Functional aerobic capacity in patients with sleep-disordered breathing

Meghna Mansukhani, Thomas G. Allison, Francisco Lopez-Jimenez, Virend Somers, Sean M. Caples

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Few studies have examined exercise capacity or cardiovascular responses to maximal exercise testing and recovery in patients with sleep-disordered breathing (SDB), and results from these studies are conflicting. The objective of this cross-sectional study conducted at a tertiary referral center was to examine the association between SDB and exercise testing outcomes independent of body mass index (BMI) and other cardiopulmonary risk factors. Between January 1, 2005 and January 1, 2010, 1,424 adults underwent exercise testing and within 6 months before first-time diagnostic polysomnography. Subjects were categorized by apnea-hypopnea index (AHI) into 4 groups: <5, 5 to 14, 15 to 29, and ≥30. A logistic regression model incorporated age, gender, BMI, smoking, hypertension, diabetes, beta-blocker use, and cardiac and pulmonary disease as covariates. The primary variable of interest was functional aerobic capacity (FAC). Mean age was 56.4 ± 12.4 years; 75% were men. Mean BMI was 32.4 ± 7.1 kg/m, and mean AHI 19.5 ± 22.1 per hour. On multivariate analysis, AHI as a continuous variable showed a negative correlation with FAC (Radj = 0.30, p <0.001) and postexercise SBP (Radj = 0.23, p = 0.03), and positively correlated with resting and peak DBP (Radj = 0.09, p = 0.01 and Radj = 0.09, p = 0.04 respectively). When comparing patients with severe SDB (AHI ≥30) with those without SDB (AHI <5), FAC and heart rate recovery were significantly lower, and resting, peak, and postexercise DBP were higher in those with severe apnea (all p <0.05), after accounting for confounders. In conclusion, SDB severity was associated with reduced FAC and increased resting and peak DBP. Even after accounting for confounders, severe SDB was associated with attenuated FAC, impaired heart rate recovery, and higher resting, peak, and postexercise DBP.

Original languageEnglish (US)
Pages (from-to)1650-1654
Number of pages5
JournalAmerican Journal of Cardiology
Volume111
Issue number11
DOIs
StatePublished - Jun 1 2013

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Sleep Apnea Syndromes
Apnea
Body Mass Index
Exercise
Heart Rate
Logistic Models
Breathing Exercises
Polysomnography
Tertiary Care Centers
Lung Diseases
Heart Diseases
Multivariate Analysis
Cross-Sectional Studies
Smoking
Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Functional aerobic capacity in patients with sleep-disordered breathing. / Mansukhani, Meghna; Allison, Thomas G.; Lopez-Jimenez, Francisco; Somers, Virend; Caples, Sean M.

In: American Journal of Cardiology, Vol. 111, No. 11, 01.06.2013, p. 1650-1654.

Research output: Contribution to journalArticle

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