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Does physical exercise reduce excessive daytime sleepiness by improving inflammatory profiles in obstructive sleep apnea patients?

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Abstract

Introduction

Obstructive sleep apnea syndrome (OSAS) is associated with a variety of long-term consequences such as high rates of morbidity and mortality, due to excessive diurnal somnolence as well as cardiovascular and metabolic diseases. Obesity, recurrent episodes of upper airway obstruction, progressive hypoxemia, and sleep fragmentation during sleep cause neural, cardiovascular, and metabolic changes. These changes include activation of peripheral sympathetic nervous system and the hypothalamic–pituitary–adrenal axis, insulin sensitivity, and inflammatory cytokines alterations, which predispose an individual to vascular damage.

Discussion

Previous studies proposed that OSAS modulated the expression and secretion of inflammatory cytokines from fat and other tissues. Independent of obesity, patients with OSAS exhibited elevated levels of C-reactive protein, tumor necrosis factor-α and interleukin-6, which are associated with sleepiness, fatigue, and the development of a variety of metabolic and cardiovascular diseases. OSAS and obesity are strongly associated with each other and share many common pathways that induce chronic inflammation. Previous studies suggested that the protective effect of exercise may be partially attributed to the anti-inflammatory effect of regular exercise, and this effect was observed in obese patients. Although some studies assessed the effects of physical exercise on objective and subjective sleep parameters, the quality of life, and mood in patients with OSAS, no study has evaluated the effects of this treatment on inflammatory profiles. In this review, we cited some studies that directed our opinion to believe that since OSAS causes increased inflammation and has excessive daytime sleepiness as a symptom and being that physical exercise improves inflammatory profiles and possibly OSAS symptoms, it must be that physical exercise improves excessive daytime sleepiness due to its improvement in inflammatory profiles.

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Acknowledgments

This work was funded by the Associação Fundo de Incentivo à Pesquisa, Centro de Estudos em Psicobiologia e Exercício, Centro de Estudo Multidisciplinar em Sonolência e Acidentes, CEPID/SONO-FAPESP (#98/14303-3), CNPq, CAPES, FAPESP (#03/11037-0), and UNIFESP.

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No conflicts of interest are declared.

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Authors and Affiliations

  1. Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo—UNIFESP, São Paulo, CEP: 04020-050, Brazil

    Eduardo da Silva Alves, Carolina Ackel-D’Elia, Gabriela Pontes Luz, Thays Crosara Abrahão Cunha, Sergio Tufik, Lia Rita Azeredo Bittencourt & Marco Tulio de Mello

  2. Disciplina de Endocrinologia, Departamento de Clínica Médica, Universidade Federal de São Paulo—UNIFESP, São Paulo, Brazil

    Gláucia Carneiro

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  1. Eduardo da Silva Alves
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  2. Carolina Ackel-D’Elia
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  8. Marco Tulio de Mello
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Correspondence to Marco Tulio de Mello.

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Eduardo da Silva Alves and Carolina Ackel-D’Elia contributed equally to this work.

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Alves, E.d.S., Ackel-D’Elia, C., Luz, G.P. et al. Does physical exercise reduce excessive daytime sleepiness by improving inflammatory profiles in obstructive sleep apnea patients?. Sleep Breath 17, 505–510 (2013). https://doi.org/10.1007/s11325-012-0729-8

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