Inspiratory muscle training as adjuvant therapy in obstructive sleep apnea: a randomized controlled trial

Inspiratory muscle training as adjuvant therapy in obstructive sleep apnea: a randomized controlled trial

The aim of this randomized controlled trial was to analyze the effects of an inspiratory muscle training (IMT) program on apnea and hypopnea index (AHI), inspiratory muscle strength, sleep quality, and daytime sleepiness in individuals with obstructive sleep apnea (OSA), whether or not they used con...

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Bibliographic Details
Published in:Brazilian journal of medical and biological research Vol. 55; no. 1; pp. 1 - e12331
Main Authors: de Azeredo, L.M, de Souza, L.C, Guimaraes, B.L.S, Puga, F.P, Behrens, N.S.C.S, Lugon, J.R
Format: Journal Article
Language:English
Published: Ribeirao Preto Associacao Brasileira de Divulgacao Cientifica (ABDC) 01-01-2022
Revista Brasileira de Pesquisas Medicas
Associação Brasileira de Divulgação Científica
Subjects:
Adjuvant therapy
Apnea
BIOLOGY
Breathing exercise
Breathing exercises
Care and treatment
Clinical trials
Continuous positive airway pressure
Daytime
Diagnosis
Health aspects
MEDICINE, RESEARCH & EXPERIMENTAL
Muscle strength
Obstructive sleep apnea
Patient outcomes
Quality of life
Respiration
Respiratory muscle training
Sleep
Sleep and wakefulness
Sleep apnea
Sleep apnea syndromes
Sleep disorders
Brazil
Breathing exercise
Sleep
Obstructive sleep apnea
Respiratory muscle training
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Summary:The aim of this randomized controlled trial was to analyze the effects of an inspiratory muscle training (IMT) program on apnea and hypopnea index (AHI), inspiratory muscle strength, sleep quality, and daytime sleepiness in individuals with obstructive sleep apnea (OSA), whether or not they used continuous positive airway pressure (CPAP (+ /-) therapy. The intervention group underwent IMT with a progressive resistive load of 40-70% of the maximum inspiratory pressure (PImax) for 30 breaths once a day for 12 weeks. The control group was submitted to a similar protocol, but with at a minimum load of 10 cm[H.sub.2]O. Changes in the AHI were the primary outcome. PImax was measured with a digital vacuometer, daytime somnolence was measured by the Epworth sleepiness scale (ESS), and the quality of sleep by the Pittsburgh Sleep Quality Index (PSQI). CPAP use was treated as a confounder and controlled by stratification resulting in 4 subgroups: IMT- /CPAP-, IMT-/CPAP + , IMT + /CPAP-, and IMT + /CPAP + . Sixty-five individuals were included in the final analysis. Significant variations were found in the 4 parameters measured throughout the study after the intervention in both CPAP- and CPAP+ participants: PImax was increased and AHI was reduced, whereas improvements were seen in both ESS and PSQI. The twelve- week IMT program increased inspiratory muscle strength, substantially reduced AHI, and had a positive impact on sleep quality and daytime sleepiness, whether or not participants were using CPAP. Our findings reinforce the role of an IMT program as an adjunct resource in OSA treatment. Key words: Sleep; Obstructive sleep apnea; Respiratory muscle training; Breathing exercise
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ISSN:0100-879X
1414-431X
1414-431X
1678-4510
DOI:10.1590/1414-431X2022e12331