Department of Sleep Medicine, Wilford Hall Ambulatory Surgical Center, JBSA-Lackland AFB, San Antonio, TX, USA.
Pediatrics, Malcolm Grow Medical Clinic, 1060 W Perimeter Rd, MD, 20762, Joint Base Andrews, USA.
Sleep Breath. 2023 Mar;27(1):137-144. doi: 10.1007/s11325-022-02587-1. Epub 2022 Feb 25.
The relationship between moderate to severe OSA and exercise capacity remains unclear. Prior studies showing a reduction in VO max in this population have mostly involved middle-aged, overweight patients. We aimed to study this relationship in a similarly aged population of military personnel with previously undiagnosed moderate to severe OSA.
We studied late-career male military personnel who underwent CPET and polysomnography (PSG). Patients were categorized either into an OSA group (apnea-hypopnea index (AHI) ≥ 15 events/h) or a control group (AHI < 15 events/h). VO max was compared between groups.
170 male military personnel met criteria for the study. Mean AHI was 29.0/h in the OSA group (n = 58) versus 7.4/h in the controls (n = 112) while SpO nadir was slightly lower (86.0% vs. 89.0%). Patients were of similar age (53.1 vs. 53.7 years), and BMI was slightly higher in the OSA group (27.5 kg/m vs. 26.3 kg/m). Percent-predicted VO max was supernormal in both groups, though it was comparatively lower in the OSA group (117% vs. 125%; p < 0.001).
Military personnel with moderate to severe OSA were able to achieve supernormal VO max values, yet had an 8% decrement in exercise capacity compared to controls. These findings suggest that OSA without significant hypoxemia may not significantly influence exercise capacity. It remains likely that the effects of untreated OSA on exercise capacity are complex and are affected by several variables including BMI, degree of associated hypoxemia, and regularity of exercise. Statistically lower VO max noted in this study may suggest that untreated OSA in less fit populations may lead to significant decrements in exercise capacity.
中重度阻塞性睡眠呼吸暂停（OSA）与运动能力之间的关系尚不清楚。先前的研究表明，该人群的最大摄氧量（VO max）降低，这些研究主要涉及中年超重患者。我们旨在研究在具有先前未诊断出的中重度 OSA 的年龄相似的军事人员人群中这种关系。
我们研究了接受 CPET 和多导睡眠图（PSG）检查的职业后期男性军事人员。将患者分为 OSA 组（呼吸暂停-低通气指数（AHI）≥15 次/小时）或对照组（AHI＜15 次/小时）。比较两组间 VO max。
170 名男性军事人员符合研究标准。OSA 组（n=58）的平均 AHI 为 29.0/小时，对照组（n=112）为 7.4/小时，而 SpO 最低值略低（86.0%比 89.0%）。患者年龄相似（53.1 岁比 53.7 岁），OSA 组的 BMI 略高（27.5kg/m 比 26.3kg/m）。两组的预测 VO max 均为超正常值，尽管 OSA 组的预测 VO max 相对较低（117%比 125%；p＜0.001）。
患有中重度 OSA 的军人能够达到超正常值的 VO max 值，但与对照组相比，运动能力降低了 8%。这些发现表明，没有明显低氧血症的 OSA 可能不会对运动能力产生显著影响。未治疗的 OSA 对运动能力的影响可能仍然复杂，并受多种变量的影响，包括 BMI、相关低氧血症的程度以及运动的规律性。本研究中观察到的 VO max 较低可能表明，在运动能力较低的人群中，未经治疗的 OSA 可能导致运动能力显著下降。
