea severity (AHI) was correlated with basal metabolic rate, resting heart rate and percent predicted maximum effort but not with anaerobic threshold or maximum oxygen uptake. Although CPET performance was similar in the two apnea severity subgroups, short-term CPAP therapy significantly improved most CPET parameters, suggesting that OSA per se has a negative influence on effort capacity.

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Does obstructive sleep apnea affect exercise capacity and the hemodynamic response to exercise? An individual patient data and aggregate meta-analysis

Cited by 25 publications

References 66 publications

European Respiratory Society International Congress 2020: highlights from best-abstract awardees

European Respiratory Society International Congress 2020: highlights from best-abstract awardees

Energy Cost of Walking and Functional Aerobic Capacity During Moderate Intensity Exercise in Adults with Obstructive Sleep Apnea: A Cross-Sectional Study

CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities

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