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Effects of respiratory muscle training (RMT) in patients with mild to moderate obstructive sleep apnea (OSA)

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Different forms of training focusing on the muscles of the upper airways showed limited effects on obstructive sleep apnea (OSA) and/or snoring. We investigated the effect of generalized respiratory muscle training (RMT) in lean patients with mild to moderate OSA.

Methods

Nine male subjects (52.0 ± 10.8 years, BMI 29.1 ± 2.1 kg/m2) with obstructive sleep apnea (apnea-hypopnea index (AHI) 9–29) participated in an open, single-arm pilot study. After a 1-week build-up phase, patients underwent 4 weeks of normocapnic hyperpnea RMT five times a week for 30 min each. The initial and final measurements comprised polysomnography, pulmonary function tests, Epworth sleepiness scale (ESS), and SF-36 questionnaire (quality of life (QoL) self-assessment). The investigational site was a university-affiliated hospital for pulmonary diseases and sleep medicine, Solingen/Germany.

Results

Patients trained effectively, seen by a significant (p < 0.01) increase of breathing frequency (23.3 ± 1.5 /min vs. 30.6 ± 2.9 /min) and minute volume (81.2 ± 13.7 L vs. 109.1 ± 21.9 L). AHI, snoring and ESS remained unchanged after training. QoL as measured by SF-36 significantly (p < 0.05) improved after the training in the subscales “bodily pain” (79 ± 21 vs. 90 ± 12) and “change of health” (3.1 ± 0.3 vs. 2.4 ± 0.5).

Conclusions

There is no evidence that AHI, pulmonary function or daytime sleepiness are affected by 5 weeks of RMT. Nevertheless, there is an improvement of parameters of quality of life.

Trial registration

ClinicalTrials.gov, register no. NCT 00936286

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Abbreviations

AHI:

apnea-hypopnea index

BF:

breathing frequency

BMI:

body mass index

CPAP:

continuous positive airway pressure

MV:

minute volume ventilation

MVV:

maximum voluntary ventilation

OAI:

obstructive apnea index

ODI:

oxygen desaturation index

OSA:

obstructive sleep apnea

QoL:

quality of life

RAI:

respiratory arousal index

RMT:

respiratory muscle training

VC:

vital capacity

VT:

tidal volume

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Acknowledgments

The authors thank idiag AG, Fehraltorf, Switzerland, for supporting this investigational trial. This includes as well the permission for showing Figs. 1 and 2.

Funding

This study was funded by idiag AG, Fehraltorf, Switzerland.

Author information

Authors and Affiliations

  1. Institute of Pneumology at the University of Cologne, Clinic for Pneumology and Allergology, Center of Sleep Medicine and Respiratory Care, Bethanien Hospital, Aufderhoeherstraße 169-175, 42699, Solingen, Germany

    Simon Dominik Herkenrath, Marcel Treml, Christina Priegnitz & Winfried J. Randerath

  2. Krankenhaus der Augustinerinnen, Jakobstraße 27, 50678, Cologne, Germany

    Wolfgang Galetke

Authors
  1. Simon Dominik Herkenrath
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  2. Marcel Treml
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  3. Christina Priegnitz
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  4. Wolfgang Galetke
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  5. Winfried J. Randerath
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Corresponding author

Correspondence to Winfried J. Randerath.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript. However, WR reports grants and personal fees outside the submitted work from Heinen and Löwenstein, Weinmann, Resmed, Inspire, and Philips Respironics.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the University of Witten/Herdecke Ethics Committee.

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Herkenrath, S.D., Treml, M., Priegnitz, C. et al. Effects of respiratory muscle training (RMT) in patients with mild to moderate obstructive sleep apnea (OSA). Sleep Breath 22, 323–328 (2018). https://doi.org/10.1007/s11325-017-1582-6

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  • DOI: https://doi.org/10.1007/s11325-017-1582-6

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