Sleep Apnea, Cardiovascular and Exercise Study
Condition: Obstructive Sleep Apnea; Vascular Diseases; Obesity
MeSH terms: Apnea; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Vascular Diseases
Study type: Interventional

Summary: 
      Obstructive sleep apnea (OSA) results in vascular dysfunction, which increases the risk of
      cardiovascular disease. In contrast, exercise confers cardioprotection through improvements
      in vascular health. This proposal evaluates whether the beneficial effects of exercise on
      vascular function are attenuated in obese individuals suffering from untreated OSA.
    

Detailed description: 
      Obstructive sleep apnea (OSA) is a serious medical condition that affects an estimated 15
      million US adults and is characterized by repeated episodes of upper airway obstruction,
      recurrent arousals and episodic oxyhemoglobin desaturations during sleep. These abnormalities
      contribute to subclinical alterations in vascular function that increase the risk of
      cardiovascular disease morbidity and mortality. In contrast, exercise decreases the risk of
      cardiovascular events and the promotion of physical activity continues to be at the top of
      our national public health agenda, as seen in the publication of the 1996 report of the US
      Surgeon General on physical activity and health. While the exact mechanisms for this
      protective benefit are not entirely clear, there is good evidence that exercise confers
      cardioprotection through its direct impact on vascular endothelial function. The American
      College of Sleep Medicine recommends exercise as a behavioral treatment option for OSA. Yet,
      most clinical trials upon which this recommendation is based have focused on establishing the
      effectiveness of lifestyle change (e.g., dietary induced weight loss and increased physical
      activity participation) for improving OSA severity in obese individuals, whereas less
      attention has been given to whether OSA moderates the effects of exercise on the
      cardiovascular disease substrate. The overarching hypothesis of this study is that OSA
      attenuates the beneficial effect of exercise on vascular function in obese individuals
      suffering from untreated OSA. The aims of the study are to 1) examine parameters of vascular
      function in obese persons with and without OSA, 2) evaluate the effects of an acute bout of
      exercise on brachial artery flow mediated dilation in obese persons with and without OSA, and
      3) examine the effects of 6 weeks of exercise training on vascular function among those with
      and without OSA. These data will be immediately useful in clinical practice and inform how
      clinicians prescribe exercise and implement lifestyle changes to reduce cardiovascular
      disease risk in OSA patients.
    

Intervention name(s): exercise training
Intervention type(s): Behavioral
Intervention description(s): Eligible participants will undergo 6 weeks of a combined aerobic and resistance exercise intervention. Training will take place 3 times per week for 1 hour. Forty minutes will be dedicated to aerobic training while 15 to 20 minutes will be devoted to resistance training.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: obstructive sleep apnea; exercise training; vascular function