Brief Review: Ergospirometry in Patients with Obstructive Sleep Apnea Syndrome

Vasileios Stavrou, Fotini Bardaka, Eleni Karetsi, Zoe Daniil, Konstantinos I Gourgoulianis, Vasileios Stavrou, Fotini Bardaka, Eleni Karetsi, Zoe Daniil, Konstantinos I Gourgoulianis

Abstract

This brief review summarizes the available literature on the intersection of obstructive sleep apnea syndrome (OSAS) and ergospirometry. Ergospirometry provides an assessment of integrative exercise responses involving pulmonary, cardiovascular, neuropsychological, and skeletal muscle systems, which are not adequately reflected through the measurement of individual organ system functions. Sleep disorders, including OSAS, often exacerbate problems in the operation of the autonomic nervous system, heart function, lung mechanics, anxiety, and muscle metabolism. Patients with OSAS have low aerobic capacity due to dysfunction of these systems, which often affect quality of sleep. Further research is necessary to elucidate the precise mechanisms through which ergospirometry can be useful in the assessment and early identification of patients with OSAS.

Keywords: exercise; maximal oxygen uptake; obstructive sleep apnea.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Cardiopulmonary responses to exercise in OSAS.

References

    1. Albouaini K., Egred M., Alahmar A. Cardiopulmonary exercise testing and its application. Postgrad. Med. J. 2007;83:675–682. doi: 10.1136/hrt.2007.121558.
    1. Wasserman K., Hansen J.E., Sue D.Y., Stringer W.W., Whipp B. Principles of Exercise Testing and Interpretation: Including Pathophysiology and Clinical Applications. 4th ed. Lippincott Williams and Wilkins; Philadelphia, PA, USA: 2004.
    1. Mendes F.A., Marone S.M., Duarte B.B., Arenas A.P. Epidemiologic profile of patients with snoring and obstructive sleep apnea in a University Hospital. Int. Arch. Otorhinolaryngol. 2014;18:142–145. doi: 10.1055/s-0033-1359309.
    1. Cintra F.D., Tufik S., Paola A., Feres M.C., Melo-Fujita L., Oliveira W., Rizzi C., Poyares D. Cardiovascular profile in patients with obstructive sleep apnea. Arquivos Bras. Cardiol. 2011;96:293–299. doi: 10.1590/S0066-782X2011005000030.
    1. Aron A., Zedalis D., Gregg J.M., Gwazdauskas F.C., Herbert W.G. Potential clinical use of cardiopulmonary exercise testing in obstructive sleep apnea hypopnea syndrome. Int. J. Cardiol. 2009;132:176–186. doi: 10.1016/j.ijcard.2008.11.014.
    1. Guillermo L.Q., Gal T.J., Mair E.A. Does obstructive sleep apnea affect aerobic fitness? Ann. Otol. Rhinol. Laryngol. 2006;115:715–720. doi: 10.1177/000348940611501001.
    1. Vanuxem D., Badier M., Guillot C., Delpierre S., Jahjah F., Vanuxem P. Impairment of muscle energy metabolism in patients with sleep apnoea syndrome. Respir. Med. 1997;91:551–557. doi: 10.1016/S0954-6111(97)90089-5.
    1. Grote L., Hedner J., Peter H. The heart rate response to exercise is blunted in patients with sleep-related breathing disorder. Cardiology. 2004;102:93–99. doi: 10.1159/000077911.
    1. Chennaoui M., Arnal P.J., Sauvet F., Leger D. Sleep and exercise: A reciprocal issue? Sleep Med. Rev. 2015;20:59–72. doi: 10.1016/j.smrv.2014.06.008.
    1. Chen H.I. Effects of 30-h sleep loss on cardiorespiratory functions at rest and in exercise. Med. Sci. Sports Exerc. 1991;23:193–198. doi: 10.1249/00005768-199102000-00008.
    1. Hill D.W., Borden D.O., Darnaby K.M., Hendricks D.N. Aerobic and anaerobic contributions to exhaustive high-intensity exercise after sleep deprivation. J. Sports Sci. 1994;12:455–461. doi: 10.1080/02640419408732195.
    1. Tryfon S., Stanopoulos I., Dascalopoulou E., Argyropoulou P., Bouros D., Mavrofridis E. Sleep apnea syndrome and diastolic blood pressure elevationduring exercise. Respiration. 2004;71:499–504. doi: 10.1159/000080635.
    1. Bonanni E., Pasquali L., Manca M.L., Maestri M., Prontera C., Fabbrini M., Berrettini S., Zucchelli G., Siciliano G., Murri L. Lactate production and catecholamine profile during aerobic exercise in normotensive OSAS patients. Sleep Med. 2004;5:137–145. doi: 10.1016/j.sleep.2003.08.009.
    1. Ozturk L.M., Metin G., Cuhadaroglu C., Utkusavas A., Tutluoglu B. Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. Tuberk Toraks. 2005;53:10–19.
    1. Lin C.C., Hsieh W.Y., Chou C.S., Liaw S.F. Cardiopulmonary exercise testing in obstructive sleep apnea syndrome. Respir. Physiol. Neurobiol. 2006;150:27–34. doi: 10.1016/j.resp.2005.01.008.
    1. Kaleth A.S., Chittenden T.W., Hawkins B.J., Hargens T.A., Guill S.G., Zedalis D., Gregg J.M., Herbert W.G. Unique cardiopulmonary exercise test responses in overweight middle-aged adults with obstructive sleep apnea. Sleep Med. 2007;8:160–168. doi: 10.1016/j.sleep.2006.08.005.
    1. Vanhecke T., Franklin B., Zalesin K., Sangal B., deJong A., Agrawal V., McCullough P. Cardiorespiratory fitness and obstructive sleep apnea syndrome in morbidly obese patients. Chest. 2008;134:539–545. doi: 10.1378/chest.08-0567.
    1. Ucok K., Aycicek A., Sezer M., Genc A., Akkaya M., Caglar V., Fidan F., Unlu M. Aerobic and anaerobic exercise capacities in obstructive sleep apnea and associations with subcutaneous fat distributions. Lung. 2009;187:29–36. doi: 10.1007/s00408-008-9128-0.
    1. Nanas S., Sakellariou D., Kapsimalakou S., Dimopoulos S., Tassiou A., Tasoulis A., Anastasiou-Nana M., Vagiakis E., Roussos C. Heart rate recovery and oxygen kinetics after exercise in obstructive sleep apnea syndrome. Clin. Cardiol. 2010;33:46–51. doi: 10.1002/clc.20707.
    1. Ackel-D’Elia C., da Silva A.C., Silva R.S., Truksinas E., Sousa B.S., de Mello M.T., Bittencourt L.R. Effects of exercise training associated with continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome. Sleep Breath. 2012;16:723–735. doi: 10.1007/s11325-011-0567-0.
    1. Rizzi C.F., Cintra F., Mello-Fujita L., Rios L.F., Mendonca E.T., Feres M.C., Poyares D. Does obstructive sleep apnea impair the cardiopulmonary response to exercise? Sleep. 2013;36:547–553. doi: 10.5665/sleep.2542.
    1. Beitler J.R., Awad K.M., Bakker J.P., Edwards B.A., DeYoung P., Djonlagic I., Malhotra A. Obstructive Sleep Apnea Is Associated with Impaired Exercise Capacity: A Cross-Sectional Study. J. Clin. Sleep Med. 2014;10:1199–1204. doi: 10.5664/jcsm.4200.
    1. Stavrou V., Vavougios G., Pastaka C., Daniil Z., Gourgoulianis K., Karetsi E. The cardiopulmonary exercise testing as a novel predictive tool of sleep apnea syndrome; Proceedings of the ERS International Congress; Amsterdam, The Nederland. 26–30 September 2015; p. PA2321.
    1. Mansukhani M.P., Allison T.G., Lopez-Jimenez F., Somers V.K., Caples S.M. Functional aerobic capacity in patients with sleep-disordered breathing. Am. J. Cardiol. 2013;111:1650–1654. doi: 10.1016/j.amjcard.2013.02.008.
    1. Carlson J.T., Hedner J.A., Sellgren J., Elam M., Wallin B.G. Depressed baroreflex sensitivity in patients with obstructive sleep apnea. Am. J. Respir. Crit. Care Med. 1996;154:1490–1496. doi: 10.1164/ajrccm.154.5.8912770.
    1. Somers V.K., Dyken M.E., Mark A.L., Abboud F.M. Sympathetic-nerve activity during sleep in normal subjects. N. Engl. J. Med. 1993;328:303–307. doi: 10.1056/NEJM199302043280502.
    1. Parati G., Lombardi C., Narkiewicz K. Sleep apnea: Epidemiology, pathophysiology, and relation to cardiovascular risk. Am. J. Physiol. Regul. Integr. Comp. Physiol. 2007;293:1671–1683. doi: 10.1152/ajpregu.00400.2007.
    1. Somers V.K., Mark A.L., Zavala D.C., Abboud F.M. Contrasting effects of hypoxia and hypercapnia on ventilation and sympathetic activity in humans. J. Appl. Physiol. 1989;67:2101–2106. doi: 10.1152/jappl.1989.67.5.2101.
    1. Cintra F.D., Leite R.P., Storti L.J., Bittencourt L.A., Poyares D., Castro L., Tufic S., Paola A. Sleep Apnea and Nocturnal Cardiac Arrhythmia: A Populational Study. Arquivos Bras. Cardiol. 2014;103:368–374. doi: 10.5935/abc.20140142.
    1. Conway J., Boon N., Jones J.V., Sleight P. Involvement of the baroreceptor reflexes in the changes in blood pressure with sleep and mental arousal. Hypertension. 1983;5:746–774. doi: 10.1161/01.HYP.5.5.746.
    1. Appelberg J., Nordahl G., Janson C. Lung volume and its correlation to nocturnal apnoea and desaturation. Respir. Med. 2000;94:233–239. doi: 10.1053/rmed.1999.0730.
    1. Abdeyrim A., Zhang Y., Li N. Impact of obstructive sleep apnea on lung volumes and mechanical properties of the respiratory system in overweight and obese individuals. BMC Pulm. Med. 2015;15:76–81. doi: 10.1186/s12890-015-0063-6.
    1. Malley W.J. Clinical Blood Gases. 2nd ed. Elsevier. Saunders; St. Louis, MO, USA: 2005. p. 355.
    1. Dempsey J. Crossing the apnoeic threshold: Causes and consequences. Exp. Physiol. 2004;90:13–24. doi: 10.1113/expphysiol.2004.028985.
    1. Kawata N., Tatsumi K., Terada J., Tada Y., Tanabe N., Takiguchi Y., Kuriyama T. Daytime hypercapnia in obstructive sleep apnea syndrome. Chest. 2007;132:1832–1838. doi: 10.1378/chest.07-0673.
    1. Temesi J., Arnal P.J., Davranche K., Bonnefoy R., Levy P., Verges S., Millet G.Y. Does central fatigue explain reduced cycling after complete sleep deprivation? Med. Sci. Sports Exerc. 2013;45:2243–2253. doi: 10.1249/MSS.0b013e31829ce379.
    1. Matsumoto Y., Mishima K., Satoh K., Shimizu T., Hishikawa Y. Physical activity increases the dissociation between subjective sleepiness and objective performance levels during extended wakefulness in human. Neurosci. Lett. 2002;326:133–136. doi: 10.1016/S0304-3940(02)00335-X.
    1. Kamphuis J., Meerlo P., Koolhaas J.M., Lancel M. Poor sleep as a potential causal factor in aggression and violence. Sleep Med. 2012;13:327–334. doi: 10.1016/j.sleep.2011.12.006.
    1. Wåhlin Larsson B., Kadi F., Ulfberg J., Piehl Aulin K. Skeletal muscle morphology and aerobic capacity in patients with obstructive sleep apnoea syndrome. Respiration. 2008;76:21–27. doi: 10.1159/000126492.
    1. Sauleda J., García-Palmer F.J., Tarraga S., Maimó A., Palou A., Agustí A.G. Skeletal muscle changes in patients with obstructive sleep apnoea syndrome. Respir. Med. 2003;97:804–810. doi: 10.1016/S0954-6111(03)00034-9.
    1. El-Manshawi A., Killian K.J., Summers E., Jones N.L. Breathlessness during exercise with and without resistive loading. J. Appl. Physiol. 1986;61:896–905. doi: 10.1152/jappl.1986.61.3.896.
    1. Aguillard R.N., Riedel B.W., Lichstein K.L., Grieve F.G., Johnson C.T., Noe S.L. Daytime functioning in obstructive sleep apnea patients: Exercise tolerance, subjective fatigue, and sleepiness. Appl. Psychophysiol. Biofeedback. 1998;23:207–217. doi: 10.1023/A:1022257514209.

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