Kyrgyz State Medical Academy named after I.K. Akhunbaev, Akhunbaev Street 92, Bishkek 720020, Kyrgyzstan.
Med Hypotheses. 2013 Feb;80(2):125-8. doi: 10.1016/j.mehy.2012.11.007. Epub 2012 Dec 3.
Obstructive sleep apnea (OSA) is a common and underdiagnosed medical disorder. OSA is associated with the symptoms of excessive daytime sleepiness (EDS). These patients typically follow a sedentary lifestyle, and sedentary behavior is related to impaired fluid dynamics in the lower body, particularly the legs. In a supine position this fluid can move towards the neck, with a subsequent increase in upper airway (UA) resistance and UA collapse. Several studies have shown that rostral fluid shift worsens OSA; however, whether physical activity can influence this has not been tested. Physical activity related improvement in OSA severity cannot be fully explained by a weight loss in the performed studies, which is of particular importance. One of the potential additional pathways is via an improvement in leg fluid dynamics, with a subsequent decrease in the supine fluid shift toward the neck, since physical activity improves leg fluid dynamics. It is likely that patients with fluid overload states such as heart failure, chronic kidney disease and resistant arterial hypertension, as well as patients with EDS are likely to benefit the most from physical exercise in terms of better leg fluid clearance, and potentially in terms of OSA severity. However, none of the studies have directly assessed the potential effect of physical activity on the leg fluid volume, and more importantly on the supine fluid shift and OSA severity. These questions should be addressed in future studies of the effects of physical exercise on OSA severity.
阻塞性睡眠呼吸暂停（OSA）是一种常见且诊断不足的医学疾病。OSA 与日间嗜睡（EDS）的症状有关。这些患者通常过着久坐的生活方式，而久坐行为与下肢（尤其是腿部）的流体动力学受损有关。在仰卧位时，这种液体可以向颈部移动，导致上呼吸道（UA）阻力增加和 UA 塌陷。多项研究表明，颅向液体移位会加重 OSA；然而，尚未测试过体力活动是否会对此产生影响。在已进行的研究中，与体力活动相关的 OSA 严重程度改善不能完全用减轻的体重来解释，这一点尤为重要。一个潜在的额外途径是通过改善腿部流体动力学，随后减少仰卧位时液体向颈部的转移，因为体力活动可以改善腿部流体动力学。患有液体超负荷状态（如心力衰竭、慢性肾病和难治性动脉高血压）以及患有 EDS 的患者，很可能会从体力锻炼中获益最多，因为这可以更好地清除腿部液体，并可能改善 OSA 严重程度。然而，没有一项研究直接评估体力活动对腿部液体量的潜在影响，更重要的是对仰卧位液体移位和 OSA 严重程度的影响。这些问题应该在未来关于体力活动对 OSA 严重程度影响的研究中得到解决。
