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Exercise capacity of patients with obstructive sleep apnea at moderate to high altitude.

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Τίτλος: Exercise capacity of patients with obstructive sleep apnea at moderate to high altitude.
Συγγραφείς: Huang Y; School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, PR China.; Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Yunnan University, Kunming, 650021, PR China., Jia D; Medical Examination Center, The Affiliated Hospital of Yunnan University, Kunming, 650021, PR China., Jiang Q; Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Yunnan University, Kunming, 650021, PR China., Pan C; Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Yunnan University, Kunming, 650021, PR China., Ma B; School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, PR China. Kittymb2024@163.com.; Research Center for Medical Device Regulatory Science, Lanzhou University, Lanzhou, 730000, PR China. Kittymb2024@163.com.; Industry Center for Evidence-Based Research and Evaluation Standards in Medical Devices, Lanzhou, 730000, PR China. Kittymb2024@163.com., Luo H; Second Department of Respiratory Medicine, Lanzhou Second People's Hospital, Lanzhou, 730046, PR China. 2296743882@qq.com.
Πηγή: Sleep & breathing = Schlaf & Atmung [Sleep Breath] 2026 Oct 08; Vol. 30 (5). Date of Electronic Publication: 2026 Oct 08.
Τύπος έκδοσης: Journal Article; Research Support, Non-U.S. Gov't
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer Country of Publication: Germany NLM ID: 9804161 Publication Model: Electronic Cited Medium: Internet ISSN: 1522-1709 (Electronic) Linking ISSN: 15209512 NLM ISO Abbreviation: Sleep Breath Subsets: MEDLINE
Imprint Name(s): Publication: 2005- : Heidelberg ; New York : Springer
Original Publication: Titisee-Neustadt, Germany : Druckbild GmbH
Ιατρικοί όροι (MeSH): Sleep Apnea, Obstructive*/physiopathology , Sleep Apnea, Obstructive*/diagnosis , Exercise Tolerance*/physiology , Altitude*, Oxygen Consumption/physiology ; Humans ; Male ; Female ; Exercise Test ; Polysomnography ; Prospective Studies ; Middle Aged ; Adult ; China ; Reference Values
Περίληψη: Background: It remains unknown to what extent exercise capacity is diminished at moderate to high altitudes in patients with obstructive sleep apnea (OSA).
Purpose: The primary aim was to compare peak oxygen uptake per kilogram body weight (VO2/kg) between OSA patients and healthy controls (HCs) at moderate-to-high altitude (~ 1,900 m) using cardiopulmonary exercise testing (CPET). Secondary aims were to evaluate the associations of OSA severity (apnea-hypopnea index, AHI) and nocturnal hypoxemia (lowest oxygen saturation, LSpO2; oxygen desaturation index, ODI) with CPET parameters, and to explore the potential discriminatory performance of CPET indices.
Methods: This prospective study enrolled 38 OSA patients (AHI ≥ 5 events/h) and 36 healthy controls from Kunming, Yunnan Province, China (study site altitude: ~1,900 m; participants' residence altitude range: 1,800-2,800 m above sea level). All participants underwent overnight polysomnography and symptom-limited CPET using a cycle ergometer ramp protocol. Both groups were subgrouped by apnea-hypopnea index (AHI) severity and by lowest oxygen saturation (LSpO2) for CPET comparisons.
Results: After adjustment for BMI, the OSA group exhibited significantly lower VO2/kg (P = 0.013) and a significantly higher VE/VCO2 slope (P = 0.038) compared with healthy controls. AHI and ODI were negatively correlated, and LSpO2 positively correlated, with VO2/kg; LSpO2 was positively correlated with VO2/WR but negatively correlated with VE/VCO2 slope; ODI was positively correlated with VE/VCO2 slope. Additionally, in an exploratory ROC analysis, VO2/kg showed a modest AUC (0.69), high sensitivity (97.4%) and limited specificity (38.9%), suggesting a supportive rather than standalone screening role.
Conclusions: OSA patients at moderate-to-high altitude show reduced exercise capacity (lower VO2/kg) and ventilatory inefficiency (higher VE/VCO2 slope), correlating with OSA severity and nocturnal hypoxemia; the VO2/kg and VE/VCO2 slope differences persisted after adjustment for BMI. These limitations may reflect superimposed chronic intermittent and environmental hypoxia, with skeletal muscle dysfunction, altered ventilatory control, and endothelial impairment as possible contributing mechanisms. CPET provides valuable functional assessment; in an exploratory analysis, CPET parameters may serve as supportive indicators to raise suspicion for OSA but cannot replace polysomnography. Validation in larger, multi-center cohorts is required.
(© 2026. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Competing Interests: Declarations. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Ethics Committee of the Affiliated Hospital of Yunnan University, ethics approval number 2023133) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Consent for publication: Not applicable. Informed consent: Informed consent was obtained from all individual participants included in the study. Conflict of interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
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Grant Information: ZKF2024080 Yunnan Provincial Key Clinical Specialty Construction Project; YDYXJJ2025-0041 Yunnan University Medical Research Foundation
Contributed Indexing: Keywords: Cardiopulmonary exercise testing; Exercise capacity; Moderate-High Altitude; Obstructive sleep apnea; Ventilatory efficiency
Entry Date(s): Date Created: 20261008 Date Completed: 20261008 Latest Revision: 20261019
Update Code: 20261020
DOI: 10.1007/s11325-026-03819-4
PMID: 42848276
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1522-1709
DOI:10.1007/s11325-026-03819-4