The Effect of Exercise Training on Obstructive Sleep Apnea and Sleep Quality: A Randomized Controlled Trial

Kline, Christopher E.; Crowley, Elizabeth; Ewing, Gary B.; Burch, James B.; Blair, Steven N.; Durstine, J. Larry; Davis, James H.; Youngstedt, Shawn D.

doi:10.5665/sleep.1422

Cited by 270 publications

(243 citation statements)

References 43 publications

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“…11 Intervention studies using prescribed exercise suggest that exercise reduces OSA severity, 25,26 and the absence of the protective effect of exercise may explain the mechanisms by which reduced activity causes sleep apnea. Exercise activity may positively modulate OSA by increase of upper airway tonus via the recruitment of upper airway muscles for breathing work or head stability.…”

Section: Discussionmentioning

confidence: 99%

“…For example, a sedentary state can lead to greater fluid accumulation in the legs. 25 Redolfi et al observed that fluid displacement from the legs into the neck increased neck circumference and the magnitude of displacement was proportional to the time spent sitting the previous day. 36 This may contribute to upper airway collapsibility independent of body weight.…”

mentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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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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“…Therefore, tailored exercise programmes fostering progressive overload and gradual conditioning of the individual may require consideration. Recent evidence suggests that exercise training may be associated with a reduction in OSA severity [78,87,88,90] and, not surprisingly, improved exercise capacity [84,85,87,91]. Exercise alone may also improve OSA severity without significant weight loss [77,88,90].…”

Section: Osa and Liver Damagementioning

confidence: 99%

“…Six randomised controlled trials have compared the effect of intensive lifestyle changes versus routine care in OSA [74][75][76][77][78][79]. The trials were mixed in duration, design and protocols employed, and no consistency was observed in the diet, exercise or structuring of the programmes employed (table 1).…”

Section: Osa and Liver Damagementioning

confidence: 99%

Sleep apnoea and metabolic dysfunction

Bonsignore¹,

Borel²,

Machan³

et al. 2013

European Respiratory Review

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Obstructive sleep apnoea (OSA) is a highly prevalent condition often associated with central obesity. In the past few years, several studies have analysed the potential independent contribution of OSA to the pathogenesis of metabolic abnormalities, including type 2 diabetes, the metabolic syndrome and nonalcoholic fatty liver disease. New perspectives in OSA patient care have been opened by the promotion of lifestyle interventions, such as diet and exercise programmes that could improve both OSA and the metabolic profile. The rich clinical literature on this subject, together with the growing amount of data on pathophysiological mechanisms provided by animal studies using the chronic intermittent hypoxia model, urged the organising Committee of the Sleep and Breathing meeting to organise a session on sleep apnoea and metabolic dysfunction, in collaboration with the European Association for the Study of Diabetes. This review summarises the state-of-the-art lectures presented in the session, more specifically the relationship between OSA and diabetes, the role of OSA in the metabolic consequences of obesity, and the effects of lifestyle interventions on nocturnal respiratory disturbances and the metabolic profile in OSA patients. @ERSpublications Treatment of obesity and metabolic diseases through diet and exercise should be part of OSA management besides CPAP

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“…It was found that the intensive lifestyle intervention reduced weight and AHI over 4 years more than diabetes support and education alone. 139 Other randomized trials investigating various lifestyle modifications such as very low-calorie diets (VLCDs) combined with active lifestyle counselling, 140 intensive exercise training, 142 cognitive-behavioural weight loss, and VLCD 143 showed improved OSA severity with these interventions. These effects of lifestyle measures in OSA may potentially be sustained over time.…”

Section: Treatment -Weight Lossmentioning

confidence: 99%

Sleep-disordered breathing, type 2 diabetes and the metabolic syndrome

Seetho

Wilding

2014

Chron Respir Dis

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Sleep-disordered breathing (SDB) encompasses a spectrum of conditions that can lead to altered sleep homeostasis. In particular, obstructive sleep apnoea (OSA) is the most common form of SDB and is associated with adverse cardiometabolic manifestations including hypertension, metabolic syndrome and type 2 diabetes, ultimately increasing the risk of cardiovascular disease. The pathophysiological basis of these associations may relate to repeated intermittent hypoxia and fragmented sleep episodes that characterize OSA which drive further mechanisms with adverse metabolic and cardiovascular consequences. The associations of OSA with type 2 diabetes and the metabolic syndrome have been described in studies ranging from epidemiological and observational studies to controlled trials investigating the effects of OSA therapy with continuous positive airway pressure (CPAP). In recent years, there have been rising prevalence rates of diabetes and obesity worldwide. Given the established links between SDB (in particular OSA) with both conditions, understanding the potential influence of OSA on the components of the metabolic syndrome and diabetes and the underlying mechanisms by which such interactions may contribute to metabolic dysregulation are important in order to effectively and holistically manage patients with SDB, type 2 diabetes or the metabolic syndrome. In this article, we review the literature describing the associations, the possible underlying pathophysiological mechanisms linking these conditions and the effects of interventions including CPAP treatment and weight loss.

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The Effect of Exercise Training on Obstructive Sleep Apnea and Sleep Quality: A Randomized Controlled Trial

Abstract: Clinicaltrials.gov identification number NCT00956423.

Cited by 270 publications

References 43 publications

Physical Inactivity Is Associated with Moderate-Severe Obstructive Sleep Apnea

Physical Inactivity Is Associated with Moderate-Severe Obstructive Sleep Apnea

Sleep apnoea and metabolic dysfunction

Sleep-disordered breathing, type 2 diabetes and the metabolic syndrome

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