Can Exercise Alone Improve Outcomes in Sleep Apnea?

A new study has found that exercise as the sole intervention for patients with obstructive sleep apnea (OSA) is linked to improved clinical outcomes.

Seeking to assess the efficacy of exercise on apnea/hypopnea index (AHI) in adult patients with OSA, a team including researchers from Arizona State University conducted a systematic review and meta-analysis of studies encompassing 182 patients. While the investigators’ search yielded more than 8,000 studies, only 8 met the criteria for inclusion. Additional objectives included evaluation of other indices of OSA and well-being in patients after completing an exercise regimen, according to the authors. The meta-analysis included studies with pre- and post-exercise intervention measures of AHI in adult patients with OSA without other major comorbidities, including heart failure, chronic obstructive pulmonary disease, and neuromuscular disorders.
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Overall, exercise was associated with a reduction in AHI after treatment. In total, 4 studies compared mean Epworth sleepiness scale (ESS) scores pre- and post-intervention for a control group and experimental group, with exercise connected to a larger decrease in the total ESS score after treatment. In addition, 4 studies compared mean body mass index (BMI) values pre- and post-intervention for a control group and experimental group. Exercise was not found to have a statistically significant effect on BMI. Relative risks and odds ratios also demonstrated decreases in AHI in patients who exercised.

“Exercise is widely applicable, cost-effective, and beneficial not only for OSA, but also [for improving] general health, cardiovascular outcomes, improving mood, sleep, and diabetes control,” said Kenneth D. Aiello, a graduate student at Arizona State University and a coauthor of the study.

Exercise, Aiello said, “should be prescribed in addition to CPAP [continuous positive airway pressure] or as an alternative in patients who are intolerant to CPAP.”

—Mark McGraw

Reference

Aiello KD, Caughey WG, Nelluri B, Sharma A, Mookadam F, Mookadam M. Effect of exercise training on sleep apnea: a systematic review and meta-analysis [published online May 21, 2016]. Respir Med. doi:http://dx.doi.org/10.1016/j.rmed.2016.05.015.