Erturk Nurel, Celik Adem, Kahraman Yaman Sevim, Yaman Huseyin, Unal Ferhat, Calik Kutukcu Ebru
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tarsus University, Mersin, Turkey.
Department of Chest Medicine and Sleep Center, University of Health Sciences, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey.
Sleep. 2024 Dec 11;47(12). doi: 10.1093/sleep/zsae221.
This study aimed to evaluate and compare the effects of high and low-intensity expiratory muscle strength training (EMST) on disease severity, systemic inflammation, oxidative stress, respiratory muscle strength, exercise capacity, symptoms, daytime sleepiness, fatigue severity, and sleep quality in male patients with obstructive sleep apnea syndrome (OSAS).
Thirty-one male patients diagnosed with moderate OSAS were included in this double-blind, randomized, parallel study. Patients were randomized into two groups: High-EMST and Low-EMST groups. EMST was used at home 7 days/week, once a day, for 25 breaths, 12 weeks. Respiratory muscle strength was measured using a mouth pressure device. Disease severity (Apnea-Hypopnea Index [AHI]) and, respiratory sleep events by polysomnography, total oxidant level(TOS), total antioxidant level(TAS), oxidative stress index (OSI), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) levels by blood serum were evaluated.
The percentage of AHI change in the high-EMST group(50.8%) was significantly higher than in the low-EMST group(6.3%; p = .002, d = 1.31). In general, as MEP increased by one unit, AHI decreased by 0.149 points (b = -0.149; CR = -3.065; p = .002), and as AHI increased by one unit, ODI increased by 0.746 points (b = 0.746; CR = 10.604; p < .001). TOS, OSI, TNF-α and IL-6 levels decreased at similar rates in both groups.
EMST significantly reduces systemic inflammation and oxidative stress while improving expiratory muscle strength in male patients with moderate OSAS. High-EMST is more effective in enhancing the severity of disease than low-EMST. EMST is a practical, effective, and promising treatment for pulmonary rehabilitation in patients with moderate OSAS.
Effect of EMST systemic inflammation and oxidative stress in patients with moderate OSAS, https://clinicaltrials.gov/study/NCT05242406, with the number NCT05242406.
本研究旨在评估和比较高强度与低强度呼气肌力量训练（EMST）对男性阻塞性睡眠呼吸暂停综合征（OSAS）患者疾病严重程度、全身炎症、氧化应激、呼吸肌力量、运动能力、症状、日间嗜睡、疲劳严重程度和睡眠质量的影响。
本双盲、随机、平行研究纳入了31例诊断为中度OSAS的男性患者。患者被随机分为两组：高EMST组和低EMST组。EMST在家中每周进行7天，每天一次，每次25次呼吸，共12周。使用口腔压力装置测量呼吸肌力量。通过多导睡眠图评估疾病严重程度（呼吸暂停低通气指数[AHI]）和呼吸睡眠事件，通过血清评估总氧化剂水平（TOS）、总抗氧化剂水平（TAS）、氧化应激指数（OSI）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和白细胞介素-10（IL-10）水平。
高EMST组AHI变化百分比（50.8%）显著高于低EMST组（6.3%；p = .002，d = 1.31）。一般来说，随着最大呼气压力（MEP）每增加一个单位，AHI降低0.149分（b = -0.149；CR = -3.065；p = .002），随着AHI每增加一个单位，氧减指数（ODI）增加0.746分（b = 0.746；CR = 10.604；p < .001）。两组中TOS、OSI、TNF-α和IL-6水平以相似的速率下降。
EMST可显著降低中度OSAS男性患者的全身炎症和氧化应激，同时提高呼气肌力量。高EMST在改善疾病严重程度方面比低EMST更有效。EMST是中度OSAS患者肺康复的一种实用、有效且有前景的治疗方法。
EMST对中度OSAS患者全身炎症和氧化应激的影响，https://clinicaltrials.gov/study/NCT05242406，编号NCT05242406。
