Exercise Is Associated with a Reduced Incidence of Sleep-disordered Breathing

Awad, Karim M.; Malhotra, Atul; Barnet, Jodi H.; Quan, Stuart F.; Peppard, Paul E.

doi:10.1016/j.amjmed.2011.11.025

Cited by 77 publications

(72 citation statements)

References 29 publications

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“…Regular physical activity can also enhance the effects of CPAP therapy, as it has been associated with reduced incidence and severity of sleep-disordered breathing in longitudinal and cross-sectional studies. [60][61][62][63] …”

Section: Discussionmentioning

confidence: 99%

Low Physical Activity Is a Determinant for Elevated Blood Pressure in High Cardiovascular Risk Obstructive Sleep Apnea

Mendelson

Tamisier

Laplaud³

et al. 2013

Respir Care

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INTRODUCTION:Obstructive sleep apnea (OSA) is associated with cardiovascular morbidity, including hypertension. Beyond the severity of nocturnal hypoxia, other factors such as metabolic abnormalities but also sedentary behaviors and insufficient physical activity may contribute to elevated blood pressure (BP). To clarify the respective role of these factors as determinants of BP in OSA patients, we examined the relationship between BP and anthropometrics, severity of sleep apnea, and objectively measured physical activity and sedentary behaviors. METHODS: Ninetyfive adults presenting with OSA (apnea-hypopnea index > 10 events/h) and high cardiovascular risk (63.3 ؎ 8.8 y; body mass index: 29.9 ؎ 4.9 kg/m 2 ; apnea-hypopnea index: 41.3 ؎ 17.5/h; cardiovascular risk score: 13.5 ؎ 3.7%) were included. Physical activity and sedentary behaviors were objectively assessed by actigraphy, and self-measured home BP monitoring was measured. Logistic regression models adjusted for sex, age, and body mass index were built to identify the predictors of self-measured morning and evening BP. RESULTS: Physical activity was significantly related to obesity but not to the severity of sleep apnea or sleepiness. Sedentary behaviors were associated with self-measured morning and evening systolic BP (r ‫؍‬ 0.32, P ‫؍‬ .002; r ‫؍‬ 0.29, P ‫؍‬ .004). Steps per day were inversely associated with evening BP (r ‫؍‬ ؊0.27, P ‫؍‬ .01). Univariate analysis identified steps/d and time spent in vigorous physical activity as determinants for evening self-measured BP. In multivariate analysis, only steps/d were identified as a significant determinant of evening BP. CONCLUSIONS: Physical activity is the major determinant for evening BP in adults with OSA presenting high cardiovascular risk. Our results emphasize the need for lifestyle counseling programs in combination with CPAP to encourage regular physical activity in OSA subjects to obtain better BP control. (ClinicalTrials.gov registration NCT01226641.)

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Section: Discussionmentioning

confidence: 99%

Low Physical Activity Is a Determinant for Elevated Blood Pressure in High Cardiovascular Risk Obstructive Sleep Apnea

Mendelson

Tamisier

Laplaud³

et al. 2013

Respir Care

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“…8,9 Longitudinal data suggests reduced incidence of OSA in those who exercise regularly. 6 Two crosssectional studies have reported lower odds of moderate-severe…”

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confidence: 99%

“…[3][4][5] Studies examining the effect of exercise on OSA demonstrate that the incidence of OSA is higher among those who rarely undertake vigorous activity. 6 Sedentary activities have been recognized to contribute to the risk of type 2 diabetes and cardiovascular disease, 7 but their impact on OSA is yet to be examined.…”

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confidence: 99%

Physical Inactivity Is Associated with Moderate-Severe Obstructive Sleep Apnea

Simpson

McArdle

Eastwood

et al. 2015

Journal of Clinical Sleep Medicine

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Study Objectives: To investigate whether low levels of physical activity were associated with an increased occurrence of obstructive sleep apnea (OSA), OSA-related symptoms, and cardiometabolic risk. Methods: A case-control study design was used. OSA cases were patients referred to a sleep clinic for suspected OSA (n = 2,340). Controls comprised participants from the Busselton community (n = 1,931). Exercise and occupational activity were derived from questionnaire data. Associations were modelled using logistic and linear regression and adjusted for confounders. Results: In comparison with moderate exercise, the high, low, and nil exercise groups had an odds ratio (OR) for moderate-severe OSA of 0.6 (95% CI 0.5-0.8), 1.6 (95% CI 1.2-2.0), and 2.7 (95% CI 1.9-3.7), respectively. Relative to men in heavy activity occupations, men in medium, light and sedentary occupations had an OR for moderate-severe OSA of 1.7 (95% CI 1.1-2.5), 2.1 (95% CI 1.4-3.2), and 1.8 (95% CI 1.2-2.8), respectively. Relative to women in medium activity occupations, women in light and sedentary occupations had an OR for moderate-severe OSA of 4.2 (95% CI 2.6-7.2) and 3.5 (2.0-6.0). OSA patients who adequately exercised had lower: levels of doctor-diagnosed depression (p = 0.047); symptoms of fatigue (p < 0.0001); systolic (p = 0.015) and diastolic blood pressure (p = 0.015); and C-reactive protein (CRP) (p = 0.003). Conclusions: Low levels of physical activity were associated with moderate-severe OSA. Exercise in individuals with OSA is associated with lower levels of depression, fatigue, blood pressure and CRP.

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“…First, we can check prospective studies on the effects of regular physical training on OSA symptoms, and second, we can focus on possible associations between training and OSA symptoms in a retrospective way. In the last months, interesting studies were published, showing that exercise training is associated with a reduced incidence of mild and moderate sleep-disordered breathing [6] and that physical exercise improves selected aspects of daytime functioning in OSA patients [7].In this issue of S&B, Verwimp et al[8] report on data of their retrospective study with moderate to severe OSA patients regarding possible associations between sleep parameters and quality of life on one hand and daily physical activity on the other hand. Up to now, only preliminary results were published assuming that there is an inverse relationship between physical activity and OSA severity.…”

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confidence: 99%

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confidence: 99%

Regular physical exercise: evidence for health benefits in OSA patients?

Schobersberger

2013

Sleep Breath

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Obstructive sleep apnea syndrome (OSA) is recognized as a growing public health problem with an increasing prevalence up to 5 % in men. As an independent risk factor, it is associated with several diseases such as hypertension, coronary heart disease, or stroke thus increasing cardiovascular morbidity and mortality [1]. Furthermore, classical OSA symptoms are daytime sleepiness, tiredness, fatigue, neurocognitive dysfunction, and depression, worsening the individual's quality of life. Physical exercise in general has impressively been shown to be an essential factor in preventive medicine. For example, regular physical training (aerobic training and/or resistance training) improves respiratory function in patients with chronic obstructive pulmonary disease [2] and improves all risk factors of patients suffering from metabolic syndrome [3]. Even in the primary prevention of some cancers (e.g., mamma carcinoma and colon carcinoma), physical exercise plays a crucial role [4]. Therefore, regular physical training is suggested to be effective in several diseases such as a medication and 10,000 steps per day were recommended as preventive measure [5]. Is there a causal link between OSA severity and lack of physical exercise? The approach to answer this question is dual. First, we can check prospective studies on the effects of regular physical training on OSA symptoms, and second, we can focus on possible associations between training and OSA symptoms in a retrospective way. In the last months, interesting studies were published, showing that exercise training is associated with a reduced incidence of mild and moderate sleep-disordered breathing [6] and that physical exercise improves selected aspects of daytime functioning in OSA patients [7].In this issue of S&B, Verwimp et al.[8] report on data of their retrospective study with moderate to severe OSA patients regarding possible associations between sleep parameters and quality of life on one hand and daily physical activity on the other hand. Up to now, only preliminary results were published assuming that there is an inverse relationship between physical activity and OSA severity. The study of Verwimp et al. could add new information on this topic by a real detection of the individual activity and energy expenditure with an established technology of Bodymedia SenseWear Pro Armband activity monitor over a 5-day period. Regarding physical exercise, the authors reported significant inverse correlations between the steps walked and the presence of comorbidities (hypertension, diabetes, obesity) and between the apnea hypopnea index in REM sleep. Moreover, the patients linked their subjective reduction of quality of life with their measured reduced physical activity. The authors concluded that the low level of physical activity is associated with OSA severity in somnolent moderate to severe OSA patients. Therefore, one could speculate that regular physical activity and training may reduce not only OSA-associated comorbidities but improve health-related quality of life. ...

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Exercise Is Associated with a Reduced Incidence of Sleep-disordered Breathing

Cited by 77 publications

References 29 publications

Low Physical Activity Is a Determinant for Elevated Blood Pressure in High Cardiovascular Risk Obstructive Sleep Apnea

Low Physical Activity Is a Determinant for Elevated Blood Pressure in High Cardiovascular Risk Obstructive Sleep Apnea

Physical Inactivity Is Associated with Moderate-Severe Obstructive Sleep Apnea

Regular physical exercise: evidence for health benefits in OSA patients?

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