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单次吸气肌训练对阻塞性睡眠呼吸暂停患者的临床安全性及血液动力学、心脏自主神经和炎症反应的影响。

Clinical safety and hemodynamic, cardiac autonomic and inflammatory responses to a single session of inspiratory muscle training in obstructive sleep apnea.

机构信息

Post Graduate Program of Physical Therapy, Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego, 1235, Cidade Universitária, Recife, PE, CEP: 50670-901, Brazil.

Department of Physical Education, Federal University of Paraíba (UFPB), Cidade Universitária, s/n - Castelo Branco III, João Pessoa, PB, CEP: 58051-900, Brazil.

出版信息

Sleep Breath. 2022 Mar;26(1):99-108. doi: 10.1007/s11325-021-02364-6. Epub 2021 Apr 5.

DOI:10.1007/s11325-021-02364-6
PMID:33821439
Abstract

PURPOSE

To determine clinical safety and cardiovascular, cardiac autonomic and inflammatory responses to a single session of inspiratory muscle training (IMT) in obstructive sleep apnea (OSA) subjects.

METHODS

In a randomized controlled trial individuals of both sexes, aged between 30 and 70 years old with diagnosis of moderate to severe OSA were enrolled. Volunteers with OSA (n = 40) performed an IMT session with three sets of 30 repetitions with a 1-min interval between them. The IMT group (n = 20) used a load of 70% of the maximum inspiratory pressure (MIP), and the placebo group (n = 20) performed the IMT without load. Measurements of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), heart rate variability (HRV), and inflammatory markers were performed pre, post-immediate and 1 h after the IMT session.

RESULTS

No differences were shown in SBP, DBP, HRV, or inflammatory markers at any of the intervals analyzed. However, HR in the IMT group was lower ​​1 h after the IMT session compared to the pre-session values ​​(p = 0002). HR was higher in the placebo group when comparing pre × post-immediate (p < 0.001). HR decreased after the first hour in relation to the pre (p < 0.001) and post-immediate (p < 0.001) values.

CONCLUSION

IMT sessions promote discreet hemodynamic, cardiac autonomic and inflammatory responses. Therefore, IMT is considered clinically safe and can be performed at home, guided but unsupervised, with lower cost and greater adherence to exercise program for subjects with OSA.

摘要

目的

确定单次吸气肌训练(IMT)对阻塞性睡眠呼吸暂停(OSA)患者的临床安全性以及心血管、心脏自主神经和炎症反应。

方法

在一项随机对照试验中,纳入了年龄在 30 至 70 岁之间、被诊断为中重度 OSA 的男女两性受试者。OSA 患者(n=40)进行了一次 IMT 治疗,共三组,每组 30 次,每组之间间隔 1 分钟。IMT 组(n=20)使用的吸气肌压力为 70%最大吸气压力(MIP),安慰剂组(n=20)则在无负荷的情况下进行 IMT。在 IMT 治疗前、治疗即刻后和治疗后 1 小时测量收缩压(SBP)、舒张压(DBP)、心率(HR)、心率变异性(HRV)和炎症标志物。

结果

在分析的任何时间间隔内,SBP、DBP、HRV 或炎症标志物均无差异。然而,与治疗前相比,IMT 组在治疗后 1 小时的 HR 更低(p=0.0002)。与治疗前相比,安慰剂组在即刻后(p<0.001)的 HR 更高。与治疗前(p<0.001)和即刻后(p<0.001)相比,HR 在治疗后 1 小时内下降。

结论

IMT 治疗可引起轻微的血液动力学、心脏自主神经和炎症反应。因此,IMT 被认为是临床安全的,可以在家庭中进行,在没有监督的情况下进行指导,成本更低,对 OSA 患者的运动计划的依从性更高。

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