Subodh K Arora1,2, Tyler A Powell3, Shannon N Foster3, Shana L Hansen3, Michael J Morris4. 1. Department of Sleep Medicine, Wilford Hall Ambulatory Surgical Center, JBSA-Lackland AFB, San Antonio, TX, USA. subodharora11@gmail.com. 2. Pediatrics, Malcolm Grow Medical Clinic, 1060 W Perimeter Rd, MD, 20762, Joint Base Andrews, USA. subodharora11@gmail.com. 3. Department of Sleep Medicine, Wilford Hall Ambulatory Surgical Center, JBSA-Lackland AFB, San Antonio, TX, USA. 4. Graduate Medical Education, Brooke Army Medical Center, JBSA-Fort Sam Houston, TX, Houston, USA.
Abstract
INTRODUCTION: The relationship between moderate to severe OSA and exercise capacity remains unclear. Prior studies showing a reduction in VO2 max in this population have mostly involved middle-aged, overweight patients. We aimed to study this relationship in a similarly aged population of military personnel with previously undiagnosed moderate to severe OSA. METHODS: We studied late-career male military personnel who underwent CPET and polysomnography (PSG). Patients were categorized either into an OSA group (apnea-hypopnea index (AHI) ≥ 15 events/h) or a control group (AHI < 15 events/h). VO2 max was compared between groups. RESULTS: 170 male military personnel met criteria for the study. Mean AHI was 29.0/h in the OSA group (n = 58) versus 7.4/h in the controls (n = 112) while SpO2 nadir was slightly lower (86.0% vs. 89.0%). Patients were of similar age (53.1 vs. 53.7 years), and BMI was slightly higher in the OSA group (27.5 kg/m2 vs. 26.3 kg/m2). Percent-predicted VO2 max was supernormal in both groups, though it was comparatively lower in the OSA group (117% vs. 125%; p < 0.001). CONCLUSIONS: Military personnel with moderate to severe OSA were able to achieve supernormal VO2 max values, yet had an 8% decrement in exercise capacity compared to controls. These findings suggest that OSA without significant hypoxemia may not significantly influence exercise capacity. It remains likely that the effects of untreated OSA on exercise capacity are complex and are affected by several variables including BMI, degree of associated hypoxemia, and regularity of exercise. Statistically lower VO2 max noted in this study may suggest that untreated OSA in less fit populations may lead to significant decrements in exercise capacity.
INTRODUCTION: The relationship between moderate to severe OSA and exercise capacity remains unclear. Prior studies showing a reduction in VO2 max in this population have mostly involved middle-aged, overweight patients. We aimed to study this relationship in a similarly aged population of military personnel with previously undiagnosed moderate to severe OSA. METHODS: We studied late-career male military personnel who underwent CPET and polysomnography (PSG). Patients were categorized either into an OSA group (apnea-hypopnea index (AHI) ≥ 15 events/h) or a control group (AHI < 15 events/h). VO2 max was compared between groups. RESULTS: 170 male military personnel met criteria for the study. Mean AHI was 29.0/h in the OSA group (n = 58) versus 7.4/h in the controls (n = 112) while SpO2 nadir was slightly lower (86.0% vs. 89.0%). Patients were of similar age (53.1 vs. 53.7 years), and BMI was slightly higher in the OSA group (27.5 kg/m2 vs. 26.3 kg/m2). Percent-predicted VO2 max was supernormal in both groups, though it was comparatively lower in the OSA group (117% vs. 125%; p < 0.001). CONCLUSIONS: Military personnel with moderate to severe OSA were able to achieve supernormal VO2 max values, yet had an 8% decrement in exercise capacity compared to controls. These findings suggest that OSA without significant hypoxemia may not significantly influence exercise capacity. It remains likely that the effects of untreated OSA on exercise capacity are complex and are affected by several variables including BMI, degree of associated hypoxemia, and regularity of exercise. Statistically lower VO2 max noted in this study may suggest that untreated OSA in less fit populations may lead to significant decrements in exercise capacity.
Authors: Dejana Popovic; Marco Guazzi; Djordje G Jakovljevic; Ratko Lasica; Marko Banovic; Miodrag Ostojic; Ross Arena Journal: Int J Cardiol Date: 2019-03-09 Impact factor: 4.164
Authors: Alberto Alonso-Fernández; Francisco García-Río; Miguel A Arias; Olga Mediano; José M Pino; Isabel Martínez; José Villamor Journal: Eur Heart J Date: 2005-11-02 Impact factor: 29.983
Authors: Jonathan Myers; Manish Prakash; Victor Froelicher; Dat Do; Sara Partington; J Edwin Atwood Journal: N Engl J Med Date: 2002-03-14 Impact factor: 91.245
Authors: Jeremy R Beitler; Karim M Awad; Jessie P Bakker; Bradley A Edwards; Pam DeYoung; Ina Djonlagic; Daniel E Forman; Stuart F Quan; Atul Malhotra Journal: J Clin Sleep Med Date: 2014-11-15 Impact factor: 4.062
Authors: Paul E Peppard; Terry Young; Jodi H Barnet; Mari Palta; Erika W Hagen; Khin Mae Hla Journal: Am J Epidemiol Date: 2013-04-14 Impact factor: 4.897
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