University of Calgary, 7007-14th St. SW, Calgary, Alberta, Canada.
Respir Med. 2011 Oct;105(10):1565-71. doi: 10.1016/j.rmed.2011.06.007. Epub 2011 Jul 13.
Obese subjects commonly suffer from exertional dyspnea and exercise intolerance. Preliminary evidence suggests that treatment with nocturnal continuous positive airway pressure (nCPAP) may improve dyspnea in obese patients with obstructive sleep apnea (OSA), but the effect on exercise tolerance is unknown. This study sought to investigate whether nCPAP improves exercise tolerance and exertional dyspnea in obese patients with OSA. Obese patients prescribed nCPAP for moderate/severe OSA and without cardiopulmonary disease were recruited. Patients completed a constant-load exercise test and Baseline and Transitional Dyspnea Index questionnaires (BDI/TDI) at baseline and after one and three months of nCPAP. Primary outcome was change in constant-load exercise time from baseline to one and three months. Secondary outcomes included changes in isotime dyspnea, isotime leg fatigue and BDI/TDI score at one and three months. Fifteen subjects (body mass index = 43 kg m(-2), apnea-hypopnea index = 49(.)hr(-1)) were studied. Constant-load exercise time increased by 2.0 min (40%, p = 0.02) at one month and 1.8 min (36%, p = 0.04) at three months. At one and three months, isotime dyspnea decreased by 1.4 (p = 0.17) and 2 units (p = 0.04), and leg fatigue decreased by 1.2 (p = 0.18) and 2 units (p = 0.02), respectively. BDI/TDI scores were 2.7 (p = 0.001) and 4.5 points (p < 0.001) at one and three months. Peak oxygen consumption and static pulmonary function were unchanged. Nocturnal CPAP improves exercise tolerance and dyspnea in obese patients with OSA. Effects on exercise time and chronic dyspnea were seen after one and three months of nCPAP, while exertional dyspnea was only improved at three months.
肥胖患者常患有运动性呼吸困难和运动不耐受。初步证据表明，夜间持续气道正压通气（nCPAP）治疗可能改善阻塞性睡眠呼吸暂停（OSA）肥胖患者的呼吸困难，但对运动耐量的影响尚不清楚。本研究旨在探讨 nCPAP 是否能改善肥胖 OSA 患者的运动耐量和运动性呼吸困难。招募了被处方 nCPAP 治疗中重度/重度 OSA 且无心肺疾病的肥胖患者。患者在基线和 nCPAP 治疗 1 个月和 3 个月时完成恒负荷运动试验和基线和过渡性呼吸困难指数问卷（BDI/TDI）。主要结局是从基线到 1 个月和 3 个月时恒负荷运动时间的变化。次要结局包括 1 个月和 3 个月时等时呼吸困难、等时腿部疲劳和 BDI/TDI 评分的变化。15 名受试者（体重指数为 43kg/m2，呼吸暂停低通气指数为 49[.]hr-1）接受了研究。恒负荷运动时间在 1 个月时增加了 2.0 分钟（40%，p=0.02），在 3 个月时增加了 1.8 分钟（36%，p=0.04）。在 1 个月和 3 个月时，等时呼吸困难分别降低了 1.4 个单位（p=0.17）和 2 个单位（p=0.04），腿部疲劳分别降低了 1.2 个单位（p=0.18）和 2 个单位（p=0.02）。BDI/TDI 评分在 1 个月和 3 个月时分别为 2.7 分（p=0.001）和 4.5 分（p<0.001）。峰值耗氧量和静态肺功能无变化。夜间 CPAP 可改善肥胖 OSA 患者的运动耐量和呼吸困难。在 nCPAP 治疗 1 个月和 3 个月后，观察到运动时间和慢性呼吸困难的改善，但仅在 3 个月时改善了运动性呼吸困难。
