Статті в журналах: "Exercise Apnea"

1

Richardson, Matt, Robert de Bruijn, H. C. Holmberg, Glenn Björklund, Helena Haughey, and Erika Schagatay. "Increase of Hemoglobin Concentration After Maximal Apneas in Divers, Skiers, and Untrained Humans." Canadian Journal of Applied Physiology 30, no. 3 (June 1, 2005): 276–81. http://dx.doi.org/10.1139/h05-120.

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Human splenic contraction occurs both during apnea and maximal exercise, increasing the circulating erythrocyte volume. We investigated the hematological responses to 3 maximal apneas performed by elite apneic divers, elite cross-country skiers, and untrained subjects. Post-apnea hemoglobin concentration had increased in all groups, but especially in divers. The increases disappeared within 10 min of recovery. Apneic duration across apneas also increased the most in divers. Responses in divers could be more pronounced as a result of apnea training. Key words: breath hold, serial apneas, spleen contraction, cross-country skiing

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2

Yıldız, M. "The acute effects of repeated static apnea on aerobic power." Physical education of students 22, no. 4 (August 28, 2018): 217–20. http://dx.doi.org/10.15561/20755279.2018.0407.

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Purpose: Apnea exercises cause a rise in hematocrit, erythropoietin, hemoglobin concentration, lung volume and oxygen store in muscle and blood, and a decrease in blood acidosis and oxidative stress. These types of physiological changes that occur in the body result in developments in both time to exhaustion and V02max. The purpose of the current study was to investigate the acute effect of repeated static apneas on aerobic power. Material: Twenty physically active male university students (age:22.80±3.84 year, height:177.40±7.49 cm and weight:68.20±8.72 kg) volunteered to participate in the current study. They were divided as the static apnea and control groups randomly. The static group performed multistage exercise treadmill test to exhaustion (maximal aerobic power) after three maximal apneas with 2-min interval in sitting position. The control group performed only the maximal aerobic power test without apnea. Their maximal oxygen consumption (Vo2max), gas exchange rate (RER), heart beat rate (HR) and rate of perceived exertion (RPE) values were measured during maximal aerobic test. Their hemoglobin (Hb) and hematocrit (Hct) values were measured before and immediately after the apnea for both groups. Results: There were no significant differences found between the control and static apnea groups for Vo2max, HR, Hb and Hct. However, RPE values measured after the static apnea were lower (17.55±0.51) than the control (18.75±0.62). Conclusions: The repeated static apneas immediately prior the maximal aerobic effort cannot increase aerobic power in untrained breath hold participants. However, the lower RPE after static apnea may be used as an ergogenic effect.

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3

Andersson, Johan P. A., Mats H. Linér, Elisabeth Rünow, and Erika K. A. Schagatay. "Diving response and arterial oxygen saturation during apnea and exercise in breath-hold divers." Journal of Applied Physiology 93, no. 3 (September 1, 2002): 882–86. http://dx.doi.org/10.1152/japplphysiol.00863.2001.

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This study addressed the effects of apnea in air and apnea with face immersion in cold water (10°C) on the diving response and arterial oxygen saturation during dynamic exercise. Eight trained breath-hold divers performed steady-state exercise on a cycle ergometer at 100 W. During exercise, each subject performed 30-s apneas in air and 30-s apneas with face immersion. The heart rate and arterial oxygen saturation decreased and blood pressure increased during the apneas. Compared with apneas in air, apneas with face immersion augmented the heart rate reduction from 21 to 33% ( P < 0.001) and the blood pressure increase from 34 to 42% ( P < 0.05). The reduction in arterial oxygen saturation from eupneic control was 6.8% during apneas in air and 5.2% during apneas with face immersion ( P < 0.05). The results indicate that augmentation of the diving response slows down the depletion of the lung oxygen store, possibly associated with a larger reduction in peripheral venous oxygen stores and increased anaerobiosis. This mechanism delays the fall in alveolar and arterial Po 2 and, thereby, the development of hypoxia in vital organs. Accordingly, we conclude that the human diving response has an oxygen-conserving effect during exercise.

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4

Lindholm, Peter, Jessica Nordh, and Dag Linnarsson. "Role of hypoxemia for the cardiovascular responses to apnea during exercise." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 283, no. 5 (November 1, 2002): R1227—R1235. http://dx.doi.org/10.1152/ajpregu.00036.2002.

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We sought to define the role of hypoxemia in eliciting the cardiovascular responses to apnea during exercise. Eleven men performed repeated apneas during 100-W steady-state exercise, either with normoxic gas (air) or 95% oxygen (oxygen). Beat-by-beat arterial blood pressure, arterial oxygen saturation, and heart rate (HR) were determined, and stroke volume (SV) was estimated from impedance cardiography calibrated with soluble gas rebreathing. There were large interindividual variabilities of HR, mean arterial pressure (MAP), and total peripheral resistance (TPR) at end-apnea (ea). However, for each individual, HRea, MAPea, and TPRea were highly correlated between air and oxygen ( R = 0.94, 0.78, and 0.93). HR decreased and MAP increased faster during apnea with air than with oxygen (ANOVA, P < 0.05), but MAPea was not different between conditions. Cardiac output was reduced by 33% with air and by 11% with oxygen ( P < 0.001 for air vs. oxygen). We conclude that the hypoxemia component cannot account for the wide interindividual differences of HR and TPR responses to apnea. However, hypoxemia augments the HR and TPR responses and may limit the MAP response to apnea by preventing a bradycardia-associated increase of SV.

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5

Andersson, Johan P. A., Mats H. Linér, Anne Fredsted, and Erika K. A. Schagatay. "Cardiovascular and respiratory responses to apneas with and without face immersion in exercising humans." Journal of Applied Physiology 96, no. 3 (March 2004): 1005–10. http://dx.doi.org/10.1152/japplphysiol.01057.2002.

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The effect of the diving response on alveolar gas exchange was investigated in 15 subjects. During steady-state exercise (80 W) on a cycle ergometer, the subjects performed 40-s apneas in air and 40-s apneas with face immersion in cold (10°C) water. Heart rate decreased and blood pressure increased during apneas, and the responses were augmented by face immersion. Oxygen uptake from the lungs decreased during apnea in air (-22% compared with eupneic control) and was further reduced during apnea with face immersion (-25% compared with eupneic control). The plasma lactate concentration increased from control (11%) after apnea in air and even more after apnea with face immersion (20%), suggesting an increased anaerobic metabolism during apneas. The lung oxygen store was depleted more slowly during apnea with face immersion because of the augmented diving response, probably including a decrease in cardiac output. Venous oxygen stores were probably reduced by the cardiovascular responses. The turnover times of these gas stores would have been prolonged, reducing their effect on the oxygen uptake in the lungs. Thus the human diving response has an oxygen-conserving effect.

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6

Torres-Castro, Rodrigo, Jordi Vilaró, Joan-Daniel Martí, Onintza Garmendia, Elena Gimeno-Santos, Bárbara Romano-Andrioni, Cristina Embid, and Josep Montserrat. "Effects of a Combined Community Exercise Program in Obstructive Sleep Apnea Syndrome: A Randomized Clinical Trial." Journal of Clinical Medicine 8, no. 3 (March 14, 2019): 361. http://dx.doi.org/10.3390/jcm8030361.

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Physical activity is associated with a decreased prevalence of obstructive sleep apnea and improved sleep efficiency. Studies on the effects of a comprehensive exercise program in a community setting remain limited. Our objective was to investigate the effects of a combined physical and oropharyngeal exercise program on the apnea-hypopnea index in patients with moderate to severe obstructive sleep apnea. This was a randomized clinical trial where the intervention group followed an eight-week urban-walking program, oropharyngeal exercises, and diet and sleep recommendations. The control group followed diet and sleep recommendations. A total of 33 patients were enrolled and randomized and, finally, 27 patients were included in the study (IG, 14; CG, 13) Obstructive sleep apnea patients were analyzed with a median age of 67 (52–74) and median apnea-hypopnea index of 32 events/h (25–41). The apnea-hypopnea index did not differ between groups pre- and post-intervention. However, in intervention patients younger than 60 (n = 6) a reduction of the apnea-hypopnea index from 29.5 (21.8–48.3) to 15.5 (11–34) events/h (p = 0.028) was observed. While a comprehensive multimodal program does not modify the apnea-hypopnea index, it could reduce body weight and increase the walking distance of patients with moderate to severe obstructive sleep apnea. Patients younger than 60 may also present a decreased apnea-hypopnea index after intervention.

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7

Sundblad, P., and D. Linnarsson. "Influence of apnea on cardiovascular responses to neck suction during exercise." American Journal of Physiology-Heart and Circulatory Physiology 271, no. 4 (October 1, 1996): H1370—H1374. http://dx.doi.org/10.1152/ajpheart.1996.271.4.h1370.

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Short-lasting neck suction (NS) is a common method to assess the carotid-cardiac baroreflex, and NS is usually applied during apnea to avoid breath-synchronous variations of heart rate (HR) and blood pressure. We hypothesized that the apnea might provoke cardiovascular effects that could confound the HR and blood pressure responses to NS. HR and blood pressure responses to 10-s trains of 50-mmHg pulses of NS were studied in six male subjects during supine rest, upright rest, isometric arm exercise at 30% of maximal voluntary contraction, and dynamic leg exercise at 100 W in the sitting position. Repeated NS sequences were performed during apnea preceded by a relaxed expiration to functional residual capacity and during eupnea. Initial HR responses to NS were similar during eupnea and apnea in all conditions. However, during isometric and dynamic exercise, recordings made under eupneic and apneic conditions differed during the second half of the NS period. During apneic isometric arm contraction, the elevation of mean carotid distending pressure (MCDP) (arterial pressure at carotid level minus NS pressure) was maintained at a 25-35% higher level than during eupneic isometric exercise over the last half of the NS period. In dynamic exercise, mean arterial pressure and MCDP started to increase after 3-5 s of apneic NS, whereas they were maintained during eupnea. One to three seconds later, HR started to drop markedly in apneic subjects, reaching values 20 beats/min lower than those in eupneic subjects at the end of the NS. We conclude that cardiovascular effects of apnea may appear after only 8 s of apnea in dynamic exercise and therefore could confound responses to NS.

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8

Bouten, Janne, Jonas Debusschere, Leen Lootens, Louise Declercq, Peter Van Eenoo, Jan Boone, and Jan G. Bourgois. "Six weeks of static apnea training does not affect Hbmass and exercise performance." Journal of Applied Physiology 132, no. 3 (March 1, 2022): 673–81. http://dx.doi.org/10.1152/japplphysiol.00770.2021.

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Apnea training has been suggested as a promising method to improve exercise performance for over a decade. However, to our knowledge, this study is the first to evaluate its value on both hematological parameters and exercise performance, including Hbmass and a control group. No changes in Hbmass nor exercise performance were observed. Contradicting previous research, no acute increase in [EPO] following apnea was observed either, indicating that more intense protocols are needed, at least in nonapnea-trained individuals.

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9

Castellini, M. A., D. P. Costa, and A. Huntley. "Hematocrit variation during sleep apnea in elephant seal pups." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 251, no. 2 (August 1, 1986): R429—R431. http://dx.doi.org/10.1152/ajpregu.1986.251.2.r429.

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Hematocrit (Hct) levels were found to increase throughout long-duration sleep apnea in the northern elephant seal pup. Breath holds ranging from 4 to greater than 11 min were sampled. Blood collected from the extradural intravertebral vein showed an increase in Hct from 55.6 to 63.1% with the peak value occurring within 1 min of the end of apnea. Plasma lactate did not change throughout the breath hold. Previous observations of changing Hct levels in seals were made on animals diving naturally, and consequently the effects of exercise could not be separated from those of apnea. The results of this study demonstrate that the rise in Hct is produced quickly upon apnea, occurs without significant levels of hypoxic metabolism, and does not depend on exercise.

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10

Hoffmann, U., M. Smerecnik, D. Leyk, and D. Essfeld. "Cardiovascular Responses to Apnea during Dynamic Exercise." International Journal of Sports Medicine 26, no. 6 (July 2005): 426–31. http://dx.doi.org/10.1055/s-2004-821113.

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11

Mahoney, Diana. "Exercise Cuts Daytime Fatigue In Sleep Apnea." Family Practice News 36, no. 17 (September 2006): 45. http://dx.doi.org/10.1016/s0300-7073(06)73792-6.

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12

Lee-Iannotti, Joyce K., and James M. Parish. "Exercise as a treatment for sleep apnea." Journal of Clinical Sleep Medicine 16, no. 7 (July 15, 2020): 1005–6. http://dx.doi.org/10.5664/jcsm.8582.

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13

Nishiyasu, Takeshi, Rina Tsukamoto, Katsuhito Kawai, Keiji Hayashi, Shunsaku Koga, and Masashi Ichinose. "Relationships between the extent of apnea-induced bradycardia and the vascular response in the arm and leg during dynamic two-legged knee extension exercise." American Journal of Physiology-Heart and Circulatory Physiology 302, no. 3 (February 2012): H864—H871. http://dx.doi.org/10.1152/ajpheart.00413.2011.

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Our aim was to test the hypothesis that apnea-induced hemodynamic responses during dynamic exercise in humans differ between those who show strong bradycardia and those who show only mild bradycardia. After apnea-induced changes in heart rate (HR) were evaluated during dynamic exercise, 23 healthy subjects were selected and divided into a large response group (L group; n = 11) and a small response group (S group; n = 12). While subjects performed a two-legged dynamic knee extension exercise at a work load that increased HR by 30 beats/min, apnea-induced changes in HR, cardiac output (CO), mean arterial pressure (MAP), arterial O2 saturation (SaO2), forearm blood flow (FBF), and leg blood flow (LBF) were measured. During apnea, HR in the L group (54 ± 2 beats/min) was lower than in the S group (92 ± 3 beats/min, P < 0.05). CO, SaO2, FBF, LBF, forearm vascular conductance (FVC), leg vascular conductance (LVC), and total vascular conductance (TVC) were all reduced, and MAP was increased in both groups, although the changes in CO, TVC, LBF, LVC, and MAP were larger in the L group than in the S group ( P < 0.05). Moreover, there were significant positive linear relationships between the reduction in HR and the reductions in TVC, LVC, and FVC. We conclude that individuals who show greater apnea-induced bradycardia during exercise also show greater vasoconstriction in both active and inactive muscle regions.

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14

Fico, Brandon G., Taha A. Alhalimi, and Hirofumi Tanaka. "Vascular responses to simulated breath-hold diving involving multiple reflexes." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 322, no. 3 (March 1, 2022): R153—R160. http://dx.doi.org/10.1152/ajpregu.00202.2021.

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Breath-hold diving evokes a complex cardiovascular response. The degrees of hypertension induced by the diving reflex are substantial and accentuated by the underwater swimming. This condition provides a circulatory challenge to properly buffer and cushion cardiac pulsations. We determined hemodynamic changes during the diving maneuver and hypothesized that central artery compliance would be augmented during simulated breath-hold diving. A total of 20 healthy young adults were studied. Hemodynamics were measured during exercise on a cycle ergometer, apnea, face immersion in cold water (trigeminal stimulation), and simulated breath-hold diving. Arterial compliance was measured by recording the carotid artery diameter from images derived from an ultrasound machine at the cephalic portion of the common carotid artery 1–2 cm proximal to the carotid bulb, whereas arterial pressure waveforms were obtained using an arterial tonometry placed on the contralateral carotid artery and recorded on a data acquisition software. The change in diameter was divided by the change in blood pressure to calculate arterial compliance. Arterial compliance increased with simulated diving compared with rest ( P = 0.007) and was elevated compared with exercise and apnea alone ( P < 0.01). A significant increase in heart rate was observed with exercise, apnea, and facial immersion when compared with rest ( P < 0.001). However, simulated diving brought the heart rate down to resting levels. Cardiac output increased with all conditions ( P < 0.001), with an attenuated response during simulated diving compared with exercise and facial immersion ( P < 0.05). Mean blood pressure was elevated during all conditions ( P < 0.001), with a further elevation observed during simulated diving compared with exercise ( P < 0.001), apnea ( P = 0.016), and facial immersion ( P < 0.001). Total peripheral resistance was decreased during exercise and facial immersion compared with rest ( P < 0.001) but was increased during simulated diving compared with exercise ( P < 0.001), apnea ( P = 0.008), and facial immersion ( P = 0.003). We concluded that central artery compliance is augmented during simulated breath-hold diving to help buffer cardiac pulsations.

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15

Son, Heejeong, Yunah Jeon, and Hyosik Kim. "Effects of Static Apnea Training on Pulmonary Function, Blood Lactate Response and Exercise Performance of Elite Swimmers." Exercise Science 29, no. 3 (August 31, 2020): 272–80. http://dx.doi.org/10.15857/ksep.2020.29.3.272.

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PURPOSE: The purpose of this study was to investigate the effects of training on improvement in pulmonary function and swimming performance by implementing static apnea training for 4 weeks in elite male swimmers.METHODS: Twenty elite swimmers were divided into two groups, the apnea training group (Apnea, n=11) and the control group (control, n=9). Each swimmer received identical swimming and ground training for 4 weeks. The apnea group performed 10 sets of breathholding a day additionally. In all participants, the pulmonary function tests [forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1)] were evaluated. The blood lactate level was also measured after each swimmer completed swimming 5 laps.RESULTS: After 4 weeks of static apnea training, the FVC of the apnea group significantly increased (p=.008), whereas the FEV1/FVC ratio did not change. Breath-holding time increased significantly after apnea training (p=.001). There were no significant differences between the groups in the 50-m time trial records. However, the apnea group show a significant difference at the 4th (p=.013) and 5th trial (p=.023). The blood lactate levels after the 50-m trial was not significantly different between the groups, but the levels in the apnea group showed a significant increase in the results of the 2nd trial compared to those before apnea training (p=.008).CONCLUSIONS: The results of our study reveal that static apnea training improves pulmonary function, in contrast to a few time trials that show varying differences in swimming records and blood lactate levels. These results warrant a review of the training protocol to evaluate the effect on performance. In conclusion, static apnea training is a potential exercise that can improve performance in competitive sports.

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16

van der Spuy, Ina, Gaungming Zhao, Chandima Karunanayake, and Punam Pahwa. "Predictors of Sleep Apnea in the Canadian Population." Canadian Respiratory Journal 2018 (August 28, 2018): 1–11. http://dx.doi.org/10.1155/2018/6349790.

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Older age, obesity, hypertension, snoring, and excessive daytime sleepiness have been associated with sleep apnea. The objective of this study was to determine the prevalence (crude and adjusted), as well as the risk factors, of sleep apnea in the adult Canadian population. Data from the 2009 Sleep Apnea Rapid Response (SARR) questionnaire were used to identify the risk factors, and all sleep-related questions in the SARR questionnaire were used. The outcome variable of interest was health professional-diagnosed sleep apnea. Covariates of interest were demographic variables, population characteristics, respiratory and cardiovascular diseases, and enabling resources. The multiple logistic regression model adjusted for the clustering effect was used to analyze the data. Sleep apnea was diagnosed in 858,913 adults (3.4% of the population), and more men (65.4%) than women (34.6%) were diagnosed with sleep apnea. Multivariable logistic regression analysis indicated that age (45 and older), loud snoring, sudden awakening with gasping/choking (rare/sometimes and once or more a week), and nodding off/falling asleep in driving in the past 12 months were significantly associated with diagnosed sleep apnea. Predictive probability demonstrated that in overweight and obese persons, ≥15 minutes of daily exercise significantly decreased the risk of diagnosed sleep apnea. The conclusion of this study is that in the Canadian population, sleep apnea is associated with older age, loud snoring, and sleeping problems. The protective effect of exercise warrants further investigation.

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17

Pertiwi, Aniesa Nur Laily, Nada Rajbiana, and Rida Hayati. "OROPHARINGEAL EXERCISE UNTUK MEMPERBAIKI JALAN NAFAS AKIBAT OBSTRUCTIVE SLEEP APNEA SYNDROM PADA KONDISI STROKE." FISIO MU: Physiotherapy Evidences 1, no. 1 (December 26, 2019): 21–28. http://dx.doi.org/10.23917/fisiomu.v1i1.9395.

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ABSTRAKObstructive Sleep Apnea Syndrome (OSAS) merupakan faktor resiko terjadinya stroke berulang hingga kematian. OSAS adalah sindrom obstruksi total atau parsial jalan napas yang menyebabkan gangguan nafas saat tidur. Peningkatan derajat OSAS berhubungan dengan peningkatan kematian. Oleh karena itu OSAS harus diberikan pengananan yang tepat. Penelitian menunjukkan Oropharingeal Exercise dipercaya dapat memperbaiki jalan nafas akibat OSAS pada kondisi stroke. Orofarigeal Exercise merupakan metode alternatif pada pasien stroke yang menderita OSAS dengan melakukan latihan isotonic dan isometric saluran nafas bagian atas untuk meningkatkan mobilitas dan tonisitas otot-otot pernafasan bagian atas sehingga membuka jalan nafas dan meningkatkan fungsi serta kinerja saluran pernapasan. Oleh karena itu Oropharingeal Exercise dapat digunakan sebagai terapi alternatif untuk memperbaiki jalan nafas akibat OSAS pada kondisi stroke.Keywords : Obstructve Sleep Apnea Syndrome, Stroke, Oropharingeal Exercise

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18

Andrade, Flávio Maciel Dias de, and Rodrigo Pinto Pedrosa. "The role of physical exercise in obstructive sleep apnea." Jornal Brasileiro de Pneumologia 42, no. 6 (December 2016): 457–64. http://dx.doi.org/10.1590/s1806-37562016000000156.

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ABSTRACT Obstructive sleep apnea (OSA) is a common clinical condition, with a variable and underestimated prevalence. OSA is the main condition associated with secondary systemic arterial hypertension, as well as with atrial fibrillation, stroke, and coronary artery disease, greatly increasing cardiovascular morbidity and mortality. Treatment with continuous positive airway pressure is not tolerated by all OSA patients and is often not suitable in cases of mild OSA. Hence, alternative methods to treat OSA and its cardiovascular consequences are needed. In OSA patients, regular physical exercise has beneficial effects other than weight loss, although the mechanisms of those effects remain unclear. In this population, physiological adaptations due to physical exercise include increases in upper airway dilator muscle tone and in slow-wave sleep time; and decreases in fluid accumulation in the neck, systemic inflammatory response, and body weight. The major benefits of exercise programs for OSA patients include reducing the severity of the condition and daytime sleepiness, as well as increasing sleep efficiency and maximum oxygen consumption. There are few studies that evaluated the role of physical exercise alone for OSA treatment, and their protocols are quite diverse. However, aerobic exercise, alone or combined with resistance training, is a common point among the studies. In this review, the major studies and mechanisms involved in OSA treatment by means of physical exercise are presented. In addition to systemic clinical benefits provided by physical exercise, OSA patients involved in a regular, predominantly aerobic, exercise program have shown a reduction in disease severity and in daytime sleepiness, as well as an increase in sleep efficiency and in peak oxygen consumption, regardless of weight loss.

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19

Park, Chan-Soon. "Upper Airway Myofunctional Exercise for Obstructive Sleep Apnea." Journal of Clinical Otolaryngology Head and Neck Surgery 33, no. 2 (June 2022): 39–43. http://dx.doi.org/10.35420/jcohns.2022.33.2.39.

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20

Van Offenwert, Evelien, Bart Vrijsen, Catharina Belge, Thierry Troosters, Bertien Buyse, and Dries Testelmans. "Physical activity and exercise in obstructive sleep apnea." Acta Clinica Belgica 74, no. 2 (May 4, 2018): 92–101. http://dx.doi.org/10.1080/17843286.2018.1467587.

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21

Lin, Ching-Chi, Wen-Yeh Hsieh, Chon-Shin Chou, and Shwu-Fang Liaw. "Cardiopulmonary exercise testing in obstructive sleep apnea syndrome." Respiratory Physiology & Neurobiology 150, no. 1 (January 2006): 27–34. http://dx.doi.org/10.1016/j.resp.2005.01.008.

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22

MAHONEY, DIANA. "Exercise Improves Daytime Fatigue in Sleep Apnea Patients." Clinical Psychiatry News 34, no. 10 (October 2006): 56. http://dx.doi.org/10.1016/s0270-6644(06)71838-0.

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23

Zota, Ioana Mădălina, Cristian Stătescu, Radu Andy Sascău, Mihai Roca, Radu Sebastian Gavril, Teodor Flaviu Vasilcu, Daniela Boișteanu, et al. "CPAP Effect on Cardiopulmonary Exercise Testing Performance in Patients with Moderate-Severe OSA and Cardiometabolic Comorbidities." Medicina 56, no. 2 (February 15, 2020): 80. http://dx.doi.org/10.3390/medicina56020080.

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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 (Δ = 14.23 W, p = 0.0004), maximum oxygen uptake (Δ = 203.87 mL/min, p = 0.004), anaerobic threshold (Δ = 316.4 mL/min, p = 0.001), minute ventilation (Δ = 5.1 L/min, p = 0.01) and peak oxygen pulse (Δ = 2.46, p = 0.007) as well as a decrease in basal metabolic rate (BMR) (Δ = −8.3 kCal/24 h, p = 0.04) and average Epworth score (Δ = −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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Castellini, Michael A. "Visualizing metabolic transitions in aquatic mammals: does apnea plus swimming equal "diving"?" Canadian Journal of Zoology 66, no. 1 (January 1, 1988): 40–44. http://dx.doi.org/10.1139/z88-005.

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While diving, aquatic mammals must balance the oxygen conservation requirements of apnea with the oxygen utilization requirements of exercise. The resulting metabolic state depends on a complex range of behavioral, physiological, and metabolic conditions as required by the particular dive profile. Thus, at the one extreme of long duration diving, oxygen conservation requirements will outweigh those of exercise, while under conditions of rapid, short diving or propoising, exercise parameters will probably be of more importance than those of oxygen conservation. In the last several years, techniques for monitoring radioactively tagged plasma metabolites have allowed the visualization of metabolic variation throughout various diving and surface exercise regimes in aquatic mammals. By comparing such tracer turnover dilution curves under conditions of surface exercise, quiet forced diving, free diving, and sleep apnea, patterns emerge that demonstrate the extreme metabolic plasticity of the diving response. These comparisons have led to the conclusions that even short diving periods probably involve a marked change in metabolic steady state, and that aerobic diving is not simply analogous to aerobic exercise.

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Busch, Stephen A., Lydia L. Simpson, Frances Sobierajski, Laurel Riske, Philip N. Ainslie, Chris K. Willie, Mike Stembridge, Jonathan P. Moore, and Craig D. Steinback. "Muscle sympathetic reactivity to apneic and exercise stress in high-altitude Sherpa." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 318, no. 3 (March 1, 2020): R493—R502. http://dx.doi.org/10.1152/ajpregu.00119.2019.

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Lowland-dwelling populations exhibit persistent sympathetic hyperactivity at altitude that alters vascular function. High-altitude populations, such as Sherpa, have previously exhibited greater peripheral blood flow in response to acute stress than Lowlanders, which may be explained through lower sympathetic activity. Our purpose was to determine whether Sherpa exhibit lower sympathetic reactivity to stress than Lowlanders. Muscle sympathetic nerve activity (MSNA; microneurography) was measured at rest in Lowlanders ( n = 14; age = 27 ± 6 yr) at 344 m and between 1 and 10 days at 5,050 m. Sherpa (age = 32 ± 11 yr) were tested at 5,050 m ( n = 8). Neurovascular reactivity (i.e., change in MSNA patterns) was measured during maximal end-expiratory apnea, isometric hand grip (IHG; 30% maximal voluntary contraction for 2-min), and postexercise circulatory occlusion (PECO; 3 min). Burst frequency (bursts/min) and incidence (bursts/100 heartbeats) and total normalized SNA (arbitrary units/min) were analyzed at rest, immediately before apnea breakpoint, and during the last minute of IHG and PECO. Vascular responses to apnea, IHG, and PECO were also measured. MSNA reactivity to apnea was smaller in Sherpa than Lowlanders at 5,050 m, although blood pressure responses were similar between groups. MSNA increases in Lowlanders during apnea at 5,050 m were significantly lower than at 344 m ( P < 0.05), indicating that a possible sympathetic ceiling was reached in Lowlanders at 5,050 m. MSNA increased similarly during IHG and PECO in Lowlanders at both 334 m and 5,050 m and in Sherpa at 5,050 m, while vascular changes (mean brachial arterial pressure, contralateral brachial flow and resistance) were similar between groups. Sherpa demonstrate overall lower sympathetic reactivity that may be a result of heightened vascular responsiveness to potential apneic stress at altitude.

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Baser, Duygu Ayhan, Serdar Baser, and Adin Selcuk. "The Role of Weight Management as First-line Treatment Modality in Obstructive Sleep Apnea of Obese Patients." Eurasian Journal of Family Medicine 9, no. 2 (June 26, 2020): 103–8. http://dx.doi.org/10.33880/ejfm.2020090206.

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Aim: Weight loss has been shown to improve obstructive sleep apnea and is considered the first choice of treatment. The aim of this study is to evaluate the weight-management strategies and the relationship between the weight loss and obstructive sleep apnea on obese patients. Methods: A prospective study was applied on consecutive 50 patients with obstructive sleep apnea whose body mass indexes over 25. The first part of questionnaire form and the Epworth Sleepiness Scale scores was applied to patients by face to face interviews at first visit between November 2017 and May 2018. All of the patients who applied to the snoring policlinic were offered weight loss. The second part of questionnaire form and Epworth Sleepiness Scale scores was applied to patients after 3 months later and the weights 3 months after weight loss recommendation were also recorded. For the statistical analysis, SPSS 15.0 program was used. Results: All patients were offered to lose weight. 26% of them had only diet; 12% had only exercise and 12% had both diet and exercise. 50% of the patients did nothing to lose weight. 76.9% of the dieters; 100% of the exercisers and 83.3% of those who did diet and exercise, lost weight. There was a statistically significant difference between beginning and control (after 3 months) body mass indexes and Epworth Sleepiness Scale scores of the patients. Conclusion: When weight loss is considered as the patient's attempt, along with the pursuance and maintenance, its compliance is high. Although the number of sample in our study was not suitable for generalization, we confirmed that weight loss had a positive effect on obstructive sleep apnea. Keywords: sleep apnea syndromes, weight loss, obesity

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Guimard, Alexandre, Houssem Zorgati, Sylvain Brulaire, Virgile Amiot, Fabrice Prieur, and Katia Collomp. "Physiological Dynamic Apnea Responses in Relation to Apnea Capacity in Triathletes." International Journal of Sports Medicine 38, no. 07 (May 17, 2017): 521–26. http://dx.doi.org/10.1055/s-0043-101375.

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AbstractThe aim was to assess the cardiac, arterial oxygen saturation, lactate, hormonal and Borg rating of perceived exertion (RPE) responses to acute apnea in relation to apnea capacity in 18 middle-aged triathletes. Subjects were monitored while swimming two 50-m freestyle exercise trials with fins at maximal speed: with normal frequency breathing (NB) and with complete apnea (Ap); the latter was used to assess apnea capacity. The subjects with significant alteration in swimming performance inducing a time increase greater than 2.5% during Ap vs. NB were put in the group: bad apnea capacity (Bad Ap); the others, who showed no significant alteration in performance, were put in the group: Good Ap. Under apnea, both groups showed a decrease in arterial oxygen saturation (p<0.05). In Ap conditions, only Bad Ap had a significant lower maximal heart rate vs. NB (p<0.05), with lower blood lactate (p<0.05) and arm stroke frequency (p<0.01). No change in saliva hormonal concentrations was found during the experiment for both groups, whereas RPE responses were increased in the Good Ap group under Ap vs. NB conditions. In conclusion, a good apnea capacity seems to be associated with lower cardiovascular and metabolic apnea alterations in middle-aged recreationally-trained triathletes.

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Smith, Simon S., Geoffrey Doyle, Thomas Pascoe, James A. Douglas, and Greg Jorgensen. "Intention to Exercise in Patients with Obstructive Sleep Apnea." Journal of Clinical Sleep Medicine 03, no. 07 (December 15, 2007): 689–94. http://dx.doi.org/10.5664/jcsm.27024.

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Sechser, Nasya R., Hadlie L. Overhue, and Gary P. Van Guilder. "An Oral Myofunctional Exercise Prescription For Obstructive Sleep Apnea." ACSM'S Health & Fitness Journal 25, no. 3 (May 2021): 35–43. http://dx.doi.org/10.1249/fit.0000000000000670.

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Lin, Ching-Chi. "Cardiopulmonary Exercise Testing in Patients of Sleep Apnea Syndrome." Chest 126, no. 4 (October 2004): 902S. http://dx.doi.org/10.1016/s0012-3692(16)46967-9.

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Rizzi, Camila F., Fátima Cintra, Thais Risso, Cristiane Pulz, Sergio Tufik, Angelo de Paola, and Dalva Poyares. "Exercise Capacity and Obstructive Sleep Apnea in Lean Subjects." Chest 137, no. 1 (January 2010): 109–14. http://dx.doi.org/10.1378/chest.09-1201.

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Thomas, L. Nathan, and Bryan Tagge. "Exercise is Medicine Application on Obstructive Sleep Apnea Patients." Medicine & Science in Sports & Exercise 46 (May 2014): 374–75. http://dx.doi.org/10.1249/01.mss.0000494297.91900.70.

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Alameri, Hatem, Yusra Al-Kabab, and Ahmed BaHammam. "Submaximal exercise in patients with severe obstructive sleep apnea." Sleep and Breathing 14, no. 2 (September 25, 2009): 145–51. http://dx.doi.org/10.1007/s11325-009-0300-4.

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Morgan, Barbara J. "Exercise: Alternative Therapy for Heart Failure-Associated Sleep Apnea?" Sleep 32, no. 5 (May 2009): 585–86. http://dx.doi.org/10.1093/sleep/32.5.585.

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Mabry, Jessica E., Trent A. Hargens, Stephen G. Guill, Don Zedalis, John M. Gregg, William G. Herbert, and William G. Herbert. "Obstructive sleep apnea has implications for aerobic exercise prescription." Medicine & Science in Sports & Exercise 38, Supplement (May 2006): S105. http://dx.doi.org/10.1249/00005768-200605001-01364.

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Chien, Meng-Yueh, Ya-Ju Chang, Peilin Lee, Pan-Chyr Yang, and Ying-Tai Wu. "Electrophysiologic changes with incremental exercise in obstructive sleep apnea." Muscle & Nerve 48, no. 2 (May 22, 2013): 212–18. http://dx.doi.org/10.1002/mus.23745.

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Jurado-García, Antonio, Guillermo Molina-Recio, Nuria Feu-Collado, Ana Palomares-Muriana, Adela María Gómez-González, Francisca Lourdes Márquez-Pérez, and Bernabé Jurado-Gamez. "Effect of a Graduated Walking Program on the Severity of Obstructive Sleep Apnea Syndrome. A Randomized Clinical Trial." International Journal of Environmental Research and Public Health 17, no. 17 (August 31, 2020): 6334. http://dx.doi.org/10.3390/ijerph17176334.

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Background: Obstructive sleep apnea syndrome (OSAS) is a common disease. The objective of this research was to determine the effectiveness of a graduated walking program in reducing the apnea–hypopnea index number in patients with obstructive sleep apnea syndrome (OSAS). Methods: A randomized controlled clinical trial with a two-arm parallel in three tertiary hospitals was carried out with seventy sedentary patients with moderate to severe OSAS. Twenty-nine subjects in each arm were analyzed by protocol. The control group received usual care, while usual care and an exercise program based on progressive walks without direct supervision for 6 months were offered to the intervention group. Results: The apnea–hypopnea index decreased by six points in the intervention group, and improvements in oxygen desaturation index, total cholesterol, and Low-Density Lipoprotein of Cholesterol (LDL-c) were observed. A higher decrease in sleep apnea–hypopnea index (45 ± 20.6 vs. 34 ± 26.3/h; p = 0.002) was found in patients with severe vs. moderate OSAS, as well as in oxygen desaturation index from baseline values (43.3 vs. 34.3/h; p = 0.046). Besides, High-Density Lipoprotein of Cholesterol (HDL-c) values showed a higher increase in the intervention group (45.3 vs. 49.5 mg/dL; p = 0.009) and also, a higher decrease in LDL-c was found in this group (141.2 vs. 127.5 mg/dL; p = 0.038). Conclusion: A home physical exercise program is a useful and viable therapeutic measure for the management of OSAS.

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38

Peng, Jiale, Yuling Yuan, Yuanhui Zhao, and Hong Ren. "Effects of Exercise on Patients with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis." International Journal of Environmental Research and Public Health 19, no. 17 (August 31, 2022): 10845. http://dx.doi.org/10.3390/ijerph191710845.

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With exercise being more frequently utilized in treatment for obstructive sleep apnea (OSA), a systematic review of the intervention efficacy of exercise on OSA is necessary. PubMed, EBSCO, Web of Science, VIP, and CNKI databases were searched to collect randomized controlled trials (RCTs) of exercise applied to OSA from January 2000 to January 2022. The literature screening, data extraction, and risk of bias assessment of included studies were conducted independently by two reviewers. Meta-analysis was then performed using Rev Man 5.4 software. A total of 9 RCTs were included, including 444 patients. Compared with the control group, exercise made an improvement in apnea–hypopnea index (AHI) [MD = −6.65, 95% CI (−7.77, −5.53), p < 0.00001], minimum oxygen saturation (SaO2min%) [MD = 1.67, 95% CI (0.82, 2.52), p = 0.0001], peak oxygen uptake (VO2peak) [SMD = 0.54, 95% CI (0.31, 0.78), p < 0.00001], Pittsburgh sleep quality index (PSQI) [MD = −2.08, 95% CI (−3.95, −0.21), p = 0.03], and Epworth Sleepiness Scale (ESS) values [MD = −1.64, 95% CI, (−3.07, −0.22), p = 0.02]. However, there were no significant changes in body mass index (BMI). As for the results of subgroup analysis, aerobic exercise combined with resistance exercise [MD = −7.36, 95% CI (−8.64, −6.08), p < 0.00001] had a better effect on AHI reduction than aerobic exercise alone [MD = −4.36, 95% CI (−6.67, −2.06), p = 0.0002]. This systematic review demonstrates that exercise reduces the severity of OSA with no changes in BMI, and the effect of aerobic exercise combined with resistance training is better than aerobic exercise alone in AHI reduction. Exercise also improves cardiopulmonary fitness, sleep quality, and excessive daytime sleepiness.

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Kerbikov, Oleg B., Alexander V. Averyanov, Ekaterina N. Borskaya, and Tamara V. Krutova. "Cardiopulmonary exercise testing in clinical practice." Journal of Clinical Practice 3, no. 2 (October 26, 2021): 58–70. http://dx.doi.org/10.17816/clinpract83781.

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The review is dedicated to the use of the cardiopulmonary exercise testing (CPET) in clinical practice. Main modes of CPET, most popular protocols and testing methods are discussed in details. Ample space is dedicated to main parameters measuring during CPET, their physiological values and changes in different pathological states. Main indications for CPET are presented and special attention is given to the use of CPET in chronic heart failure, apnea, lung diseases, skeletal muscle fiber and mitochondrial myopathy, rehabilitation. Emerging applications of CPET like congenital heart disease, pulmonary resection and several other are also discussed.

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Lindholm, Peter, Patrik Sundblad, and Dag Linnarsson. "Oxygen-conserving effects of apnea in exercising men." Journal of Applied Physiology 87, no. 6 (December 1, 1999): 2122–27. http://dx.doi.org/10.1152/jappl.1999.87.6.2122.

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We sought to determine whether apnea-induced cardiovascular responses resulted in a biologically significant temporary O2 conservation during exercise. Nine healthy men performing steady-state leg exercise carried out repeated apnea (A) and rebreathing (R) maneuvers starting with residual volume +3.5 liters of air. Heart rate (HR), mean arterial pressure (MAP), and arterial O2 saturation (SaO2 ; pulse oximetry) were recorded continuously. Responses (ΔHR, ΔMAP) were determined as differences between HR and MAP at baseline before the maneuver and the average of values recorded between 25 and 30 s into each maneuver. The rate of O2 desaturation (ΔSaO2 /Δ t) was determined during the same time interval. During apnea, ΔSaO2/Δ t had a significant negative correlation to the amplitudes of ΔHR and ΔMAP ( r 2 = 0.88, P < 0.001); i.e., individuals with the most prominent cardiovascular responses had the slowest ΔSaO2 /Δ t. ΔHR and ΔMAP were much larger during A (−44 ± 8 beats/min, +49 ± 4 mmHg, respectively) than during R maneuver (+3 ± 3 beats/min, +30 ± 5 mmHg, respectively). ΔSaO2 /Δ t during A and R maneuvers was −1.1 ± 0.1 and −2.2 ± 0.2% units/s, respectively, and nadir SaO2 values were 58 ± 4 and 42 ± 3% units, respectively. We conclude that bradycardia and hypertension during apnea are associated with a significant temporary O2 conservation and that respiratory arrest, rather than the associated hypoxia, is essential for these responses.

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Danish, Madina, Alyx Shepherd, Kitty Lui, Atul Malhotra, Sheri Hartman, Ellen Lee, Erin Sundermann, and Sarah Banks. "LONELINESS IS INVERSELY ASSOCIATED WITH EXERCISE AND SLEEP APNEA IN OLDER WOMEN AT RISK FOR ALZHEIMER’S DISEASE." Innovation in Aging 6, Supplement_1 (November 1, 2022): 773–74. http://dx.doi.org/10.1093/geroni/igac059.2800.

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Abstract Background Modifiable risk factors (MRF) for Alzheimer’s disease (AD) include sedentary behavior, sleep apnea, and loneliness; however, how these MRFs influence one another is unclear. We examined correlations among loneliness, physical activity and sleep apnea among older women at higher risk for AD. Methods Data were collected as part of the Women: Inflammation and Tau Study, which recruits women age 65–85 with higher AD genetic risk and mild impairment on the Montreal Cognitive Assessment. Participants completed the UCLA Loneliness Scale and home sleep tests to derive the Apnea Hypopnea Index (AHI), a measure of sleep apnea severity. Women wore ActiGraph accelerometers for one week to measure average Moderate-Vigorous Activity per day (MVPA). We used Spearman correlation to examine the relationships among AHI, MVPA and Loneliness Scale score. Results Preliminary data were available for 12 women (mean age=72.4 [SD=2.8], 100% non-Hispanic White). MVPA ranged from 0.3–52.8 minutes (mean=9.38 [SD=14.1]; AHI ranged from 1.5–28.3 (mean=14.0 [SD=9.0] and Loneliness Scale score ranged from 0–34 (mean=9.8 [SD=x]). Significant, positive associations were observed between AHI and Loneliness (rho=.80, p=.006) and a moderate relationship at trend level was notable between higher MVPA and less Loneliness (rho=-9.53, p=.07). AHI did not relate to MVPA. Conclusion Results suggest that loneliness independently relate to both sleep apnea severity and sedentary behavior in older women. Combined interventions that target loneliness in addition to physical activity and sleep may be important in women at-risk for AD.

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Olagunju, Abdulbaril, Naser Yamani, Samuel Unzek, Joyce K. Lee-Iannotti, Farouk Mookadam, and Martina Mookadam. "Impact of Exercise Training on Obstructive Sleep Apnea: A Systematic Review and Meta-analysis of Randomized Trials." Journal of Clinical Exercise Physiology 11, no. 3 (September 1, 2022): 80–90. http://dx.doi.org/10.31189/2165-6193-11.3.80.

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ABSTRACT Background Randomized controlled trials have highlighted the importance of exercise training on the severity of obstructive sleep apnea (OSA). The primary objective of this meta-analysis was to analyze the data from these studies on the severity of OSA indices as measured by formal polysomnography. The secondary objective was to evaluate the effect of exercise on oxygen desaturation index, body mass index and several metabolic parameters associated with OSA. Methods Two independent reviewers and an experienced librarian searched MEDLINE, EMBASE, COCHRANE, and Scopus and SPORTDiscus databases from January 1, 2000, to October 21, 2021 to identify randomized controlled trials that evaluated the impact of exercise training on OSA severity. Pre-exercise and postexercise training data on the primary and secondary objectives were extracted. Results A total of 11 randomized controlled trials (533 study participants) were identified based on the inclusion criteria. The mean pre-exercise and postexercise reduction in apnea hypopnea index was −6.94 event per hour (95% confidence interval [CI]: −10.74 to −3.13, I2 = 84%). The mean changes in oxygen desaturation index and body mass index were −5.32 events per hour (95% CI: −9.65 to −0.99, I2 = 73%) and −1.21 kg·m−2 (95% CI: −1.80 to −0.62, I2 = 49%) respectively. Conclusion In adult patients with OSA, exercise training was associated with statistically significant reduction in OSA severity.

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Alruwaily, Ayyad, Heshma Alruwaili, John Garvey, and Carel W. le Roux. "Can Weight Loss Improve the Cardiovascular Outcomes of Patients with Obesity and Obstructive Sleep Apnea?" Hearts 3, no. 2 (May 24, 2022): 54–65. http://dx.doi.org/10.3390/hearts3020008.

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Cardiovascular events are the primary cause of mortality in patients with obstructive sleep apnea and obesity. The rising prevalence of obstructive sleep apnea in recent decades has been linked to increasing rates of obesity. Obstructive sleep apnea has also been linked with many different cardiovascular diseases including coronary artery disease, stroke, heart failure, hypertension, and atrial fibrillation. Obesity is an increasing health concern globally, in part because obesity complications such as hypertension, diabetes, and obstructive sleep apnea increase the risk of cardiovascular diseases. More than 10% weight loss may be required to prevent or reverse obesity complications. Treatment approaches to obesity include nutritional therapy, exercise therapy, pharmacotherapy, and surgical therapies. This review intends to identify the effects of weight loss on cardiovascular outcomes in patients with obesity and obstructive sleep apnea. Despite the strong association between cardiovascular diseases and obstructive sleep apnea, randomized trials have failed to demonstrate that treatment of obstructive sleep apnea reduces cardiovascular events, even in patients with established cardiovascular diseases. Weight loss in patients with obstructive sleep apnea improves HbA1c, systolic blood pressure, HDL cholesterol, and triglycerides, but thus far no changes in cardiovascular events have been shown. The combination of weight loss with continuous positive airway pressure (CPAP) appears more beneficial than either treatment in isolation. Large well-controlled trials in patients with obstructive sleep apnea to assess the effects of different weight reduction programs on cardiovascular disease are still needed.

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Aron, Adrian, and William G. Herbert. "Factors Influencing Exercise Capacity in Obstructive Sleep Apnea Syndrome Patients." Medicine & Science in Sports & Exercise 41 (May 2009): 226–27. http://dx.doi.org/10.1249/01.mss.0000355247.78679.ce.

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45

Tryfon, Stavros, Ioannis Stanopoulos, Efi Dascalopoulou, Paraskevi Argyropoulou, Demosthenes Bouros, and Euklides Mavrofridis. "Sleep Apnea Syndrome and Diastolic Blood Pressure Elevation during Exercise." Respiration 71, no. 5 (2004): 499–504. http://dx.doi.org/10.1159/000080635.

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46

Vitacca, Michele, Mara Paneroni, Alberto Braghiroli, Bruno Balbi, Maria Aliani, Patrizia Guido, Francesco Fanfulla, et al. "Exercise capacity and comorbidities in patients with obstructive sleep apnea." Journal of Clinical Sleep Medicine 16, no. 4 (April 15, 2020): 531–38. http://dx.doi.org/10.5664/jcsm.8258.

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Rizzi, Camila F., Fatima Cintra, Luciane Mello-Fujita, Lais F. Rios, Elisangela T. Mendonca, Marcia C. Feres, Sergio Tufik, and Dalva Poyares. "Does Obstructive Sleep Apnea Impair the Cardiopulmonary Response to Exercise?" Sleep 36, no. 4 (April 2013): 547–53. http://dx.doi.org/10.5665/sleep.2542.

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Iftikhar, Imran H., Christopher E. Kline, and Shawn D. Youngstedt. "Effects of Exercise Training on Sleep Apnea: A Meta-analysis." Lung 192, no. 1 (September 29, 2013): 175–84. http://dx.doi.org/10.1007/s00408-013-9511-3.

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Edmunds, Kyle, Erika Hagen, Julian Gaitán, Jodi Barnet, Ira Driscoll, Sarah Lose, Alice Motovylyak, Ozioma Okonkwo, and Paul Peppard. "244 Physical fitness attenuates the deleterious association of sleep apnea with gray matter volume in the Wisconsin Sleep Cohort Study." Sleep 44, Supplement_2 (May 1, 2021): A98. http://dx.doi.org/10.1093/sleep/zsab072.243.

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Abstract Introduction Recent evidence has illustrated that gray matter (GM) atrophy, a diagnostic hallmark of Alzheimer’s disease (AD), may be influenced by psychosocial risk modifiers such as physical exercise and sleep. Cardiorespiratory fitness, a measure of oxygen delivery and utilization during exercise, is positively associated with both sleep quality and gray matter volume in brain areas associated with age-related cognitive decline, such as the hippocampus. In contrast, sleep apnea has been linked to global and regional gray matter atrophy, which is thought to be driven in-part by the incomplete modulation of cardiovascular and respiratory control during sleep. This study examines whether cardiorespiratory fitness modifies the deleterious relationship between sleep apnea and GM volume in a sample of non-demented older participants from the Wisconsin Sleep Cohort (WSC). Methods Using data from a subset of WSC participants (n=129, 51% female, mean [range] age at baseline=68 [49-85] years), cardiorespiratory fitness was estimated using a Non-Exercise CardioRespiratory Fitness Measure (NECRFM; based on age, sex, BMI, self-reported physical activity, and resting heart rate). Sleep apnea severity was measured by overnight polysomnography and characterized by the base 10 logarithm of the apnea-hypopnea index, log10(AHI+1). We assembled cross-sectional linear models of MRI-measured total GM volume using NECRFM and log10(AHI+1) as predictors while controlling for age, sex, BMI, education, and hypertension. Regional volumetric changes in the hippocampus and amygdala were assessed using analogous linear models, adjusting both outcome volumetrics for total intracranial volume. Results While the interaction between fitness and apnea severity was not significant (p=0.50), results stratified at the median NECRFM illustrated that among the less fit individuals, higher log10(AHI+1) was associated with a significant reduction in total GM volume (B(SE)=-0.06 (0.02); p=0.007); this relationship was not significant among those who were more fit (B(SE)=-0.03 (0.02); p=0.11). There were no significant effects in the hippocampus or amygdala. Conclusion These results indicate that cardiovascular fitness may attenuate the effect of severe sleep apnea on GM volume in older adults, supporting the protective role of cardiovascular fitness in aging brain health. Support (if any) This work was supported by United States National Institutes of Health grants R01AG058680, R01HL62252, 1R01AG036838, 1UL1RR025011, and R01AG062167.

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Choi, Bo Yoon, Jin Kook Kim, and Jae Hoon Cho. "A Review of a Recent Meta-Analysis Study on Obstructive Sleep Apnea." Journal of Rhinology 29, no. 3 (November 30, 2022): 134–40. http://dx.doi.org/10.18787/jr.2022.00422.

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This paper summarizes a recent meta-analysis of various topics in obstructive sleep apnea (OSA). In addition to cardiovascular disease and neurocognitive dysfunction, a wide variety of diseases have been associated with OSA, and associations with cancer have also been reported. Although continuous positive airway pressure is a very effective treatment, the results have shown that it does not reduce the incidence of various complications. It has been reported that uvulopalatopharyngoplasty was effective, and robotic surgery for the tongue root and hypoglossal nerve stimulation were also effective. The effectiveness of various medications to reduce daytime sleepiness has also been demonstrated. Although exercise lowered the apnea-hypopnea index, it was not related to changes in body composition, and it was also reported that exercise combined with weight control were effective. Additionally, interesting and clinically meaningful meta-analysis results were summarized and presented.

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