title: The effect of acute aerobic exercise on hemostasis in obstructive sleep apnea.
abstract: OBJECTIVE
  Individuals with obstructive sleep apnea (OSA) have an altered hemostatic balance; however, the exercise response is less described. The purpose of this study is to determine the hemostatic response after acute aerobic exercise in obstructive sleep apnea.
  
  
  METHODS
  Eighteen males (nine OSA vs. nine controls) were recruited from the university and local community. Individuals with evidence of cardiovascular, pulmonary, or metabolic disease were excluded. An apnea-hypopnea index (AHI) of >5 was a criterion for OSA. Subjects performed a treadmill exercise test at 35 and 70% predicted VO2reserve during the morning hours. Pre-exercise blood samples were obtained after 15 min supine rest and within 2 min following exercise. Repeated measures ANOVA were performed for factor VIII antigen, tissue plasminogen activator (tPA) antigen, tPA activity, and PAI-1 activity. Correlational analysis compared resting and post-exercise hemostatic factors with age, BMI, and AHI.
  
  
  RESULTS
  Mean AHI was 13.00 ± 12.6. No exercise × condition interactions were observed for hemostatic markers. There was a main effect for exercise in factor VIII, tPA antigen, and tPA activity in both groups. PAI-1 activity tended to be elevated in OSA (145%) compared to controls which remained after exercise (205%) (P = 0.05). Post-exercise FVIII/Ag correlated with BMI (r = 0.52), while resting tPA/Ag correlated with AHI (r = 0.49) and age (r = 0.50).
  
  
  CONCLUSIONS
  The hemostatic response after acute aerobic exercise is unaffected in mild OSA, although PAI-1 activity seems to be elevated, reducing fibrinolytic potential. BMI seems to correlate with FVIII/Ag, while tPA/Ag is associated with AHI and age.
authors.affiliation: Department of Kinesiology, James Madison University, Harrisonburg, VA, 22807, USA.
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Martin
authors.affiliation: Department of Kinesiology, James Madison University, Harrisonburg, VA, 22807, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Strosnider
authors.affiliation: Department of Kinesiology, James Madison University, Harrisonburg, VA, 22807, USA.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Giersch
authors.affiliation: Department of Kinesiology, James Madison University, Harrisonburg, VA, 22807, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Womack
authors.affiliation: Department of Kinesiology, James Madison University, Harrisonburg, VA, 22807, USA. hargenta@jmu.edu.
authors.forename: Trent A
authors.initials: TA
authors.lastname: Hargens
mesh_terms: D000328:Adult; D015444:Exercise / Q000502:physiology*; D005169:Factor VIII / Q000032:analysis / Q000378:metabolism; D006487:Hemostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000503:physiopathology*; D010959:Tissue Plasminogen Activator / Q000097:blood
chemical_list: D017395:Plasminogen Activator Inhibitor 1; D005169:Factor VIII; D010959:Tissue Plasminogen Activator
keywords: Coagulation; Exercise; Fibrinolysis; Obstructive sleep apnea; Sleep