CPAP increases exercise tolerance in obese subjects with obstructive sleep apnea
Sachin R Pendharkar1, Willis H Tsai, Neil D Eves
1University of Calgary, 7007-14th St. SW, Calgary, Alberta, Canada.
Respiratory Medicine
|July 12, 2011
Summary
Nocturnal continuous positive airway pressure (nCPAP) significantly improves exercise tolerance and reduces dyspnea in obese patients with obstructive sleep apnea (OSA). These benefits were observed after one and three months of nCPAP treatment.
Area of Science:
- Pulmonary Medicine
- Sleep Medicine
- Cardiorespiratory Exercise Physiology
Background:
- Obesity is frequently associated with exertional dyspnea and reduced exercise tolerance.
- Obstructive sleep apnea (OSA) is common in obese individuals and may contribute to these symptoms.
- The impact of nocturnal continuous positive airway pressure (nCPAP) on exercise capacity in obese OSA patients is not well-established.
Purpose of the Study:
- To investigate the effects of nCPAP on exercise tolerance and exertional dyspnea in obese patients with moderate to severe OSA.
- To determine the time course of these improvements during nCPAP therapy.
Main Methods:
- A prospective study involving obese patients with moderate/severe OSA and no cardiopulmonary disease.
- Patients underwent constant-load exercise testing and completed the Baseline and Transitional Dyspnea Index (BDI/TDI) at baseline, one month, and three months of nCPAP treatment.
- Primary outcome was change in exercise time; secondary outcomes included changes in dyspnea, leg fatigue, and BDI/TDI scores.
Main Results:
- Constant-load exercise time increased significantly by 40% at one month (p=0.02) and 36% at three months (p=0.04).
- Isotime dyspnea and leg fatigue showed significant reductions at three months (p=0.04 and p=0.02, respectively).
- BDI/TDI scores improved significantly at both one and three months (p<0.001). Peak oxygen consumption and pulmonary function remained unchanged.
Conclusions:
- Nocturnal CPAP therapy is effective in improving exercise tolerance and reducing chronic dyspnea in obese patients with OSA.
- Improvements in exercise time and chronic dyspnea are evident after one month and sustained at three months.
- While exertional dyspnea shows improvement, significant changes are primarily observed at the three-month mark.
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