Does Obstructive Sleep Apnea Affect Aerobic Fitness?

Abstract

Objectives:

We sought to determine whether patients with obstructive sleep apnea (OSA) had an objective change in aerobic fitness during cycle ergometry compared to a normal population. The most accurate test of aerobic fitness is measurement of maximum oxygen consumption (V̇O2max) with cycle ergometry.

Methods:

We performed a retrospective cohort analysis (247 patients with OSA) of V̇O2max from annual cycle ergometry tests compared to a large control group (normative data from 1.4 million US Air Force tests) in a tertiary care setting.

Results:

Overall, individuals with OSA had increased V̇O2max when compared to the normalized US Air Force data (p > .001). Patients with an apnea-hypopnea index of greater than 20 demonstrated a decreased V̇O2max as compared to normalized values (p > .001). No differences in V̇O2max were observed after either medical or surgical therapy for OSA.

Conclusions:

Overall, in a US Air Force population, OSA does not predict a decrease in aerobic fitness as measured by cycle ergometry. However, patients with an apnea-hypopnea index of greater than 20 have a statistically significant decrease in aerobic fitness compared to the normal population. This study demonstrates the effects of OSA on aerobic fitness. Further correlation of fitness testing results with OSA severity and treatment is needed.

Keywords

aerobic fitness cycle ergometry obstructive sleep apnea

Get full access to this article

View all access options for this article.

References

Young

Palta

Dempsey

Skatrud

Weber

Badr

. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230–5.

Partinen

Guilleminault

. Daytime sleepiness and vascular morbidity at seven-year follow-up in obstructive sleep apnea patients. Chest 1990;97:27–32.

Plyley

Shephard

Davis

Goode

. Sleep deprivation and cardiorespiratory function. Influence of intermittent submaximal exercise. Eur J Appl Physiol Occup Physiol 1987;56:338–44.

Martin

Gaddis

. Exercise after sleep deprivation. Med Sci Sports Exerc 1981;13:220–3.

Bond

Balkissoon

Franks

. Effects of sleep deprivation on performance during submaximal and maximal exercise. J Sports Med Phys Fitness 1986;26:169–74.

Shifflett

Walker

Gregg

Zedalis

Herbert

. Effects of short-term PAP treatment on endurance exercise performance in obstructive sleep apnea patients. Sleep Med 2001;2:145–51.

Taguchi

Hida

Okabe

. Improvement of exercise performance with short-term nasal continuous positive airway pressure in patients with obstructive sleep apnea. Tokohu J Exp Med 1997;183:45–53.

Konermann

Sanner

Klewer

Kreuzer

Laschewski

Burmann-Urbanek

. Modification of cardiopulmonary performance parameters in patients with obstructive sleep apnea treated with nCPAP therapy [in German]. Wien Med Wochenschr 1996; 146:340–3.

Montoye

Ayen

Washburn

. The estimation of V̇O2max from maximal and submaximal measurements in males, age 10–39. Res Q Exerc Sport 1986;57:250–3.

10.

DeVries

Klafs

. Prediction of maximal oxygen intake from submaximal tests. J Sports Med Phys Fitness 1965; 5:207–14.

11.

Kasch

. The validity of the Astrand and Sjostrand submaximal tests. Physiol Sports Med 1984;12:47–52.

12.

Willich

Lewis

Lowel

Arntz

Schubert

Schroder

. Physical exertion as a trigger of acute myocardial infarction. Triggers and Mechanisms of Myocardial Infarction Study Group. N Engl J Med 1993;329:1684–90.

13.

Directorate CSDaCT. User's guide for the Air Force cycle ergometry test for estimating aerobic capacity. Version 3.1. Armstrong Laboratory, Human Systems Center (AFMC), 1993.

14.

Astrand

Ryhming

. A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during submaximal work. J Appl Physiol 1954;7:218–21.

15.

Sajkov

Cowie

Thornton

Espinoza

McEvoy

. Pulmonary hypertension and hypoxia in obstructive sleep apnea syndrome. Am J Respir Crit Care Med 1994; 149:416–22.

16.

Shiomi

Guilleminault

Stoohs

Schnittger

. Leftward shift of the interventricular septum and pulsus paradoxus in obstructive sleep apnea syndrome. Chest 1991;100:894–902.

17.

Hedner

Darpo

Ejnell

Carlson

Caidahl

. Reduction in sympathetic activity after long-term CPAP treatment in sleep apnoea: Cardiovascular implications. Eur Respir J 1995;8:222–9.

18.

Lin

Chang

Lee

Chou

Lin

. Effect of treatment by laser-assisted uvulopalatoplasty on cardiopulmonary exercise test in obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg 2005;133:55–61.

19.

George

Kab

Levy

. Increased prevalence of sleep-disordered breathing among professional football players. N Engl J Med 2003;348:367–8.

20.

Kribbs

Pack

Kline

. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis 1993; 147:887–95.