Blunted heart rate recovery is improved following exercise training in overweight adults with obstructive sleep apnea

Christopher E. Kline, E. Patrick Crowley, Gary B. Ewing, James B. Burch, Steven N. Blair, J. Larry Durstine, J. Mark Davis, Shawn Youngstedt

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Obstructive sleep apnea (OSA) predisposes individuals to cardiovascular morbidity, and cardiopulmonary exercise test (CPET) markers prognostic for cardiovascular disease have been found to be abnormal in adults with OSA. Due to the persistence of OSA and its cardiovascular consequences, whether the cardiovascular adaptations normally conferred by exercise are blunted in adults not utilizing established OSA treatment is unknown. The aims of this study were to document whether OSA participants have abnormal CPET responses and determine whether exercise modifies these CPET markers in individuals with OSA. Methods: The CPET responses of 43 sedentary, overweight adults (body mass index [BMI] > 25) with untreated OSA (apnea-hypopnea index [AHI] ≥ 15) were compared against matched non-OSA controls (n = 9). OSA participants were then randomized to a 12-week exercise training (n = 27) or stretching control treatment (n = 16), followed by a post-intervention CPET. Measures of resting, exercise, and post-exercise recovery heart rate (HRR), blood pressure, and ventilation, as well as peak oxygen consumption (VO 2peak), were obtained. Results: OSA participants had blunted HRR compared to non-OSA controls at 1 (P =.03), 3 (P =.02), and 5-min post-exercise (P =.03). For OSA participants, exercise training improved VO2peak (P =.04) and HRR at 1 (P =.03), 3 (P <.01), and 5-min post-exercise (P <.001) compared to control. AHI change was associated with change in HRR at 5-min post-exercise (r = -.30, P <.05), but no other CPET markers. Conclusions: These results suggest that individuals with OSA have autonomic dysfunction, and that exercise training, by increasing HRR and VO 2peak, may attenuate autonomic imbalance and improve functional capacity independent of OSA severity reduction.

Original languageEnglish (US)
Pages (from-to)1610-1615
Number of pages6
JournalInternational Journal of Cardiology
Volume167
Issue number4
DOIs
StatePublished - Aug 20 2013
Externally publishedYes

Fingerprint

Obstructive Sleep Apnea
Heart Rate
Exercise
Exercise Test
Sleep Apnea Syndromes
Apnea
Oxygen Consumption
Ventilation
Body Mass Index
Cardiovascular Diseases
Blood Pressure
Morbidity

Keywords

  • Exercise testing
  • Exercise training
  • Heart rate recovery
  • Obstructive sleep apnea
  • Peak oxygen consumption

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Blunted heart rate recovery is improved following exercise training in overweight adults with obstructive sleep apnea. / Kline, Christopher E.; Crowley, E. Patrick; Ewing, Gary B.; Burch, James B.; Blair, Steven N.; Durstine, J. Larry; Davis, J. Mark; Youngstedt, Shawn.

In: International Journal of Cardiology, Vol. 167, No. 4, 20.08.2013, p. 1610-1615.

Research output: Contribution to journalArticle

Kline, Christopher E. ; Crowley, E. Patrick ; Ewing, Gary B. ; Burch, James B. ; Blair, Steven N. ; Durstine, J. Larry ; Davis, J. Mark ; Youngstedt, Shawn. / Blunted heart rate recovery is improved following exercise training in overweight adults with obstructive sleep apnea. In: International Journal of Cardiology. 2013 ; Vol. 167, No. 4. pp. 1610-1615.
@article{d65643e53ced4902b802e6f62686bf07,
title = "Blunted heart rate recovery is improved following exercise training in overweight adults with obstructive sleep apnea",
abstract = "Background: Obstructive sleep apnea (OSA) predisposes individuals to cardiovascular morbidity, and cardiopulmonary exercise test (CPET) markers prognostic for cardiovascular disease have been found to be abnormal in adults with OSA. Due to the persistence of OSA and its cardiovascular consequences, whether the cardiovascular adaptations normally conferred by exercise are blunted in adults not utilizing established OSA treatment is unknown. The aims of this study were to document whether OSA participants have abnormal CPET responses and determine whether exercise modifies these CPET markers in individuals with OSA. Methods: The CPET responses of 43 sedentary, overweight adults (body mass index [BMI] > 25) with untreated OSA (apnea-hypopnea index [AHI] ≥ 15) were compared against matched non-OSA controls (n = 9). OSA participants were then randomized to a 12-week exercise training (n = 27) or stretching control treatment (n = 16), followed by a post-intervention CPET. Measures of resting, exercise, and post-exercise recovery heart rate (HRR), blood pressure, and ventilation, as well as peak oxygen consumption (VO 2peak), were obtained. Results: OSA participants had blunted HRR compared to non-OSA controls at 1 (P =.03), 3 (P =.02), and 5-min post-exercise (P =.03). For OSA participants, exercise training improved VO2peak (P =.04) and HRR at 1 (P =.03), 3 (P <.01), and 5-min post-exercise (P <.001) compared to control. AHI change was associated with change in HRR at 5-min post-exercise (r = -.30, P <.05), but no other CPET markers. Conclusions: These results suggest that individuals with OSA have autonomic dysfunction, and that exercise training, by increasing HRR and VO 2peak, may attenuate autonomic imbalance and improve functional capacity independent of OSA severity reduction.",
keywords = "Exercise testing, Exercise training, Heart rate recovery, Obstructive sleep apnea, Peak oxygen consumption",
author = "Kline, {Christopher E.} and Crowley, {E. Patrick} and Ewing, {Gary B.} and Burch, {James B.} and Blair, {Steven N.} and Durstine, {J. Larry} and Davis, {J. Mark} and Shawn Youngstedt",
year = "2013",
month = "8",
day = "20",
doi = "10.1016/j.ijcard.2012.04.108",
language = "English (US)",
volume = "167",
pages = "1610--1615",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "4",

}

TY - JOUR

T1 - Blunted heart rate recovery is improved following exercise training in overweight adults with obstructive sleep apnea

AU - Kline, Christopher E.

AU - Crowley, E. Patrick

AU - Ewing, Gary B.

AU - Burch, James B.

AU - Blair, Steven N.

AU - Durstine, J. Larry

AU - Davis, J. Mark

AU - Youngstedt, Shawn

PY - 2013/8/20

Y1 - 2013/8/20

N2 - Background: Obstructive sleep apnea (OSA) predisposes individuals to cardiovascular morbidity, and cardiopulmonary exercise test (CPET) markers prognostic for cardiovascular disease have been found to be abnormal in adults with OSA. Due to the persistence of OSA and its cardiovascular consequences, whether the cardiovascular adaptations normally conferred by exercise are blunted in adults not utilizing established OSA treatment is unknown. The aims of this study were to document whether OSA participants have abnormal CPET responses and determine whether exercise modifies these CPET markers in individuals with OSA. Methods: The CPET responses of 43 sedentary, overweight adults (body mass index [BMI] > 25) with untreated OSA (apnea-hypopnea index [AHI] ≥ 15) were compared against matched non-OSA controls (n = 9). OSA participants were then randomized to a 12-week exercise training (n = 27) or stretching control treatment (n = 16), followed by a post-intervention CPET. Measures of resting, exercise, and post-exercise recovery heart rate (HRR), blood pressure, and ventilation, as well as peak oxygen consumption (VO 2peak), were obtained. Results: OSA participants had blunted HRR compared to non-OSA controls at 1 (P =.03), 3 (P =.02), and 5-min post-exercise (P =.03). For OSA participants, exercise training improved VO2peak (P =.04) and HRR at 1 (P =.03), 3 (P <.01), and 5-min post-exercise (P <.001) compared to control. AHI change was associated with change in HRR at 5-min post-exercise (r = -.30, P <.05), but no other CPET markers. Conclusions: These results suggest that individuals with OSA have autonomic dysfunction, and that exercise training, by increasing HRR and VO 2peak, may attenuate autonomic imbalance and improve functional capacity independent of OSA severity reduction.

AB - Background: Obstructive sleep apnea (OSA) predisposes individuals to cardiovascular morbidity, and cardiopulmonary exercise test (CPET) markers prognostic for cardiovascular disease have been found to be abnormal in adults with OSA. Due to the persistence of OSA and its cardiovascular consequences, whether the cardiovascular adaptations normally conferred by exercise are blunted in adults not utilizing established OSA treatment is unknown. The aims of this study were to document whether OSA participants have abnormal CPET responses and determine whether exercise modifies these CPET markers in individuals with OSA. Methods: The CPET responses of 43 sedentary, overweight adults (body mass index [BMI] > 25) with untreated OSA (apnea-hypopnea index [AHI] ≥ 15) were compared against matched non-OSA controls (n = 9). OSA participants were then randomized to a 12-week exercise training (n = 27) or stretching control treatment (n = 16), followed by a post-intervention CPET. Measures of resting, exercise, and post-exercise recovery heart rate (HRR), blood pressure, and ventilation, as well as peak oxygen consumption (VO 2peak), were obtained. Results: OSA participants had blunted HRR compared to non-OSA controls at 1 (P =.03), 3 (P =.02), and 5-min post-exercise (P =.03). For OSA participants, exercise training improved VO2peak (P =.04) and HRR at 1 (P =.03), 3 (P <.01), and 5-min post-exercise (P <.001) compared to control. AHI change was associated with change in HRR at 5-min post-exercise (r = -.30, P <.05), but no other CPET markers. Conclusions: These results suggest that individuals with OSA have autonomic dysfunction, and that exercise training, by increasing HRR and VO 2peak, may attenuate autonomic imbalance and improve functional capacity independent of OSA severity reduction.

KW - Exercise testing

KW - Exercise training

KW - Heart rate recovery

KW - Obstructive sleep apnea

KW - Peak oxygen consumption

UR - http://www.scopus.com/inward/record.url?scp=84881480725&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84881480725&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2012.04.108

DO - 10.1016/j.ijcard.2012.04.108

M3 - Article

C2 - 22572632

AN - SCOPUS:84881480725

VL - 167

SP - 1610

EP - 1615

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 4

ER -