Higher apnoea-hypopnoea index is associated with reduced exercise capacity and increased all-cause mortality in a general population
In a population-based study of 1001 participants, a higher AHI was inversely associated with peak oxygen uptake (V'O2 peak) and significantly associated with all-cause mortality over a median 10.3-year follow-up (hazard ratio 1.31-1.72). Mediation analysis suggested a possible but non-significant indirect effect via reduced exercise capacity.
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Higher apnoea-hypopnoea index is associated with reduced exercise capacity and increased all-cause mortality in a general population The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 34/100 (low).
The Claim
Higher apnoea-hypopnoea index is associated with reduced exercise capacity and increased all-cause mortality in a general population
This conclusion is most relevant to: General population adults aged 44-63 years from the SHIP-TREND cohort (47.1% women, mean age 54 years).
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Association of obstructive sleep apnoea with exercise capacity and mortality in a population-based study: results of SHIP-TREND. (ERJ open research, 2026) —
How It Works
The proposed biological pathway:
- ▸Obstructive sleep apnoea leads to intermittent hypoxia and sleep fragmentation
- ▸These disturbances impair cardiovascular and respiratory function
- ▸Reduced cardiopulmonary fitness (lower V'O2 peak) may contribute to mortality risk
- ▸Result: Elevated AHI is directly associated with increased mortality, with a non-significant indirect pathway through reduced exercise capacity
Who Might Benefit
Evidence fit by population:
- ▸General population adults aged 44-63 years from the SHIP-TREND cohort (47.1% women, mean age 54 years)
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Observational design cannot establish causality
- ▸Mediation analysis showed non-significant indirect effect, limiting conclusions about the mediating role of exercise capacity
Frequently Asked Questions
What is the apnoea-hypopnoea index (AHI) and how was it measured?▼
AHI measures the number of apnoea and hypopnoea events per hour of sleep, assessed via single-night polysomnography in this study.
Did the study find that exercise capacity mediates the link between sleep apnoea and mortality?▼
No, the indirect effect via V'O2 peak was not statistically significant, though a possible role was suggested for further investigation.
How many participants died during follow-up?▼
73 deaths occurred over a median follow-up of 10.3 years.
What was the average AHI in men versus women?▼
Men had a higher AHI (7.9 events/h) compared to women (2.6 events/h).
References
- 1.Obst A, Stubbe B, Kaczmarek S, Daboul A, Krüger M, Völzke H, Penzel T, Fietze I, Ewert R. “Association of obstructive sleep apnoea with exercise capacity and mortality in a population-based study: results of SHIP-TREND..” ERJ open research, 2026. PMID: 42516907 DOI: 10.1183/23120541.01520-2025