Effect of continuous positive airway pressure (CPAP) on maximal exercise capacity in patients with obstructive sleep apnoea: a systematic review and meta-analysis

Abstract

Introduction: CPAP is recognised as the gold standard treatment for obstructive sleep apnoea (OSA), but the extent to which it alters maximal exercise capacity and anaerobic threshold is under debate. Therefore, a systematic review was carried out to determine changes in maximal exercise capacity (VO2 max, VO2 peak) and anaerobic threshold (AT) after a CPAP intervention. Methods: We searched six databases (PubMed, MEDLINE, Embase, Cochrane Central, CINAHL and Google Scholar) with specific search terms. Inclusion criteria were a diagnosis of OSA (apnoea-hypopnoea index >5 events/hour by polysomnography), CPAP intervention for a minimum of 7 days and maximum of 1 year, and objectively measured VO2 max, VO2 peak or AT. Results: From 449 articles, 8 studies involving 175 subjects were included in the meta-analysis of maximal exercise capacity. A mean (95% CI) net difference of -1.95 mL·kg-1·min-1(-3.01, -0.89): P Conclusion: CPAP treatment significantly improves maximal exercise capacity and AT in patients with OSA. Future studies should investigate the impact of improvement exercise capacity with CPAP on physical activity.