Repercusiones del síndrome de apneas e hipopneas obstructivas del sueño sobre el rendimiento físico

OBJECTIVES: to determine if Sleep Apnea-Hypopnea Syndrome (SAHS) is a cause of low physical performance, if physical performance is improved with nasal CPAP treatment and to study if there is a relationship between deterioration in physical performance and increased severity parameters of SAHS . METHODS: we conducted 32 patients diagnosed with SAHS (24 patients with severe SAHS measured as an apnea-hypopnea index �AHI- of ? 50 and 8 with moderate SAHS with AHI between 27-49) to undergo an exercise test on a treadmill up to maximum force before and after 30 days of treatment with nasal CPAP. Blood samples were taken at each test (haemogram, proteinogram, arterial gasometry) and measure of oxygen consumption was registered, before and after treatment. RESULTS: patients with severe SAHS reached a maximum potential of 191,83 ± 54 Watts before and 215 ± 57 Watts after treatment (p<0.001), while moderate SAHS patients reached 136,75 ± 54 and 145,87 ± 65 (p<0.05) respectively. Maximun oxygen consumption ranged from 2.851 ± 575 ml/min to 3.220 ± 569 (p<0.001) in patients with severe SAHS and from 2.199± 727 ml/min to 2.330 ± 678 (p<0.05) in moderate SAHS patients. Oxygen consumption in the anaerobic threshold varied from 1,647±277 ml/min to 2,012±328 (p<0.001) and from 1,316±489 to 1,432±602 (p<0.05) respectively, and the maximum ventilation per minute from 85.83±19 litres to 92.25±22 (p<0.05) in the severe and with no significant change in the moderates. The PaO2 increased from 84.87±8.4 to 93.31±6.5 (p<0.05) in the severe and from 79.97±8.6 to 87.8±8.1 (p<0.001) in the moderates, the PaCO2 reduced from 43.33±2.1 to 40.77±2.7 (p<0.05) and from 44.38±3.5 to 42.73±3.4 (p<0.05) respectively, the haemoglobin was 8.41% (p<0.001) and the haematocrit 3.55% (p<0.001) in the severe. No lineal correlations were found between the SAHS severity parameters and the objective deteriorations and improvements. CONCLUSIONS: In our patients, after a month of treatment with CPAP, improvement in physical performance was observed, but no correlation between the the ergometric parameters and severity of SAHS was found.