Effects of exercise training associated with continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome
- First Online:
- 669 Downloads
The aim of this study was to evaluate the effects of a 2-month exercise training associated with continuous positive airway pressure (CPAP) treatment on the subjective and objective sleep measurements, quality of life, and mood in moderate to severe obstructive sleep apnea syndrome (OSAS) patients.
Male patients were randomized into two treatment groups: CPAP (n = 19) and CPAP + exercise (n = 13). All patients completed 1 month of sleep hygiene, 2 months of treatment (CPAP or CPAP + exercise), and 1 week of washout (no treatment). Fletcher and Luckett sleep questionnaire, Epworth sleepiness scale, sleep diaries, polysomnography, SF-36 inventory of quality of life, Profile of Mood States (POMS) questionnaire, neck circumference, and body composition were evaluated. CPAP + exercise group also underwent cardiopulmonary exercise test before and after treatment.
Both treatments were effective in improving subjective sleepiness but CPAP + exercise treatment was more effective in maintaining this improvement after washout. No significant differences were found in most of the sleep parameters studied in both groups. CPAP + exercise group showed lower values of tension and fatigue on POMS and higher values of physical functioning, general health perception, and vitality on SF-36 after treatment.
A 2-month exercise training associated with CPAP treatment for OSAS patients has a positive impact on subjective daytime sleepiness, quality of life (physical functioning and general health perception), and mood state (tension and fatigue).
KeywordsObstructive sleep apnea syndrome CPAP Exercise training Mood state Quality of life Polysomnography
- 1.American Academy of Sleep Medicine (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definitions and measurements techniques in clinical research. The report of an American Academy of Sleep Medicine task force. Sleep 22:667–689Google Scholar
- 2.Conrad I, Ancoli-Israel S, Chesson AL (2007) The American Academy of Sleep Medicine manual for the scoring of sleep and associated events: rules, terminology and technical specifications. American Academy of Sleep Medicine, WestchesterGoogle Scholar
- 5.Ozturk L, Metin G, Çuhadaroglu Ç, Utkusavas A, Tutluoglu B (2005) Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. Tuberkuloz vê Toraks Dergisi 53:10–18Google Scholar
- 12.Kushida CA, Littner MR, Hirshkowitz M, Morgenthaler TI, Alessi CA, Bailey D, Boehlecke B, Brown TM, Coleman J Jr, Friedman L, Kapen S, Kapur VK, Kramer M, Lee-Chiong T, Owens J, Pancer JP, Swick TJ, Wise MS (2006) American Academy of Sleep Medicine. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 29:375–380PubMedGoogle Scholar
- 15.Przybylowski T, Bielicki P, Kumor M, Hildebrand K, Maskey-Warzechowska M, Wiwala J, Kosciuch J, Korczyniski P, Chazan R (2006) Influence of nasal continuous positive airway pressure on response to exercise in patients with obstructive sleep apnea syndrome. Pneumonol Alergol Pol 74:39–44PubMedGoogle Scholar
- 27.American College of Sports Medicine (2000) ACSM’s guidelines for exercise testing and prescription, 6th edn. Williams & Wilkins, BaltimoreGoogle Scholar
- 29.McArdle N, Devereux G, Heidarnejad H, Engleman HM, Mackay TW, Douglas NJ (1999) Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Crit Care Med 159:1108–1114Google Scholar
- 31.Zarcone VP Jr (2000) Sleep Hygiene. In: Kryger MH, Roth T, Dement WC (eds) Principles and practice of sleep medicine. Elsevier Saunders, PhiladelphiaGoogle Scholar
- 34.McNair DM, Lorr M, Droppleman LF (1971) Profile of mood states. Educational and Industrial Testing Service, San DiegoGoogle Scholar
- 35.Rechtschaffen A, Kales A (1968) A manual of standardized technology, techniques and scoring system for sleep stages of human subjects. Brain Information Service/Brain Research Institute, UCLA, Los AngelesGoogle Scholar
- 36.American Sleep Disorders Association (1992) Atlas Task Force—EEG arousals: scoring rules and examples. Sleep 15:174–184Google Scholar
- 37.American Sleep Disorders Association (1993) Atlas Task Force—recording and scoring leg movements. Sleep 16:749–759Google Scholar
- 40.Siri WE (1961) Body composition from fluid spaces and density: analysis of methods. In: Henschel A (ed) Techniques for measuring body composition. National Academy of Sciences, National Research Council, Washington DCGoogle Scholar
- 52.Hack M, Davies RJ, Mullins R, Choi SJ, Ramdassingh-Dow S, Jenkinson C, Stradling JR (2000) Randomised prospective parallel trial of therapeutic versus subtherapeutic nasal continuous positive airway pressure on simulated steering performance in patients with obstructive sleep apnoea. Thorax 55:224–231PubMedCrossRefGoogle Scholar
- 53.Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jenkinson C, Stradling JR, Davies RJ (2002) Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 359:204–210PubMedCrossRefGoogle Scholar
- 60.Monasterio C, Vidal S, Duran J, Ferrer M, Carmona C, Barbé F, Mayos M, Gonzalez-Mangado N, Juncadella M, Navarro A, Barreira R, Capote F, Mayoralas LR, Peces-Barba G, Alonso J, Montserrat JM (2001) Effectiveness of continuous positive airway pressure in mild sleep apnea–hypopnea syndrome. Am J Respir Crit Care Med 164:939–943PubMedGoogle Scholar
- 65.Barbé F, Mayoralas LR, Duran J, Masa JF, Maimó A, Montserrat JM, Monasterio C, Bosch M, Ladaria A, Rubio M, Rubio R, Medinas M, Hernandez L, Vidal S, Douglas NJ, Agustí AG (2001) Treatment with continuous positive airway pressure is not effective in patients with sleep apnea but no daytime sleepiness. a randomized, controlled trial. Ann Intern Med 134:1015–1023PubMedGoogle Scholar
- 66.Montserrat JM, Ferrer M, Hernandez L, Farré R, Vilagut G, Navajas D, Badia JR, Carrasco E, De Pablo J, Ballester E (2001) Effectiveness of CPAP treatment in daytime function in sleep apnea syndrome: a randomized controlled study with an optimized placebo. Am J Respir Crit Care Med 164:608–613PubMedGoogle Scholar