Jeremy R Beitler1, Karim M Awad2, Jessie P Bakker3, Bradley A Edwards3, Pam DeYoung4, Ina Djonlagic3, Daniel E Forman5, Stuart F Quan6, Atul Malhotra4. 1. Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 2. Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA. 3. Division of Sleep Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 4. Division of Pulmonary and Critical Care Medicine, University of California, San Diego, San Diego, CA. 5. Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 6. Division of Sleep Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA and Arizona Respiratory Center, University of Arizona College of Medicine, Tucson, AZ.
Abstract
OBJECTIVE: Obstructive sleep apnea (OSA) is associated with increased risk of adverse cardiovascular events. Because cardiopulmonary exercise testing (CPET) aids in prognostic assessment of heart disease, there is rising interest in its utility for cardiovascular risk stratification of patients with OSA. However, the relationship between OSA and exercise capacity is unclear. This study was conducted to test the hypothesis that OSA is associated with impaired exercise capacity. METHODS: Fifteen subjects with moderate-to-severe OSA (apnea-hypopnea index [AHI] ≥15 events/h) and 19 controls with mild or no OSA (AHI <15 events/h) were enrolled. Subjects underwent standard polysomnography to determine AHI and exclude other sleep disorders. Resting metabolic rate was measured via indirect calorimetry, followed by maximum, symptom-limited CPET. Subjects completed a sleep diary and physical activity questionnaire characterizing behaviors in the week prior to testing. RESULTS: Percent predicted peak oxygen uptake (V˙O2) was significantly lower in OSA subjects than controls (70.1%±17.5% vs 83.8%±13.9%; p = 0.02). Each 1-unit increase in log-transformed AHI was associated with a decrease in percent predicted peak V˙O2 of 3.20 (95% CI 0.53-5.88; p = 0.02). After adjusting for baseline differences, this association remained significant (p < 0.01). AHI alone explained 16.1% of the variability observed in percent predicted peak V˙O2 (p = 0.02). CONCLUSIONS: OSA is associated with impaired exercise capacity. Further study is needed to evaluate the utility of CPET for prognostic assessment of patients with OSA.
OBJECTIVE: Obstructive sleep apnea (OSA) is associated with increased risk of adverse cardiovascular events. Because cardiopulmonary exercise testing (CPET) aids in prognostic assessment of heart disease, there is rising interest in its utility for cardiovascular risk stratification of patients with OSA. However, the relationship between OSA and exercise capacity is unclear. This study was conducted to test the hypothesis that OSA is associated with impaired exercise capacity. METHODS: Fifteen subjects with moderate-to-severe OSA (apnea-hypopnea index [AHI] ≥15 events/h) and 19 controls with mild or no OSA (AHI <15 events/h) were enrolled. Subjects underwent standard polysomnography to determine AHI and exclude other sleep disorders. Resting metabolic rate was measured via indirect calorimetry, followed by maximum, symptom-limited CPET. Subjects completed a sleep diary and physical activity questionnaire characterizing behaviors in the week prior to testing. RESULTS: Percent predicted peak oxygen uptake (V˙O2) was significantly lower in OSA subjects than controls (70.1%±17.5% vs 83.8%±13.9%; p = 0.02). Each 1-unit increase in log-transformed AHI was associated with a decrease in percent predicted peak V˙O2 of 3.20 (95% CI 0.53-5.88; p = 0.02). After adjusting for baseline differences, this association remained significant (p < 0.01). AHI alone explained 16.1% of the variability observed in percent predicted peak V˙O2 (p = 0.02). CONCLUSIONS: OSA is associated with impaired exercise capacity. Further study is needed to evaluate the utility of CPET for prognostic assessment of patients with OSA.
Authors: Jaume Sauleda; Francisco José García-Palmer; Salvador Tarraga; Andreu Maimó; Andreu Palou; Alvar G N Agustí Journal: Respir Med Date: 2003-07 Impact factor: 3.415
Authors: Cora L Craig; Alison L Marshall; Michael Sjöström; Adrian E Bauman; Michael L Booth; Barbara E Ainsworth; Michael Pratt; Ulf Ekelund; Agneta Yngve; James F Sallis; Pekka Oja Journal: Med Sci Sports Exerc Date: 2003-08 Impact factor: 5.411
Authors: E Shahar; C W Whitney; S Redline; E T Lee; A B Newman; F J Nieto; G T O'Connor; L L Boland; J E Schwartz; J M Samet Journal: Am J Respir Crit Care Med Date: 2001-01 Impact factor: 21.405
Authors: J D Parker; D Brooks; L F Kozar; C L Render-Teixeira; R L Horner; T Douglas Bradley; E A Phillipson Journal: Am J Respir Crit Care Med Date: 1999-12 Impact factor: 21.405
Authors: Terence Kavanagh; Donald J Mertens; Larry F Hamm; Joseph Beyene; Johanna Kennedy; Paul Corey; Roy J Shephard Journal: Circulation Date: 2002-08-06 Impact factor: 29.690
Authors: P A Levy; C Guilleminault; D Fagret; J M Gaio; P Romand; C Bonnet; C M Pison; J E Wolf; B Paramelle Journal: Eur Respir J Date: 1991-03 Impact factor: 16.671
Authors: Meghna P Mansukhani; Thomas G Allison; Francisco Lopez-Jimenez; Virend K Somers; Sean M Caples Journal: Am J Cardiol Date: 2013-04-08 Impact factor: 2.778
Authors: Michele Vitacca; Mara Paneroni; Alberto Braghiroli; Bruno Balbi; Maria Aliani; Patrizia Guido; Francesco Fanfulla; Mario Pertosa; Piero Ceriana; Elisabetta Zampogna; Rita Raccanelli; Nicola Sarno; Antonio Spanevello; Mauro Maniscalco; Alberto Malovini; Nicolino Ambrosino Journal: J Clin Sleep Med Date: 2020-04-15 Impact factor: 4.062
Authors: Martinha Millianny Barros de Carvalho; Ricardo Quental Coutinho; Isly Maria L Barros; Laura O B F Costa; Ana Kelley L Medeiros; Thais C Lustosa; Carolina A Medeiros; Marcus Vinícius França; Tarcya L G Couto; Ulisses R Montarroyos; Virend K Somers; Rodrigo Pinto Pedrosa Journal: J Clin Sleep Med Date: 2018-09-15 Impact factor: 4.062
Authors: Roberto P da Silva; Denis Martinez; Martina M Pedroso; Camila G Righi; Emerson F Martins; Leticia M T Silva; Maria do Carmo S Lenz; Cintia Z Fiori Journal: J Clin Sleep Med Date: 2017-02-15 Impact factor: 4.062
Authors: Christopher E Kline; David M Reboussin; Gary D Foster; Thomas B Rice; Elsa S Strotmeyer; John M Jakicic; Richard P Millman; F Xavier Pi-Sunyer; Anne B Newman; Thomas A Wadden; Gary Zammit; Samuel T Kuna Journal: Sleep Date: 2016-02-01 Impact factor: 5.849