[Influence of treatment with continuous positive airway pressure on respiratory muscle function and physical fitness in patients with obstructive sleep apnoea and overlap syndrome].
BACKGROUND
The aim of this study was to evaluate the effect of CPAP treatment on respiratory muscle strength and exercise tolerance in patients with obstructive sleep apnoea (OSA) and overlap syndrome (OS).


METHODS
9 patients with OSA and 9 patients with OS were studied. Respiratory muscle assessment, 6 minute walking distance (6MWD) and cycloergometry exercise test were performed before and after six month period of CPAP treatment.


RESULTS
In OSA group exercise tolerance did not change after the treatment. Mean 6MWD was 571.8 +/- 76.6 m before and 554.0 +/- 125.5 m after treatment, mean W(max) was 142 +/- 41 W before and 139 +/- 38 W after treatment. PI(max) in OSA group did not change significantly, 140.4 +/- 32.0 cm H(2)O before and 155.9 +/- 31.5 after treatment (p = 0.14). PE(max) improved from 170.5 +/- 49.2 cm H(2)O, to 199.9 +/- 27.6 cm H(2)O (p = 0.067). Handgrip force in OSA group improved from 50.5 +/- 16.5 kg to 61.0 +/- 17.0 kg (left hand) (p = 0.05) and from 53.3 +/- 14.2 to 58.9 +/- 15.9 (right hand) (p < 0.05). In OS group exercise tolerance improved by 17% after CPAP treatment from W(max) = 81 +/- 33 W before to 95 +/- 38 W after. Mean 6MWD was at the same level before (504 +/- 144 m) and after treatment (492 +/- 108 m). PI(max) in OS group improved from 89.2 +/- 35.7 cm H(2)O to 106.3 +/- 31.4 cm H(2)O (p < 0.05). PE(max) in OS group did not change significantly, 159.9 +/- 45.8 cm H(2)O before and 184.2 +/- 45.0 cm H(2)O after treatment (NS). Handgrip force in OS group improved from 38.1 +/- 15.9 kg to 46.9 +/- 11.1 kg (left hand) (p < 0.05) and did not change in right hand (44.5 +/- 17.7 kg vs. 47.9 +/- 10.4 kg) (NS). Data analysis of the whole group (18 pts) showed clear tendency to improve strength of respiratory muscles in patients treated with CPAP. Mean PI(max) improved from 123 to 133 cm H(2)O (p = 0.006) and PE(max) improved from 168.1 to 192 cm H(2)O (p = 0.02).


CONCLUSIONS
CPAP treatment improved strentgh of respiratory and skeletal muscles in patients with OSA and OS and improved exercise tolerance in patients with OS.
Nowiński
Adam
A
II Klinika Chorób Płuc Instytutu Gruźlicy i Chorób Płuc w Warszawie.
Bieleń
Przemysław
P
Jonczak
Luiza
L
Sliwiński
Paweł
P
D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005080:Exercise Test; D017079:Exercise Tolerance; D006801:Humans; D007366:Intercostal Muscles / Q000503:physiopathology*; D008297:Male; D010809:Physical Fitness; D017286:Polysomnography; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012123:Pulmonary Ventilation; D012129:Respiratory Function Tests / Q000706:statistics & numerical data; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013577:Syndrome; D016896:Treatment Outcome