有氧运动和抗阻训练对阻塞性睡眠呼吸暂停的影响：系统评价和荟萃分析。
Effects of aerobic exercise and resistance training on obstructive sleep apnea: a systematic review and meta-analysis.
机构信息
Department of Otorhinolaryngology - Head and Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
出版信息
J Clin Sleep Med. 2024 Nov 1;20(11):1839-1849. doi: 10.5664/jcsm.11310.
STUDY OBJECTIVES
We investigated the therapeutic effects of exercise in patients with obstructive sleep apnea, aiming to identify the subgroups that benefit the most and determine the optimal exercise protocol.
METHODS
Major databases were searched for randomized controlled trials involving patients with obstructive sleep apnea performing aerobic exercise and/or resistance training. The investigated outcomes included apnea-hypopnea index (AHI), Epworth Sleepiness Scale, body mass index, and peak oxygen consumption during exercise (VOpeak). The pre- and postintervention unstandardized mean difference (USMD) of these parameters was compared between the exercise and control groups.
RESULTS
Twelve studies involving 526 patients were included. Exercise training significantly reduced AHI (USMD = -7.08 events/h, 95% confidence interval: -9.98 to -4.17, < .00001), Epworth Sleepiness Scale (USMD = -2.37, 95% confidence interval: -3.21 to -1.54, < .00001), and body mass index (USMD = -0.72 kg/m, 95% confidence interval: -1.22 to -0.22, = .005) and enhanced VOpeak (USMD = 3.46 ml·kg·min, 95% confidence interval: 1.20 to 5.71, = .003). Subgroup analyses revealed that in continuous positive airway pressure-adherent patients, exercise significantly improved VOpeak but did not reduce AHI and Epworth Sleepiness Scale. A trend was observed that combining resistance training with aerobic exercise resulted in greater AHI reduction and VOpeak enhancement. Notably, exercise improved AHI, Epworth Sleepiness Scale, body mass index, and VOpeak regardless of the baseline AHI or body mass index.
CONCLUSIONS
Exercise, including resistance and aerobic training, should be part of treatment for patients with obstructive sleep apnea of all severities, regardless of obesity status, and even for those who are already under continuous positive airway pressure.
CITATION
Lin C-F, Ho N-H, Hsu W-L, Lin C-H, Wang Y-H, Wang Y-P. Effects of aerobic exercise and resistance training on obstructive sleep apnea: a systematic review and meta-analysis. 2024;20(11):1839-1849.
研究目的
本研究旨在探讨运动疗法对阻塞性睡眠呼吸暂停患者的治疗效果，以确定获益最大的亚组，并确定最佳的运动方案。
方法
检索了涉及接受有氧运动和/或抗阻训练的阻塞性睡眠呼吸暂停患者的随机对照试验的主要数据库。研究的结局指标包括呼吸暂停低通气指数（apnea-hypopnea index，AHI）、Epworth 嗜睡量表、体质量指数（body mass index，BMI）和运动时峰值摄氧量（peak oxygen consumption during exercise，VOpeak）。比较运动组和对照组这些参数的干预前后未标准化均数差值（unstandardized mean difference，USMD）。
结果
共纳入 12 项涉及 526 例患者的研究。运动训练可显著降低 AHI（USMD = -7.08 次/小时，95%置信区间：-9.98 至 -4.17，<.00001）、Epworth 嗜睡量表评分（USMD = -2.37，95%置信区间：-3.21 至 -1.54，<.00001）和 BMI（USMD = -0.72 kg/m，95%置信区间：-1.22 至 -0.22，=.005），并提高 VOpeak（USMD = 3.46 ml·kg·min，95%置信区间：1.20 至 5.71，=.003）。亚组分析显示，在持续气道正压通气（continuous positive airway pressure，CPAP）依从性良好的患者中，运动可显著提高 VOpeak，但对 AHI 和 Epworth 嗜睡量表评分无显著降低作用。结果还提示，联合抗阻和有氧运动训练可能会更显著地降低 AHI 和提高 VOpeak。值得注意的是，无论基线 AHI 或 BMI 如何，运动均可改善 AHI、Epworth 嗜睡量表评分、BMI 和 VOpeak。
结论
对于各种严重程度的阻塞性睡眠呼吸暂停患者，包括肥胖患者和 CPAP 治疗患者，运动（包括抗阻和有氧运动）都应作为治疗的一部分，而且运动可改善阻塞性睡眠呼吸暂停的各项指标。
引文
Lin C-F, Ho N-H, Hsu W-L, Lin C-H, Wang Y-H, Wang Y-P. Effects of aerobic exercise and resistance training on obstructive sleep apnea: a systematic review and meta-analysis. 2024;20(11):1839-1849.
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