The implementation of a physical activity intervention in adults with Obstructive Sleep Apnoea over the age of 50 years: a feasibility uncontrolled clinical trial

Abstract

Background: Obstructive Sleep Apnoea (OSA) is a risk factor for cardiovascular disease (CVD) and Type 2 diabetes (T2D). Observational studies suggested that OSA treatment might reduce CVD and T2D but RCTs failed to support these observations in part due to poor adherence to continuous positive airway pressure (CPAP). Physical activity (PA) has been shown to have favourable impact on CVD and the risk of T2D independent of its impact on weight and therefore might provide additional health gains to patients with OSA, whether or not adherent to CPAP. Methods: The main aim of this study was to explore the feasibility of providing a 12-week PA intervention to adults aged over 50 with OSA. The secondary aim was to assess the impact of the PA intervention on OSA severity. Patients with moderate-severe OSA (apnoea hypopnea index (AHI) ≥ 15 events/hour (based on overnight ApneaLink™) were recruited in response to posters displayed in workplaces. A 12-week daily PA intervention was delivered in participant's home setting and PA was monitored via text and validated by objective PA measures (GT3X accelerometers). Results: The intervention was feasible as all 10 patients (8 males, mean (SD) age 57.3 (6.01)) completed the intervention and PA increased across the 12-weeks. The duration of PA increased from baseline (113.1 min (64.69) per week to study-end following the intervention (248.4 min (148.31) (p = 0.02). Perceived Exertion (RPE) (physical effort) increased significantly between baseline (M = 10.7 (1.94)) to end of intervention (M = 13.8, (1.56) (p < 0.001). The intervention had no significant impact on weight or composition. Following the intervention, there was a statistically non-significant a reduction in AHI from baseline to study end (22.3 (7.35) vs. 15.8 (7.48); p = 0.09). Conclusion: It is feasible to deliver a PA intervention to adults aged over 50 with OSA. The intervention resulted in improved PA and AHI levels somewhat and seemingly independent of weight changes. Future trials need to examine whether PA can reduce the burden of OSA associated comorbidities.

An individualized mobile health intervention to promote physical activity in adults with obstructive sleep apnea: An intervention mapping approach

“…Despite the benefit of PA in the context of OSA, 10 – 13 , 16 – 41 , 125 few studies have incorporated an outcome associated with PA level to measure the effect of interventions on the PA behavior itself. 24 – 29 , 40 , 41 The results are nevertheless heterogeneous, and more RCTs that integrate behavioral outcomes are needed.…”

“…Despite the benefit of PA in the context of OSA, 10 – 13 , 16 – 41 , 125 few studies have incorporated an outcome associated with PA level to measure the effect of interventions on the PA behavior itself. 24 – 29 , 40 , 41 The results are nevertheless heterogeneous, and more RCTs that integrate behavioral outcomes are needed. 11 The analysis of PA interventions from 20 experimental studies targeting patients with OSA 12 , 24 – 41 , 125 indicate that only 2 (10%) studies provided educational content 12 …”

“…Only one trial observed increased PA levels after the intervention in patients with OSA and coronary artery disease. 25 Since the publication of this meta-analysis, three studies have measured PA levels, 27 – 29 but only Black et al 28 and Berger et al 29 evaluated this outcome (i.e. PA questionnaire and accelerometer: unit in counts) before and after the intervention.…”

“… 29 Many studies have focused on the effects of PA interventions on the parameters associated with OSA. 12 , 24 , 25 , 27 , 28 , 30 – 41 By contrast, few have explicitly investigated the effect of a PA intervention on PA behavior itself using objective 26 or subjective measurements. 29 This limited number of studies integrating the outcome of PA is surprising insofar as CPAP, as the first-line treatment of OSA, has a limited impact on cardiometabolic risk factors, whereas exercise training has a well-documented effect on numerous cardiometabolic risk factors.…”

The affection of plasma exosomes on airway obstruction and endothelial function in OSA patients

“…Obstructive Sleep Apnea (OSA) is a common and complex respiratory disease characterized by repeated complete or incomplete upper airway collapse during sleep and has a high incidence. According to relevant statistics, the incidence rate is about 1%~3% (1) and about 1 billion people around the world are affected (2).…”