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This cross-sectional study assessed 33 men with the Pittsburgh Sleep Quality Index (PSQI) and breath-by-breath CPET gas analysis to evaluate correlations and group differences between good and poor sleepers. Poorer sleep quality initially related to lower chronotropic response and ventilatory measures at peak, with expired O2 remaining associated after adjusting for age, height, and 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the Chronotropic and Ventilatory Response Relationship with Sleep Quality in Healthy Young Men: ACross-Sectional Study  \nAhmad M. Osailan   \nAcademic Editor: Izolde Bouloukaki  \nReceived: 5 November 2025  \nRevised: 15 December 2025  \nAccepted: 26 December 2025  \nPublished: 27 December 2025  \nCopyright: © 2025 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \nHealth and Rehabilitation Sciences Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj 16278, Saudi Arabia; [a.osailan@psau.edu.sa](a.osailan@psau.edu.sa)  \nAbstract  \nBackground: Sleep quality is critical to health, and its disturbances may affect multiple systems, including autonomic and respiratory regulation. However, its relationship with chronotropic and ventilatory responses in healthy young men remains underexplored. Thus, the study aimed to investigate the relationship between sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), and chronotropic and ventilatory responses during cardiopulmonary exercise testing (CPET) in a healthy young male population and to explore group differences between good and poor sleepers. Methods: Thirty-three healthy men completed the PSQI and a graded CPET with breath-by-breath gas analysis. Pearson correlation was used to examine relationships between the PSQI and CPET outcomes: chronotropic response (%), tidal volume (VT), minute ventilation (VE), VO 2, VCO2, expired O2 /CO2, VE/VO2, and VE/VCO2. After accounting for age, height, and weight, the correlation was reassessed. Secondary analyses using a standard cut-off point compared good (PSQI \u003C 5) vs. poor sleepers (PSQI ≥ 5) with Welch’s t-tests. Results: Participants were predominantly poor sleepers (84.8%; PSQI 7.3 ± 3.2) . A higher PSQI correlated with lower chronotropic response (r = −0.35, p = 0.04), lower VT (r = −0.42, p = 0.02), lower expired O 2 (r = −0.46, p = 0.01), and lower expired CO 2 (r = −0.33, p = 0.05) . Associations with VE, VO2, VCO2, VE/VO2, and VE/VCO2 were small and non-significant (p > 0.05) . When age, height, and weight were controlled for, the attenuated chronotropic response association with the PSQI was not significant; however, the PSQI association remained significant for expired O 2 (r = −0.32, p = 0.04), with a trend for VT. In group comparisons, chronotropic response was higher but not significant; good sleepers showed higher VT and greater expired O 2/CO2 (p \u003C 0.05) . Conclusions: Poorer sleep quality was initially associated with multiple cardiopulmonary responses at peak during CPET. However, after controlling for age and anthropometry measures, only expired O 2 remained linked. The findings suggest that routine sleep quality screening may add interpretive value to CPET by flagging individuals with reduced ventilatory depth, warranting prospective studies to test whether improving sleep quality can enhance exercise responses.  \nKeywords: sleep quality; chronotropic response; blunted autonomic response; ventilatory response; exercise testing  \n1. Introduction  \nSleep is an essential component of health and is known to be fundamental in supporting metabolic, immune, neurocognitive, and cardiovascular homeostasis [1,2] . Because sleep is critical to many physiological functions, inadequate or disrupted sleep can disrupt multiple systems. For example, it may lead to glucose intolerance and elevated blood pressure [3] . Additionally, a blunted autonomic response has been reported among those with poor sleep quality, whereas ventilatory insufficiency has been reported in people with sleep disorders [4,5] . This sleep inadequacy may subsequently lead to an increased risk of cardiovascular morbidity and mortality [6] .  \nThere are numerous methods for non-invasively e","cbCait3EjLksegbB","https://ap.wps.com/l/cbCait3EjLksegbB","pdf",914565,15,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# 1. Introduction\n## Autonomic nervous system and chronotropic response\n## Ventilatory control and exercise gas exchange dynamics","[{\"question\":\"What was the study’s main objective?\",\"answer\":\"To investigate how sleep quality relates to chronotropic and ventilatory responses during CPET in healthy young men, and to compare good versus poor sleepers.\"},{\"question\":\"How was sleep quality measured?\",\"answer\":\"Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI).\"},{\"question\":\"Which CPET outcome remained associated with PSQI after controlling for age and body measures?\",\"answer\":\"After adjusting for age, height, and weight, the association with chronotropic response attenuated and only expired O2 remained significantly linked to PSQI.\"}]","Sleep Quality and Cardiopulmonary Responses During Exercise Testing - Exploring the Chronotropic and Ventilatory Response Relationship with Sleep Quality in Healthy Young Men | PDF",1790762705,38]