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吸气肌训练对阻塞性睡眠呼吸暂停患者睡眠和运动功能的影响:一项随机对照试验。

Effectiveness of inspiratory muscle training on sleep and functional capacity to exercise in obstructive sleep apnea: a randomized controlled trial.

机构信息

Department of Physical Therapy, Federal University of Pernambuco, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, PE, 50670-901, Brazil.

Sleep and Heart Laboratory, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), University of Pernambuco, Rua dos Palmares, s/n, Santo Amaro, Recife, PE, 50100-060, Brazil.

出版信息

Sleep Breath. 2018 Sep;22(3):631-639. doi: 10.1007/s11325-017-1591-5. Epub 2017 Nov 9.

Abstract

PURPOSE

The aim of this study was to evaluate the effectiveness of inspiratory muscle training (IMT) on sleep and functional capacity to exercise in subjects with obstructive sleep apnea (OSA).

METHODS

This is a controlled, randomized, double-blind study conducted in 16 OSA patients divided into two groups: training (IMT: n = 8) and placebo-IMT (P-IMT: n = 8). IMT was conducted during 12 weeks with a moderate load (50-60% of maximal inspiratory pressure-MIP), while P-IMT used a load < 20% of MPI. Total daily IMT time for both groups was 30 min, 7 days per week, twice a day.

RESULTS

There was no difference comparing IMT to P-IMT group after training for lung function (p > 0.05) and respiratory muscle strength (p > 0.05). Maximal oxygen uptake (VO) was not significantly different between IMT and P-IMT group (mean difference - 1.76, confidence interval (CI) - 7.93 to 4.41, p = 0.71). The same was observed for the other ventilatory and cardiometabolic variables measured (p > 0.05). A significant improvement in sleep quality was found when Pittsburgh Sleep Quality Index (PSQI) values of IMT and P-IMT group after training were compared (mean difference: 3.7, confidence interval 95% (CI95%) 0.6 to 6.9, p = 0.02) but no significant changes were seen in daytime sleepiness between both groups after the intervention (mean difference: 3.4, CI 95%: - 3.3 to 10.0; p = 0.29).

CONCLUSION

According to these results, 12 weeks of moderate load IMT resulted in improved sleep quality, but there were no significant repercussions on functional capacity to exercise or excessive daytime sleepiness.

摘要

目的

本研究旨在评估吸气肌训练(IMT)对阻塞性睡眠呼吸暂停(OSA)患者睡眠和运动功能的影响。

方法

这是一项对照、随机、双盲研究,共纳入 16 例 OSA 患者,分为两组:训练组(IMT:n=8)和假训练组(P-IMT:n=8)。IMT 持续 12 周,负荷为最大吸气压力(MIP)的 50-60%,而 P-IMT 则使用<20%的 MIP 负荷。两组的总 IMT 时间为 30 分钟,每周 7 天,每天两次。

结果

训练后,与 P-IMT 组相比,IMT 组的肺功能(p>0.05)和呼吸肌力量(p>0.05)无差异。最大摄氧量(VO)在 IMT 和 P-IMT 组之间也没有显著差异(平均差值为-1.76,置信区间(CI)为-7.93 至 4.41,p=0.71)。其他通气和心血管代谢变量的测量结果也是如此(p>0.05)。当比较 IMT 和 P-IMT 组训练后的匹兹堡睡眠质量指数(PSQI)值时,发现睡眠质量显著改善(平均差值:3.7,置信区间 95%(CI95%)为 0.6 至 6.9,p=0.02),但干预后两组日间嗜睡无显著变化(平均差值:3.4,CI 95%:-3.3 至 10.0;p=0.29)。

结论

根据这些结果,12 周的中等负荷 IMT 可改善睡眠质量,但对运动功能或日间嗜睡无显著影响。

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