Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, ON, Canada.
Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, ON, Canada Dept of Medicine, University Health Network, Toronto General Hospital, Toronto, ON, Canada.
Eur Respir J. 2016 Jul;48(1):142-50. doi: 10.1183/13993003.01897-2015. Epub 2016 Apr 13.
Overnight fluid shift from the legs to the neck and lungs may contribute to the pathogenesis of obstructive sleep apnoea (OSA) and central sleep apnoea (CSA). We hypothesised that exercise training will decrease the severity of OSA and CSA in patients with coronary artery disease (CAD) by decreasing daytime leg fluid accumulation and overnight rostral fluid shift.Patients with CAD and OSA or CSA (apnoea-hypopnoea index >15 events per h) were randomised to 4 weeks of aerobic exercise training or to a control group. Polysomnography, with measurement of leg, thoracic and neck fluid volumes and upper-airway cross-sectional area (UA-XSA) before and after sleep, was performed at baseline and follow-up.17 patients per group completed the study. Apnoea-hypopnoea index decreased significantly more in the exercise group than in the control group (31.1±12.9 to 20.5±9.4 versus 28.1±13.5 to 27.0±15.1 events per h, p=0.047), in association with a greater reduction in the overnight change in leg fluid volume (579±222 to 466±163 versus 453±164 to 434±141 mL, p=0.04) and by a significantly greater increase in the overnight change in UA-XSA in the exercise group (p=0.04).In patients with CAD and sleep apnoea, exercise training decreases sleep apnoea severity via attenuation of overnight fluid shift and an increase in UA-XSA.
夜间体液从腿部转移到颈部和肺部可能导致阻塞性睡眠呼吸暂停（OSA）和中枢性睡眠呼吸暂停（CSA）的发病机制。我们假设，运动训练通过减少白天腿部液体积累和夜间向前的液体转移，将降低冠心病（CAD）患者的 OSA 和 CSA 的严重程度。
患有 CAD 和 OSA 或 CSA（呼吸暂停-低通气指数>15 次/小时）的患者被随机分为有氧运动训练组或对照组，每组 4 周。在基线和随访时，进行多导睡眠图检查，并测量腿部、胸部和颈部的液体量以及上气道横截面积（UA-XSA），在睡眠前后进行。每组有 17 名患者完成了研究。与对照组相比，运动组的呼吸暂停-低通气指数明显降低（31.1±12.9 至 20.5±9.4 与 28.1±13.5 至 27.0±15.1 次/小时，p=0.047），夜间腿部液体量的变化也明显减少（579±222 至 466±163 与 453±164 至 434±141 毫升，p=0.04），并且运动组的夜间 UA-XSA 变化明显增加（p=0.04）。
在患有 CAD 和睡眠呼吸暂停的患者中，运动训练通过减轻夜间体液转移和增加 UA-XSA 来降低睡眠呼吸暂停的严重程度。
