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Effect of exercise on sleep and cardiopulmonary parameters in patients with pulmonary artery hypertension

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Background

Pulmonary arterial hypertension (PAH) is considered to be a rare progressive disease resulting from restricted flow through the pulmonary arterial circulation resulting ultimately in right-sided heart failure. Most patients with PAH suffer from sleep disorders, reduced aerobic fitness, and mortality risk despite optimized medical treatment. This study investigated the effect of 12 weeks of aerobic training on sleep quality, sleep efficiency, right ventricular systolic pressure (RVSP), and aerobic fitness in patients with PAH.

Methods

Thirty patients with PAH were randomized to two equal groups, training group (A) and control group (B). The Pittsburg sleep quality index (PSQI) questionnaire and a wrist-worn actigraph were used for the assessment of sleep quality and sleep efficiency respectively. RVSP was measured using echocardiography. Cardiopulmonary exercise testing (CPET) assessed maximal heart rate and VO2max. All were measured before and after the study period for both groups. Exercise training was conducted on a bicycle ergometer as an individually-tailored moderate-intensity aerobic training session (60 to 70% of the maximal heart rate reached during the initial exercise test) for 30 to 45 min/day, 3 sessions/week for 12 weeks (36 sessions).

Results

Sleep scores and RVSP showed significant reductions and VO2max—representing the aerobic fitness—showed a significant increase in the group (A) compared with group (B).

Conclusion

These results suggest that aerobic training has a positive effect on three risk factors for mortality in patients with PAH, namely sleep quality, decline in exercise capacity, and right ventricular remodeling.

Clinical trials registration

Clinical trial registered in ClinicalTrials.gov, ID: NCT04337671.

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Authors and Affiliations

  1. Faculty of physical therapy, Cairo University, Cairo, Egypt

    Hady Atef & Heba Abdeen

Authors
  1. Hady Atef
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  2. Heba Abdeen
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Correspondence to Hady Atef.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The investigation conforms to the principles outlined in the Declaration of Helsinki (Br Med J 1964; ii: 177). Approval of Research Ethical committee of faculty of physical therapy, Cairo University was taken for this study on 3/12/2017 under number: P.T.REC/012/001806 and written informed consent for patient information and anonymous data usage to be published was provided by the patients. This randomized controlled trial includes a completed CONSORT flow chart and conducted following CONSORT guidelines. [44]

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What’s new?

According to our search, this paper is the first to address the cumulative effect of 3 mortality markers in PAH patients (sleep deprivation, physical fitness decline, and right ventricular remodeling), and highlights the utility of the aerobic training in the control of these markers.

Take-home messages

• Aerobic training can influence disturbed sleep, improve aerobic fitness, and has an antiremodeling effect (decrease RSVP) in PAH

• Rehabilitation using physical activity is a promising treatment in patients with PAH

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Atef, H., Abdeen, H. Effect of exercise on sleep and cardiopulmonary parameters in patients with pulmonary artery hypertension. Sleep Breath 25, 1953–1960 (2021). https://doi.org/10.1007/s11325-020-02286-9

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  • DOI: https://doi.org/10.1007/s11325-020-02286-9

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