. Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil.
. Programa de Pós-Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil.
J Bras Pneumol. 2019 Jun 19;45(3):e20180085. doi: 10.1590/1806-3713/e20180085.
To investigate the extent to which exercise is associated with symptoms in patients with severe obstructive sleep apnea (OSA).
We included subjects with an apnea-hypopnea index (AHI) > 30 events/h who completed validated sleep and exercise questionnaires. We compared symptom frequency/scores between exercisers and nonexercisers, adjusting for the usual confounders.
The sample included 907 nonexercisers and 488 exercisers (mean age, 49 ± 14 years; mean AHI, 53 ± 20 events/h; 81% men). Nonexercisers and exercisers differed significantly in terms of obesity (72% vs. 54%), the mean proportion of sleep in non-rapid eye movement stage 3 sleep (9 ± 8% vs. 11 ± 6%), and tiredness (78% vs. 68%). Nonexercisers had a higher symptom frequency/scores and poorer sleep quality. Adjustment for exercise weakened the associations between individual symptoms and the AHI, indicating that exercise has a mitigating effect. In binary logistic models, exercise was associated with approximately 30% lower adjusted questionnaire1 score > 2, tiredness; poor-quality sleep, unrefreshing sleep, and negative mood on awakening. Although the odds of an Epworth Sleepiness Scale score > 10 were lower in exercisers, that association did not withstand adjustment for confounders.
Exercise is associated with lower frequency/intensity of symptoms in patients with severe OSA. Because up to one third of patients with severe OSA might exercise regularly and therefore be mildly symptomatic, it is important not to rule out a diagnosis of OSA in such patients.
探讨运动与严重阻塞性睡眠呼吸暂停（OSA）患者症状之间的关联程度。
我们纳入了 AHI＞30 次/小时且完成了经过验证的睡眠和运动问卷的患者。我们比较了运动者和非运动者之间的症状频率/评分，并对常见混杂因素进行了调整。
样本包括 907 名非运动者和 488 名运动者（平均年龄 49±14 岁；平均 AHI 53±20 次/小时；81%为男性）。非运动者和运动者在肥胖（72%比 54%）、非快速眼动睡眠 3 期睡眠的平均比例（9±8%比 11±6%）和疲劳感（78%比 68%）方面存在显著差异。非运动者的症状频率/评分更高，睡眠质量更差。运动的调整削弱了个别症状与 AHI 之间的关联，表明运动具有缓解作用。在二元逻辑模型中，运动与调整后问卷 1 评分＞2 的疲劳感、睡眠质量差、醒来时无精打采和情绪消极的可能性降低了约 30%。虽然运动者出现 Epworth 嗜睡量表评分＞10 的几率较低，但这种关联在调整混杂因素后并不成立。
运动与严重 OSA 患者症状的频率/强度降低有关。由于多达三分之一的严重 OSA 患者可能经常运动，因此症状较轻，因此在这些患者中，不要排除 OSA 的诊断很重要。
