Effects of Exercise Training on Structure and Cerebral Metabolism, Cognition and Neurovascular Control in Individuals With Obstructive Sleep Apnea
试验速览
- 阶段
- 不适用
- 入组人数
- 70
- 试验地点
- 1
- 主要终点
- effects of exercise training in patients with sleep apnea
研究概览
简要总结
Abstract
Obstructive sleep apnea syndrome (OSA) is characterized by complete or partial collapse of a narrowed pharynx and it's associated with reduction in cerebral blood flow, cardiovascular disease, and neuropsychological deficits and reduces survival. In patients with AOS structural, metabolic and hypoperfusion cerebral were associated not only with physiological functions but also with attention and executive function. There is a higher association between apnea hypopnea index and Mini-Mental State Examination in individuals with the exon 4 of APO E gene, indicating that exon 4 of APO E gene confers an increased risk for cognitive decline in individuals with sleep apnea. The analysis of presence and consequences of OSA in cerebral structure, inflammation and neurovascular control can permit a better investigation of abnormalities in these individuals and implement interventions to reduce the risk of development of cognitive and cardiovascular impairment. The non-pharmacological intervention through exercise training can represent an important strategy for improvement in cerebral alterations, cognition and reduction in sleep apnea index. The purpose of present study is investigate the volume and metabolism cerebral, neurovascular control, cognition and exon 4 of APO E gene and their
详细描述
The investigators recruited both male and female sedentary individuals between 40 to 65 years from sleep laboratory that had recently performed sleep study. All non-menopause women were studied between the first and the fifth day after the onset of menstruation, since hormonal variability during the regular menstrual cycle may affect blood pressure (BP) or stress perception. Hypertension was carefully excluded in the groups. All subjects had at least three office BP measurements made by one of the study investigators, in addition three out of office BP measurements. Study subjects who had a body mass index (BMI) > 30 kg/m2, cardiopulmonary disease, chronic renal disease, diabetes mellitus, atrial fibrillation, pacemaker, hypertension, renal failure, echocardiographic evidence of impaired left ventricular function (ejection fraction >45%), history of psychiatric disorders, dementia or other neurodegenerative disorders, a history of smoking or alcohol abuse (2 or more drinks per day), any sleep apnea treatment, story of circadian desynchrony (e.g. shift workers), incomplete 2 years of formal education, resting blood pressure lower than 140/90 mmHg, body mass index (BMI) greater than 30 kg/m2. The study was approved by the institutional committee on human research and all subjects gave written, informed consent.
Daytime sleepiness. The chance of falling asleep in different situations was assessed by means of Epworth Sleepiness Scale.
Screening of Cognitive Functions. Brief cognitive functions were assessed by means of Mini Mental State Examination test (Folstein et al., 1975).
Intelligence Quotient. Intelligence was estimated by means of Kaufman Brief Intelligence Test using vocabulary and matrices subtests (Wagner et al., 2010).
Depression. Symptoms and depressive attitudes were assessed by means of Beck Depression Inventory that consists of 21 items, whose intensity varies from 0 to 3. Individuals with cutoffs < 10 (no or minimal depression) were included in the protocol (Beck et al., 1961).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 40 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •apparently healthy individual
- •realize all tests
- •participate in exercise training if selected by training group
排除标准
- •Body mass index > 35 kg/m2
- •cardiopulmonary disease
- •chronic renal disease
- •diabetes mellitus
- •atrial fibrillation, pacemaker
- •hypertension or renal failure
- •echocardiographic evidence of impaired left ventricular function (ejection fraction >45%)
- •history of psychiatric disorders
- •dementia or other neurodegenerative disorders
- •a history of smoking or alcohol abuse (2 or more drinks per day)
- •any sleep apnea treatment, story of circadian desynchrony (e.g. shift workers), incomplete 2 years of formal education, resting BP lower than 140/90 mmHg.
研究组 & 干预措施
Attentional performance in OSA
To investigate the attentional performance and muscle sympathetic nerve activity (MSNA) response during Color Word Stroop Test (CWST) in patients with obstructive sleep apnea (OSA) before and after intervention with exercise training.Individuals with no other comorbidities (age=52±1 years, body mass index=29±0.4) were divided in control (n=15) and untreated OSA (n=20) defined by polysomnography.
干预措施: Exercise Training (Other)
metaboreflex in OSA
To investigate the metaboreflex control of MSNA before and after intervention with exercise training in patients with obstructive sleep apnea.
Methods: Thirty-five patients underwent conventional polysomnography. The MSNA was assessed by microneurography technique. Beat to beat blood pressure was measured during 4 minutes at rest, 3 minutes of isometric exercise at 30% maximal voluntary contraction, followed by 2 minutes of occlusion of the circulation in previously exercised muscle. The metaboreflex sensitivity was calculated during the first and second minutes of circulatory occlusion when metaboreceptors are evaluated independently of central command and muscle mechanoreceptors.
干预措施: Exercise Training (Other)
结局指标
主要结局
effects of exercise training in patients with sleep apnea
时间窗: 6 month of exercise training intervention.
structure and cerebral metabolism will be measure with Magnetic Resonance and regional blood flow. Cognition will be evaluate by neurocognitive tests. All measures will be applied before and after exercise training intervention.
次要结局
未报告次要终点
研究者
Linda Massako Ueno
Linda Massako Ueno
University of Sao Paulo General Hospital