Yang Hongyan, Liu Yuanhua, Zheng Huan, Liu Guanghui, Mei Aihong
Department of Neurology, Tongji Hospital Branch affiliated to Tongji University, Shanghai, China.
Department of Neurology, Tongji Hospital affiliated to Tongji University, Shanghai, China.
Sleep Breath. 2018 Dec;22(4):1189-1195. doi: 10.1007/s11325-018-1736-1. Epub 2018 Oct 16.
Regular exercise is confirmed as a lifestyle treatment option for all obstructive sleep apnea (OSA) patients. It has beneficial effects other than weight loss, although the mechanisms remain unclear. Autonomic function imbalance plays an important role in OSA, so that it is meaningful to observe the effect of exercise on autonomic function.
Seventy mild to moderate OSA patients were divided into two groups. The exercise group received a 12-week exercise program prescribed according to their first cardiopulmonary exercise tests, while the control group kept previous lifestyle. All patients underwent blood tests, cardiopulmonary exercise tests, and polysomnography studies at enrollment and at the 12-week's follow-up.
At the end of 12 weeks, three patients of the exercise group did not complete the program due to lack of adherence. The current study showed 12-week aerobic exercises could improve body mass index (27.6 ± 4.7 kg/m vs. 24.5 ± 4.2 kg/m, P < 0.05), exercise capacities, apnea-hypopnea index (total AHI 20.2 ± 7.5 vs. 16.4 ± 5.2, P < 0.05; supine AHI 22.1 ± 6.3 vs. 18.3 ± 4.9, P < 0.05), average oxyhemoglobin saturation (AverSpO2), time/percentage SpO2 below 90%, and heart rate recovery (HRR) of OSA patients. Moreover, AverSpO2 change was significantly associated with HRR change in the exercise group.
Our findings suggested regular aerobic exercise had beneficial effects on body mass index, functional capacity, intermittent hypoxia, and parasympathetic tone of OSA patients, and whether parasympathetic tone modification plays a role in improving intermittent hypoxia or not deserves further exploration.
规律运动已被确认为所有阻塞性睡眠呼吸暂停（OSA）患者的一种生活方式治疗选择。尽管其机制尚不清楚，但运动除了有助于减肥外，还有其他有益作用。自主神经功能失衡在OSA中起重要作用，因此观察运动对自主神经功能的影响具有重要意义。
70例轻度至中度OSA患者被分为两组。运动组根据其首次心肺运动试验接受为期12周的运动方案，而对照组保持以往的生活方式。所有患者在入组时和随访12周时均接受血液检查、心肺运动试验和多导睡眠图研究。
12周结束时，运动组有3例患者因依从性差未完成方案。本研究表明，12周的有氧运动可改善OSA患者的体重指数（27.6±4.7kg/m²对24.5±4.2kg/m²，P<0.05）、运动能力、呼吸暂停低通气指数（总AHI：20.2±7.5对16.4±5.2，P<0.05；仰卧位AHI：22.1±6.3对18.3±4.9，P<0.05）、平均氧合血红蛋白饱和度（AverSpO2）、SpO2低于90%的时间/百分比以及心率恢复（HRR）。此外，运动组中AverSpO2变化与HRR变化显著相关。
我们的研究结果表明，规律有氧运动对OSA患者的体重指数、功能能力、间歇性缺氧和副交感神经张力有有益影响，副交感神经张力调节是否在改善间歇性缺氧中起作用值得进一步探索。
