, Volume 192, Issue 1, pp 175–184

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

  • Imran H. Iftikhar
  • Christopher E. Kline
  • Shawn D. Youngstedt

DOI: 10.1007/s00408-013-9511-3

Cite this article as:
Iftikhar, I.H., Kline, C.E. & Youngstedt, S.D. Lung (2014) 192: 175. doi:10.1007/s00408-013-9511-3



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.


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.


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 VO2 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.


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.


Exercise Obstructive sleep apnea Cardiorespiratory fitness Daytime sleepiness 

Supplementary material

408_2013_9511_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 13 kb)

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Imran H. Iftikhar
    • 1
  • Christopher E. Kline
    • 2
  • Shawn D. Youngstedt
    • 3
    • 4
  1. 1.Division of Pulmonary, Critical Care and Sleep Medicine, Department of MedicineUniversity of South CarolinaColumbiaUSA
  2. 2.Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghUSA
  3. 3.Departments of Exercise Science and PsychologyUniversity of South CarolinaColumbiaUSA
  4. 4.WJB Dorn VA Medical CenterColumbiaUSA

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