Effects of short-term PAP treatment on endurance exercise performance in obstructive sleep apnea patients

Edward Shifflett, D; Walker, Eric W; Gregg, John M; Zedalis, Don; Herbert, William G

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Volume 2, Issue 2 , Pages 145-151, March 2001

Effects of short-term PAP treatment on endurance exercise performance in obstructive sleep apnea patients

D Edward Shifflett Jr
- Laboratory for Health and; Exercise Sciences, 230 War Memorial Hall, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
Eric W Walker
- Laboratory for Health and; Exercise Sciences, 230 War Memorial Hall, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
John M Gregg
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA 24061, USA
Don Zedalis
- Sleep Disorders Network of Southwest Virginia, 2955 Market Street, Christiansburg, VA, USA 24073
William G Herbert
- Laboratory for Health and; Exercise Sciences, 213 War Memorial Hall, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
- Corresponding author. Tel.: +1-540-231-6565; fax: +1-540-231-8476

Received 24 February 2000; received in revised form 25 July 2000; accepted 29 August 2000.

Abstract

Objective: To measure the effects of 4 weeks of nasal positive airway pressure therapy (PAP) on exercise performance in obstructive sleep apnea patients (OSA).

Background: Little published research is available which describes the effects of OSA on exercise tolerance or upon the potential of exercise testing to evaluate the outcomes of PAP therapy.

Methods: Exercise testing was performed on an electronic cycle ergometer with continuous ramping to allow collection of numerous data points for each subject, up to a vigorous terminal intensity. Linear regression established each subject's pre-treatment scores for the dependent variables at 60% of estimated peak power (W_60%). Responses at the pre-treatment W_60% test were used to quantify and compare to responses at the same power output after treatment.

Results: OSA by nocturnal polysomnography was moderately severe in this group; the respiratory distress index was 48±22 (mean±SD; n=9). Exercise heart rates after PAP therapy averaged 10.2 bt/min less at W_60% (P<0.05). Other variables were lower but non-significantly so, further suggesting a lower cardiorespiratory exercise demand after treatment, i.e. oxygen consumption (↓7.6%), and Rating of Perceived Exertion (↓8.8%).

Conclusion: Brief treatment with PAP therapy improves objective markers of aerobic exercise performance.

Keywords: Obstructive sleep apnea, Nasal continuous positive pressure breathing treatment, Exercise tolerance, Oxygen consumption, Perceived exertion, Exercise heart rate, Exercise blood pressure