Objective

Obstructive sleep apnoea (OSA) syndrome is improved by physical activity in the general population. This has not been demonstrated in patients with coronary artery disease (CAD). We aimed to determine a correlation between cardiac rehabilitation and OSA syndrome in CAD patients.

Material/patients and methods

Forty-five CAD patients were included in cardiac rehabilitation programme of Saint-Étienne University Hospital. Patients were classified according to the severity of OSA syndrome. The number of events per hour was reported as the apnoea-hypopnoea index (AHI) measured from the Holter ECG and electrocardiogram-derived respiratory (EDR). An AHI less than 5 was considered normal. An AHI of 5–14 was mild, 15–29 was moderate and more than 30 events per hour characterized severe OSA. Cardiopulmonary exercise testing (CPET) and baroreflex (BRS) were performed to assess respectively <SPAN role=presentation tabIndex=0 id=MathJax-Element-1-Frame class=MathJax style="POSITION: relative" data-mathml='VO2max’>VO2maxVO2max
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and autonomic nervous system at the beginning and at the end of the cardiac rehabilitation.

Results

The reduction in AHI was significant in CAD patients with severe OSA syndrome (8.15 ± 12, P = 0.019). This correlation was even stronger than <SPAN role=presentation tabIndex=0 id=MathJax-Element-2-Frame class=MathJax style="POSITION: relative" data-mathml='VO2max’>VO2maxVO2max
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and BRS were improved (10.2 ± 8, P < 0.05 with a gain over 20% of <SPAN role=presentation tabIndex=0 id=MathJax-Element-3-Frame class=MathJax style="POSITION: relative" data-mathml='VO2max’>VO2maxVO2max
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and BRS) at the end of the rehabilitation.

Discussion–conclusion

Severe OSA syndrome is improved by cardiac rehabilitation among CAD patients. Autonomic nervous system regulation by physical activity might be key for alternative therapy for OSA syndrome.