PhyMedExp INSERM U1046 / CNRS UMR9214, Montpellier University, Montpellier, University Hospital, France.
Specialized Medical Center Medimarien, Marcel Marien Street 21, 1030, Brussels, Belgium; LaboCenter for the Study of Sleep Disorders, Neuroscience Pole, DELTA Hospital, CHIREC, Boulevard of the Triumph 201, 1160, Brussels, Belgium.
Sleep Med. 2020 Jun;70:33-42. doi: 10.1016/j.sleep.2020.02.008. Epub 2020 Feb 18.
Obstructive sleep apnea (OSA) is a high prevalent disorder with severe consequences including sleepiness, metabolic, and cardiovascular disorders. The aim of this study was to assess the effect of an individualized exercise-training (IET) program with educational sessions vs educational sessions alone on severity markers of OSA over an eight-week duration.
This was a randomised, controlled, parallel-design study. In sum, 64 patients with moderate-to-severe OSA (apnea-hypopnea index AHI 15-45/hour), low physical activity level (Voorrips<9), body-mass index (BMI) <40 kg/m were included in intervention group (IG) or control group (CG), and 54 patients finished the study. All underwent polysomnography (PSG), multiple sleep latency test (MSLT), constant workload exercise test, blood samples and fulfilled questionnaires twice. The primary endpoint was the change in apnea-hypopnea (AHI) at eight weeks from baseline. Main secondary endpoints were daytime sleepiness assessed by questionnaire and objective tests.
No significant between-group differences were found for changes in AHI. A reduction in AHI was found in IG only (p = 0.005). Compared to CG, exercise training leads to a greater decrease in AHI during REM sleep (p = 0.0004), with a significant increase in mean daytime sleep latency (p = 0.02). Between-group differences were significant for weight reduction, severity of fatigue, insomnia and depressive symptoms with trend for sleepiness symptoms.
In adult patients with moderate-to-severe OSA, IET did not decrease AHI compared to the control group but improved markers of severity of OSA, in particular AHI in rapid eye movement (REM) sleep and objective daytime sleepiness. Adding personalized exercise training to the management of patients with OSA should be considered. CLINICALTRIALS.
NCT01256307.
阻塞性睡眠呼吸暂停（OSA）是一种高患病率疾病，其严重后果包括嗜睡、代谢和心血管疾病。本研究旨在评估个体化运动训练（IET）方案与单纯教育课程对 8 周内 OSA 严重程度标志物的影响。
这是一项随机、对照、平行设计的研究。共纳入 64 例中重度 OSA（呼吸暂停低通气指数 AHI 15-45/小时）、低体力活动水平（Voorrips<9）、体重指数（BMI）<40kg/m2 的患者，分为干预组（IG）或对照组（CG），其中 54 例完成了研究。所有患者均进行了多导睡眠图（PSG）、多次睡眠潜伏期试验（MSLT）、恒负荷运动试验、血液样本检测和两次问卷调查。主要终点是从基线开始 8 周时呼吸暂停低通气（AHI）的变化。主要次要终点是通过问卷和客观测试评估日间嗜睡。
两组间 AHI 变化无显著差异。IG 组 AHI 降低（p=0.005）。与 CG 相比，运动训练可导致 REM 睡眠中 AHI 显著降低（p=0.0004），平均日间睡眠潜伏期显著延长（p=0.02）。IG 组在体重减轻、疲劳严重程度、失眠和抑郁症状方面的改善与嗜睡症状的改善呈显著趋势。
在中重度 OSA 成年患者中，与对照组相比，IET 并未降低 AHI，但改善了 OSA 严重程度的标志物，特别是 REM 睡眠中的 AHI 和客观日间嗜睡。应考虑将个体化运动训练纳入 OSA 患者的管理。临床试验.gov 标识符：NCT01256307。
