Exercise Training Increases Metaboreflex Control in Patients with Obstructive Sleep Apnea

Introduction/Purpose We demonstrated that patients with obstructive sleep apnea (OSA) have reduced muscle metaboreflex control of muscle sympathetic nerve activity (MSNA). Additionally, exercise training increased muscle metaboreflex control in heart failure patients. Objective We tested the hypothesis that exercise training would increase muscle metaboreflex control of MSNA in patients with OSA. Methods Forty-one patients with OSA were randomized into the following two groups: (1) nontrained (OSANT, n=21) and (2) trained (OSAT, n=20). MSNA was assessed by microneurography technique, muscle blood flow (FBF) by venous occlusion plethysmography, heart rate by electrocardiography, and blood pressure (BP) with an automated oscillometric device. All physiological variables were simultaneously assessed at rest, during isometric handgrip exercise at 30% of the maximal voluntary contraction, and during posthandgrip muscle ischemia (PHMI). Muscle metaboreflex sensitivity was calculated as the difference in MSNA between PHMI and the rest period. Patients in the OSAT group underwent seventy-two sessions of moderate exercise training, whereas patients in the OSANT group were clinical follow-up for six months. Results The OSANT and OSAT groups were similar in anthropometric, neurovascular, hemodynamic and sleep parameters. Exercise training reduced the baseline MSNA (34±2 vs. 25±2 burst/min, P

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