TY - JOUR
T1 - Exercise capacity and comorbidities in patients with obstructive sleep apnea
AU - Vitacca, M.
AU - Paneroni, M.
AU - Braghiroli, A.
AU - Balbi, B.
AU - Aliani, M.
AU - Guido, P.
AU - Fanfulla, F.
AU - Pertosa, M.
AU - Ceriana, P.
AU - Zampogna, E.
AU - Raccanelli, R.
AU - Sarno, N.
AU - Spanevello, A.
AU - Maniscalco, M.
AU - Malovini, A.
AU - Ambrosino, N.
N1 - Export Date: 7 December 2020
PY - 2020
Y1 - 2020
N2 - Study Objectives: There are few studies evaluating (1) exercise capacity as assessed by the 6-minute walking distance (6MWD) test in large populations with obstructive sleep apnea (OSA); and (2) correlations with patients' comorbidities. Methods: This study presents a cluster analysis performed on the data of 1,228 patients. Severity of exercise limitation was defined on the basis of 6MWD. Results: Sixty-one percent showed exercise limitation (29.2% and 31.9% mild and severe exercise limitation, respectively). About 60% and 40% of patients were included in cluster 1 (CL1) and 2 (CL2), respectively. CL1 included younger patients with high prevalence of apneas, desaturations, and hypertension with better exercise tolerance. CL2 included older patients, all with chronic obstructive pulmonary disease (COPD), high prevalence of chronic respiratory failure (CRF), fewer apneas but severe mean desaturation, daytime hypoxemia, more severe exercise limitation, and exercise-induced desaturations. Only CRF and COPD significantly (P <.001) correlated with 6MWD < 85% of predicted value. 6MWD correlated positively with apnea-hypopnea index, oxygen desaturation index, nocturnal pulse oxygen saturation (SpO2), resting arterial oxygen tension, mean SpO2 on exercise, and negatively with age, body mass index, time spent during night with SpO2 < 90%, mean nocturnal desaturation, arterial carbon dioxide tension, and number of comorbidities. Patients without severe comorbidities had higher exercise capacity than those with severe comorbidities, (P <.001). Exercise limitation was significantly worse in OSA severity class I when compared to other classes (P <.001). Conclusions: A large number of patients with OSA experience exercise limitation. Older age, comorbidities such as COPD and CRF, OSA severity class I, severe mean nocturnal desaturation, and daytime hypoxemia are associated with worse exercise tolerance. © 2020 American Academy of Sleep Medicine. All rights reserved.
AB - Study Objectives: There are few studies evaluating (1) exercise capacity as assessed by the 6-minute walking distance (6MWD) test in large populations with obstructive sleep apnea (OSA); and (2) correlations with patients' comorbidities. Methods: This study presents a cluster analysis performed on the data of 1,228 patients. Severity of exercise limitation was defined on the basis of 6MWD. Results: Sixty-one percent showed exercise limitation (29.2% and 31.9% mild and severe exercise limitation, respectively). About 60% and 40% of patients were included in cluster 1 (CL1) and 2 (CL2), respectively. CL1 included younger patients with high prevalence of apneas, desaturations, and hypertension with better exercise tolerance. CL2 included older patients, all with chronic obstructive pulmonary disease (COPD), high prevalence of chronic respiratory failure (CRF), fewer apneas but severe mean desaturation, daytime hypoxemia, more severe exercise limitation, and exercise-induced desaturations. Only CRF and COPD significantly (P <.001) correlated with 6MWD < 85% of predicted value. 6MWD correlated positively with apnea-hypopnea index, oxygen desaturation index, nocturnal pulse oxygen saturation (SpO2), resting arterial oxygen tension, mean SpO2 on exercise, and negatively with age, body mass index, time spent during night with SpO2 < 90%, mean nocturnal desaturation, arterial carbon dioxide tension, and number of comorbidities. Patients without severe comorbidities had higher exercise capacity than those with severe comorbidities, (P <.001). Exercise limitation was significantly worse in OSA severity class I when compared to other classes (P <.001). Conclusions: A large number of patients with OSA experience exercise limitation. Older age, comorbidities such as COPD and CRF, OSA severity class I, severe mean nocturnal desaturation, and daytime hypoxemia are associated with worse exercise tolerance. © 2020 American Academy of Sleep Medicine. All rights reserved.
U2 - 10.5664/jcsm.8258
DO - 10.5664/jcsm.8258
M3 - Article
VL - 16
SP - 531
EP - 538
JO - Journal of Clinical Sleep Medicine
JF - Journal of Clinical Sleep Medicine
SN - 1550-9389
IS - 4
ER -