Effects of Exercise Training on Sleep Apnea: A Meta-analysis

• Published in: Lung Vol. 192; no. 1; pp. 175 - 184
• Main Authors: Iftikhar, Imran H., Kline, Christopher E., Youngstedt, Shawn D.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-02-2014; Springer; Springer Nature B.V
• Subjects: Body Mass Index; Care and treatment; Exercise; Exercise Therapy; Health aspects; Humans; Medicine; Medicine & Public Health; Meta-analysis; Oxygen Consumption; Patient outcomes; Physical Fitness; Physiological aspects; Pneumology/Respiratory System; Severity of Illness Index; Sleep; Sleep apnea; Sleep apnea syndromes; Sleep Apnea Syndromes - complications; Sleep Apnea Syndromes - diagnosis; Sleep Apnea Syndromes - physiopathology; Sleep Apnea Syndromes - therapy; Treatment Outcome; United States; Cardiorespiratory fitness; Exercise; Daytime sleepiness; Obstructive sleep apnea
• ISSN: 0341-2040; 1432-1750
• DOI: 10.1007/s00408-013-9511-3

Background
Several studies have shown a favorable effect of supervised exercise training on obstructive sleep apnea (OSA). This meta-analysis was conducted to analyze the data from these studies on the severity of OSA (primary outcome) in adults. Secondary outcomes of interest included body mass index (BMI), sleep efficiency, daytime sleepiness and cardiorespiratory fitness.
Methods
Two independent reviewers searched PubMed and Embase (from inception to March 6, 2013) to identify studies on the effects of supervised exercise training in adults with OSA. Pre- and postexercise training data on our primary and secondary outcomes were extracted.
Results
A total of 5 studies with 6 cohorts that enrolled a total of 129 study participants met the inclusion criteria. The pooled estimate of mean pre- to postintervention (exercise) reduction in AHI was −6.27 events/h (95 % confidence interval [CI] −8.54 to −3.99;
p
 < 0.001). The pooled estimates of mean changes in BMI, sleep efficiency, Epworth sleepiness scale and VO
2
peak were −1.37 (95 % CI −2.81 to 0.07;
p
 = 0.06), 5.75 % (95 % CI 2.47–9.03;
p
 = 0.001), −3.3 (95 % CI −5.57 to −1.02;
p
 = 0.004), and 3.93 mL/kg/min (95 % CI 2.44–5.42;
p
 < 0.001), respectively.
Conclusions
This meta-analysis shows a statistically significant effect of exercise in reducing the severity of sleep apnea in patients with OSA with minimal changes in body weight. Additionally, the significant effects of exercise on cardiorespiratory fitness, daytime sleepiness, and sleep efficiency indicate the potential value of exercise in the management of OSA.