Dobrosielski Devon A, Patil Susheel, Schwartz Alan R, Bandeen-Roche Karen, Stewart Kerry J
1Department of Kinesiology, Towson University, Towson, MD; 2Department of Medicine, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD; 3Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore MD; and 4Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Med Sci Sports Exerc. 2015 Jan;47(1):20-6. doi: 10.1249/MSS.0000000000000387.
Obstructive sleep apnea (OSA) is prevalent among older individuals and is linked to increased cardiovascular disease morbidity. This study examined the change in OSA severity after exercise training and dietary-induced weight loss in older adults and the association of the changes in OSA severity, body composition, and aerobic capacity with arterial distensibility.
Obese adults (n = 25) with OSA, age 60 yr or older, were instructed to participate in supervised exercise (3 d·wk) and follow a calorie-restricted diet. Baseline assessments of OSA parameters, body weight and composition, aerobic capacity, and arterial distensibility were repeated at 12 wk.
Nineteen participants completed the intervention. At 12 wk, there were reductions in body weight (-9%) and percentage of total body fat (-5%) and trunk fat (-8%) whereas aerobic capacity improved by 20% (all P < 0.01). The apnea-hypopnea index decreased by 10 events per hour (P < 0.01) and nocturnal SaO2 (mean SaO2) improved from 94.9% at baseline to 95.2% after intervention (P = 0.01). Arterial distensibility for the group was not different from that at baseline (P = 0.99), yet individual changes in distensibility were associated with the change in nocturnal desaturations (r = -0.49, P = 0.03) but not with the change in body weight, apnea-hypopnea index, or aerobic capacity.
The severity of OSA was reduced after an exercise and weight loss program among older adults, suggesting that this lifestyle approach may be an effective first-line nonsurgical and nonpharmacological treatment for older patients with OSA.
阻塞性睡眠呼吸暂停（OSA）在老年人中普遍存在，且与心血管疾病发病率增加有关。本研究调查了老年人运动训练和饮食诱导体重减轻后OSA严重程度的变化，以及OSA严重程度、身体成分和有氧能力的变化与动脉扩张性之间的关联。
25名年龄在60岁及以上的肥胖OSA成年人被指导参加有监督的运动（每周3天）并遵循热量限制饮食。在12周时重复进行OSA参数、体重和成分、有氧能力以及动脉扩张性的基线评估。
19名参与者完成了干预。在12周时，体重减轻了9%，全身脂肪百分比降低了5%，躯干脂肪降低了8%，而有氧能力提高了20%（所有P<0.01）。呼吸暂停低通气指数每小时减少10次事件（P<0.01），夜间血氧饱和度（平均血氧饱和度）从基线时的94.9%提高到干预后的95.2%（P = 0.01）。该组的动脉扩张性与基线时无差异（P = 0.99），但动脉扩张性的个体变化与夜间去饱和的变化相关（r = -0.49，P = 0.03），而与体重、呼吸暂停低通气指数或有氧能力的变化无关。
老年人进行运动和减肥计划后OSA严重程度降低，这表明这种生活方式可能是老年OSA患者有效的一线非手术和非药物治疗方法。
