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Abstrak
Latar belakang: Obstructive Sleep Apnea Syndrome (OSAS) yang tidak diobati dapat menyebabkan penyakit kardiovaskular. Di seluruh dunia, sekitar 425 juta atau lebih dari 45% mengalami OSAS sedang sampai berat yang harusnya membutuhkan pengobatan. Gold Standard pengobatan OSAS adalah dengan perawatan yang direkomendasikan sampai saat ini yaitu Continuous Positive Airway Pressure (CPAP). Studi observasional telah menunjukkan manfaat potensial dari CPAP yang meliputi perlindungan dari penyakit kardiovaskular. Namun, beberapa studi menyatakan bahwa penggunaan CPAP diikuti kepatuhan gaya hidup seperti olahraga dan kontrol pola makan atau tanpa kepatuhan gaya hidup, tidak melindungi terhadap penyakit kardiovaskular. Dengan demikian, manfaat klinis potensial dari penggunaan CPAP dan bahwa aktivitas fisik dapat menjadi alat manajemen yang layak untuk mengurangi keparahan OSAS dipertanyakan.
Metode: Tinjauan Kepustakaan Sistematik dilakukan pada tiga pusat data, yaitu Pubmed, Cochrane, dan Tripdatabased. Kepustakaan dengan judul yang sama atau studi yang tidak relevan dieliminasi, serta dilakukan screening abstrak dan dilanjutkan dengan membaca keseluruhan teks kepustakaan untuk memilih jurnal yang sesuai dengan kriteria inklusi. Penilaian kualitas studi menggunakan tools The Central for Evidence Based Medicine develops (CEBM).
Hasil: Terdapat 3 kepustakaan yang sesuai kriteria. Tiga studi menyatakan bahwa terdapat hubungan aktivitas fisik dengan risiko OSAS pada hipertensi. Tingkat aktivitas fisik pada pasien OSAS dengan hipertensi adalah aktivitas fisik ringan. Derajat keparahan OSAS pada pasien OSAS dengan hipertensi adalah OSAS ringan.
Kesimpulan: Aktivitas fisik rendah meningkatkan derajat keparahan OSAS pada hipertensi.
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Hak Cipta (c) 2022 Silvika Tri Novia, Syabriansyah, Diah Ayu Aguspa Dita

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Referensi
- Budhiraja, R., Javaheri, S., Parthasarathy, S., Berry, R.B., Quan, S.F., 2019. The association between obstructive sleep apnea characterized by a minimum 3 percent oxygen desaturation or arousal hypopnea definition and hypertension. Journal of Clinical Sleep Medicine, 15 September, 15(9), pp. 1261–1270.
- Osman, A.M., Carter, S.G., Carberry, J.C., Eckert, D.J., 2018. Obstructive sleep apnea: current perspectives. Nature and Science of Sleep, [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789079/ [Accessed 27 December 2020].
- Benjafield, A. V., Ayas, N.T., Eastwood, P.R., Heinzer, R., Ip, M.S.M., Morrell, M.J., et al., 2019. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. The Lancet Respiratory Medicine, [online] Available at: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(19)301985 [Accessed 1 January 2021].
- Black, Julie K. et al. 2020. The implementation of a physical activity intervention in adults with Obstructive Sleep Apnoea over the age of 50 years: A feasibility uncontrolled clinical trial. BMC Sports Science, Medicine and Rehabilitation, [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414532/ [Accessed 28 Juni 2021]
- Cvengros, J.A., Rodríguez, V.M., Snyder, S., Hood, M.M., Crawford, M., Park, M., 2017. An Adaptive Treatment to Improve Positive Airway Pressure (PAP) Adherence in Patients With Obstructive Sleep Apnea: A Proof of Concept Trial. Behav. Sleep Med. 15, 345–360. Gottlieb, D.J., Punjabi, N.M., 2020. Diagnosis and Management of Obstructive Sleep Apnea: A Review. Journal of the American Medical Association, 14 April, 323(14), pp. 1380–1400.
- Torres-Castro, R. et al. 2021. Effects of Exercise in Patients with Obstructive Sleep Apnoea. Clocks & Sleep, 3 March, 3(1), pp. 227–235.
- Van Offenwert, E. et al. 2019. Physical activity and exercise in obstructive sleep apnea. Acta Clinica Belgia: International Journal of Clinical and Laboratory Medicine, 4 May, 74(2), pp. 92–101.
- Hall, K.A., Singh, M.M., Mukherjee, S., Palmer, L.J., 2020. Physical activity is associated with reduced prevalence of self-reported obstructive sleep apnea in a large, general population cohort study. Journal of Clinical Sleep Medicine,15 July, 16(7), pp. 1179–1187.
- Riskesdas, K., 2018. Hasil Utama Riset Kesehata Dasar (RISKESDAS). [pdf] Bengkulu: Kementrian Kesehatan Republik Indonesia. Available at: http://ejournal2.litbang.kemkes.go.id/index.php/lpb/issue/view/230 [Accessed 27 December 2020].
- Patel, Avani R et al. 2019. The Association of Obstructive Sleep Apnea and Hypertension. Cureus, [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6684296/ 11(6) [Accessed 15 August 2021].
- Mônico-Neto, M., Moreira Antunes, H.K., Thomatieli Dos Santos, R.V., D’Almeida, V., Lino De Souza, A.A., Azeredo Bittencourt, L.R., et al., 2018. Physical activity as a moderator for obstructive sleep apnoea and cardiometabolic risk in the EPISONO study. Sleep Apnoea, [online] Available at: http://dx.doi.org/10.1183/13993003.01972-2017 [Accessed 1 Februari 2021].
- Vecchiato, M., Neunhaeuserer, D., Quinto, G., Bettini, S., Gasperetti, A., Battista, F., et al., 2021. Cardiopulmonary exercise testing in patients with moderate-severe obesity: a clinical evaluation tool for OSA? Sleep and Breathing, [online] Available at: https://doi.org/10.1007/s11325-021-02475-0 [Accessed 17 November 2021].
- Kasiakogias, A. et al. 2013. A hypertensive response to exercise is prominent in patients with obstructive sleep apnea and hypertension: A controlled study.Journal of Clinical Hypertension, July, 15(7), pp. 497–502.
- Barbosa, B.T., da Cruz Santos, A., Frazão, M., Petrucci, T.R., Cucato, G.G., Sarmento, A.O., 2018. Obstructive sleep apnea does not impair cardiorespiratory responses to progressive exercise performed until exhaustion in hypertensive elderly. Sleep Breath, [online] Available at: DOI:10.1007/s11325-017-1557-7 [Accessed 20 November 2021].
- Vgontzas, A.N., Li, Y., He, F., Fernandez-Mendoza, J., Gaines, J., Liao, D., et al., 2019. Mild-to-moderate sleep apnea is associated with incident hypertension: Age effect. Sleep Research Society, [online] Available at: 10.1093/sleep/zsy265 [Accessed 15 December 2021].
- Bouloukaki, I., Grote, L., McNicholas, W.T., Hedner, J., Verbraecken, J., Parati, G.,et al., 2020. Mild obstructive sleep apnea increases hypertension risk, challenging traditional severity classification. Journal Clinical Sleep Medicine, 15 June, 16(6), pp. 889–898.
- Chowdhuri, S., Quan, S.F., Almeida, F., Ayappa, I., Batool-Anwar, S., Budhiraja, R., et al., 2016. An official american thoracic society research statement: Impact of mild obstructive sleep apnea in adults. American Journal Respiratory Critical Care Medicine, 1 May, 193(9), pp.e37–e54.
- Mendelson, M., Tamisier, R., Laplaud, D., Dias-Domingos, S., Baguet, J.P., Moreau, L., Koltes, C., Chavez, L., de Lamberterie, G., Herengt, F., Levy, P., Flore, P., Pépin, J.L., 2014. Low physical activity is a determinant for elevated blood pressure in high cardiovascular risk obstructive sleep apnea. Respir. Care 59, 1218–1227.
- Gottlieb, D.J., Punjabi, N.M., 2020. Diagnosis and Management of Obstructive Sleep Apnea: A Review. Journal of the American Medical Association, 14 April, 323(14), pp. 1380–1400.
- Bangash, A., Wajid, F., Poolacherla, R., Mim, F.K., Rutkofsky, I.H., 2020. Obstructive Sleep Apnea and Hypertension: A Review of the Relationship and Pathogenic Association. Cureus, [online] Available at: DOI:10.7759/cureus.8241 [Accessed 28 November 2021].
- Schultz, M. G., La Gerche, A. and Sharman, J. E. 2017. Blood Pressure Response to Exercise and Cardiovascular Disease. Current Hypertension Reports, 18October, 19(11), pp. 1–7.
- Han, T., Zhang, L., Yan Yu, C., Ming Li, Y., Wang, Y., Zhang, X.L., 2020. Ventilatory response to exercise is preserved in patients with obesity hypoventilation syndrome. Journal Clinical Sleep Medicine, 15 December, 16(12), pp. 2089–2098.
- Qin, H., Steenbergen, N., Glos, M., Wessel, N., Kraemer, J.F., Vaquerizo-Villar, F., 2021. The Different Facets of Heart Rate Variability in Obstructive Sleep Apnea. Frontiers Psychiatry, 22 July, 12(1), pp. 1–20.
Referensi
Budhiraja, R., Javaheri, S., Parthasarathy, S., Berry, R.B., Quan, S.F., 2019. The association between obstructive sleep apnea characterized by a minimum 3 percent oxygen desaturation or arousal hypopnea definition and hypertension. Journal of Clinical Sleep Medicine, 15 September, 15(9), pp. 1261–1270.
Osman, A.M., Carter, S.G., Carberry, J.C., Eckert, D.J., 2018. Obstructive sleep apnea: current perspectives. Nature and Science of Sleep, [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789079/ [Accessed 27 December 2020].
Benjafield, A. V., Ayas, N.T., Eastwood, P.R., Heinzer, R., Ip, M.S.M., Morrell, M.J., et al., 2019. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. The Lancet Respiratory Medicine, [online] Available at: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(19)301985 [Accessed 1 January 2021].
Black, Julie K. et al. 2020. The implementation of a physical activity intervention in adults with Obstructive Sleep Apnoea over the age of 50 years: A feasibility uncontrolled clinical trial. BMC Sports Science, Medicine and Rehabilitation, [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414532/ [Accessed 28 Juni 2021]
Cvengros, J.A., Rodríguez, V.M., Snyder, S., Hood, M.M., Crawford, M., Park, M., 2017. An Adaptive Treatment to Improve Positive Airway Pressure (PAP) Adherence in Patients With Obstructive Sleep Apnea: A Proof of Concept Trial. Behav. Sleep Med. 15, 345–360. Gottlieb, D.J., Punjabi, N.M., 2020. Diagnosis and Management of Obstructive Sleep Apnea: A Review. Journal of the American Medical Association, 14 April, 323(14), pp. 1380–1400.
Torres-Castro, R. et al. 2021. Effects of Exercise in Patients with Obstructive Sleep Apnoea. Clocks & Sleep, 3 March, 3(1), pp. 227–235.
Van Offenwert, E. et al. 2019. Physical activity and exercise in obstructive sleep apnea. Acta Clinica Belgia: International Journal of Clinical and Laboratory Medicine, 4 May, 74(2), pp. 92–101.
Hall, K.A., Singh, M.M., Mukherjee, S., Palmer, L.J., 2020. Physical activity is associated with reduced prevalence of self-reported obstructive sleep apnea in a large, general population cohort study. Journal of Clinical Sleep Medicine,15 July, 16(7), pp. 1179–1187.
Riskesdas, K., 2018. Hasil Utama Riset Kesehata Dasar (RISKESDAS). [pdf] Bengkulu: Kementrian Kesehatan Republik Indonesia. Available at: http://ejournal2.litbang.kemkes.go.id/index.php/lpb/issue/view/230 [Accessed 27 December 2020].
Patel, Avani R et al. 2019. The Association of Obstructive Sleep Apnea and Hypertension. Cureus, [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6684296/ 11(6) [Accessed 15 August 2021].
Mônico-Neto, M., Moreira Antunes, H.K., Thomatieli Dos Santos, R.V., D’Almeida, V., Lino De Souza, A.A., Azeredo Bittencourt, L.R., et al., 2018. Physical activity as a moderator for obstructive sleep apnoea and cardiometabolic risk in the EPISONO study. Sleep Apnoea, [online] Available at: http://dx.doi.org/10.1183/13993003.01972-2017 [Accessed 1 Februari 2021].
Vecchiato, M., Neunhaeuserer, D., Quinto, G., Bettini, S., Gasperetti, A., Battista, F., et al., 2021. Cardiopulmonary exercise testing in patients with moderate-severe obesity: a clinical evaluation tool for OSA? Sleep and Breathing, [online] Available at: https://doi.org/10.1007/s11325-021-02475-0 [Accessed 17 November 2021].
Kasiakogias, A. et al. 2013. A hypertensive response to exercise is prominent in patients with obstructive sleep apnea and hypertension: A controlled study.Journal of Clinical Hypertension, July, 15(7), pp. 497–502.
Barbosa, B.T., da Cruz Santos, A., Frazão, M., Petrucci, T.R., Cucato, G.G., Sarmento, A.O., 2018. Obstructive sleep apnea does not impair cardiorespiratory responses to progressive exercise performed until exhaustion in hypertensive elderly. Sleep Breath, [online] Available at: DOI:10.1007/s11325-017-1557-7 [Accessed 20 November 2021].
Vgontzas, A.N., Li, Y., He, F., Fernandez-Mendoza, J., Gaines, J., Liao, D., et al., 2019. Mild-to-moderate sleep apnea is associated with incident hypertension: Age effect. Sleep Research Society, [online] Available at: 10.1093/sleep/zsy265 [Accessed 15 December 2021].
Bouloukaki, I., Grote, L., McNicholas, W.T., Hedner, J., Verbraecken, J., Parati, G.,et al., 2020. Mild obstructive sleep apnea increases hypertension risk, challenging traditional severity classification. Journal Clinical Sleep Medicine, 15 June, 16(6), pp. 889–898.
Chowdhuri, S., Quan, S.F., Almeida, F., Ayappa, I., Batool-Anwar, S., Budhiraja, R., et al., 2016. An official american thoracic society research statement: Impact of mild obstructive sleep apnea in adults. American Journal Respiratory Critical Care Medicine, 1 May, 193(9), pp.e37–e54.
Mendelson, M., Tamisier, R., Laplaud, D., Dias-Domingos, S., Baguet, J.P., Moreau, L., Koltes, C., Chavez, L., de Lamberterie, G., Herengt, F., Levy, P., Flore, P., Pépin, J.L., 2014. Low physical activity is a determinant for elevated blood pressure in high cardiovascular risk obstructive sleep apnea. Respir. Care 59, 1218–1227.
Gottlieb, D.J., Punjabi, N.M., 2020. Diagnosis and Management of Obstructive Sleep Apnea: A Review. Journal of the American Medical Association, 14 April, 323(14), pp. 1380–1400.
Bangash, A., Wajid, F., Poolacherla, R., Mim, F.K., Rutkofsky, I.H., 2020. Obstructive Sleep Apnea and Hypertension: A Review of the Relationship and Pathogenic Association. Cureus, [online] Available at: DOI:10.7759/cureus.8241 [Accessed 28 November 2021].
Schultz, M. G., La Gerche, A. and Sharman, J. E. 2017. Blood Pressure Response to Exercise and Cardiovascular Disease. Current Hypertension Reports, 18October, 19(11), pp. 1–7.
Han, T., Zhang, L., Yan Yu, C., Ming Li, Y., Wang, Y., Zhang, X.L., 2020. Ventilatory response to exercise is preserved in patients with obesity hypoventilation syndrome. Journal Clinical Sleep Medicine, 15 December, 16(12), pp. 2089–2098.
Qin, H., Steenbergen, N., Glos, M., Wessel, N., Kraemer, J.F., Vaquerizo-Villar, F., 2021. The Different Facets of Heart Rate Variability in Obstructive Sleep Apnea. Frontiers Psychiatry, 22 July, 12(1), pp. 1–20.