Rôle de la sédentarité dans les complications cardio-métaboliques du syndrome d'apnées du sommeil

Sleep apnea syndrome (OSAS) in the obese patient significantly increases the cardiometabolic risk because of the intermittent hypoxemia and sleep deprivation. Its management is mainly based on positive pressure ventilation in order to limit the pharyngeal collapse and the ventilatory flows decrements. It also includes the management of cardiovascular and metabolic comorbidities. Patients with OSAS have reduced physical activity that is poorly improved by the treatment of sleep respiratory disorders. This paper deals about an additional impact of sedentarity in cardiovascular complications of OSAS and the improvement in physical activity in these patients. Recent studies have shown that physical activity in OSAS is characterized by a limited number of daily steps and insufficient intensity of daily efforts. This limited physical activity seems to be associated to comorbidities (body mass index), to cardiovascular events and to a psychological dimension related to a fear of movements. A consequence of OSAS per se cannot be excluded. Moreover, sedentary lifestyle has an additional and dose-related cardio-metabolic impact (evening arterial blood pressure) favoring left ventricular remodeling and cardiac output decrease. Physical activity should now be integrated into the therapeutic management of patients with OSAS.