Respostas hemodinâmicas ao teste de caminhada de seis minutos em indivíduos com apneia obstrutiva do sono tratados com CPAP

Abstract

Introduction: Obstructive sleep apnea (OSA) is a respiratory disorder defined by total or partial upper airway obstruction (VAS) during sleep. The recurrent episodes of hypoxia / reoxygenation promote muscle injuries and structural alterations, which eventually lead to decreased functional exercise capacity (CFE) and alter cardiovascular responses to exertion in these individuals. Continuous positivepressure (CPAP) treatment can reverse the pathophysiological changes caused by OSA and, consequently, improve CFE and cardiovascular responses to exertion.Objective: Thus, the aim of the present study was to evaluate hemodynamic parameters in response tothe six-minute walk test (6MWT) in adult individuals with OSA treated with CPAP.Methodology: The sample consisted of 48 individuals aged between 18 and 70 years, of both sexes, affected by OSA of moderate or high severity and who presented at least 70% adherence to CPAP for five days a week. The 6MWT was performed in a 30-meter-long flat corridor where volunteers were encouraged to walk as far as possible for six minutes. The hemodynamic variables verified were: heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Perception and degree and effort were verified through lower limb fatigue. Measurements were measured during rest, immediately after the test and in the first minute of recovery. Statistical analysis was performed using the Kolmogrov-Smirnov test to verify data normality, repeated measures ANOVA for the perception of cardiovascular variables and Bonferroni test when necessary to identify the differences found. It was considered as a level of statistical significance p<0.05.Results: Higher HR (111.7 ± 14.8bpm), SBP (144.1 ± 16.8mmHg) and DBP (84.3 ± 6.1mmHg) and lower limb fatigue (4.2 ± 2, 4) during the 6 'of the 6MWT in relation to rest. There was a return to basal levels of these parameters in the first minute of recovery in relation to rest. In addition, according to the predicted HRmax (67.7 ± 0.1%) percentage achieved in the test, the 6MWT can be classified as a submaximal test.Conclusion: Individuals with OSA treated with CPAP demonstrated good physiological acceptance to the 6MWT, which may be associated with improvements linked to CPAP treatment, revealed by cardiovascular responses to exertion.