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Cardiopulmonary Exercise Test-Derived Functional Indices Associated with Moderate-to-Severe Obstructive Sleep Apnea in Young and Middle-Aged Adults

Year: 2026

Type: article

Abstract: Background: Obstructive sleep apnea (OSA) is associated with cardiovascular morbidity. However, exercise-related functional responses remain incompletely characterized in adults undergoing cardiopulmonary exercise testing (CPET) for exercise prescription without established diseases affecting exercise capacity. We examined associations between CPET-derived indices and moderate-to-severe OSA, defined as an apnea-hypopnea index (AHI) ≥ 15 events/h. Methods: This single-center retrospective observational study included 104 adults aged 18– 65 years who underwent overnight sleep monitoring with electroencephalographic recording and CPET for exercise prescription. Participants were classified into AHI ≥ 15 and AHI < 15 events/h groups. Demographic characteristics, clinical variables, and CPET-derived indices were compared between groups. Heart rate recovery (HRR), peak oxygen pulse, and peak breathing reserve (BR) were examined in separate logistic regression models. Models were sequentially adjusted for sex, age, and body mass index (BMI). Results: Among the 104 participants, 59 participants had AHI ≥ 15 events/h and 45 had AHI < 15 events/h. The AHI ≥ 15 group had higher BMI and lower HRR, peak oxygen pulse (% predicted), and BR (all p < 0.001). After adjustment for sex, age, and BMI, higher HRR was associated with lower odds of AHI ≥ 15 events/h (OR = 0.745, 95% CI 0.640– 0.867, p < 0.001). Higher BR was also associated with lower odds (OR = 0.923, 95% CI 0.878– 0.971, p = 0.002). The adjusted association for peak oxygen pulse was not statistically significant. Conclusion: Lower HRR and BR were associated with moderate-to-severe OSA after adjustment for sex, age, and BMI in this selected cohort of young and middle-aged adults. Further prospective studies in independent cohorts are warranted to confirm these findings and clarify their potential clinical relevance. Keywords: obstructive sleep apnea, cardiopulmonary exercise testing, cardiorespiratory fitness, heart rate recovery, breathing reserve

Source: International Journal of General Medicine

DOI: 10.2147/ijgm.s647240

Authors: Nibing Zheng, Bin Chen

Institutions: Fujian Medical University, Fujian Provincial Hospital, Fuzhou University

Language: English

Topic: Obstructive Sleep Apnea Research

Subfield: Physiology (medical)

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836