Effects of exercise training on sleep apnea: a meta-analysis

Abstract

Background: Several studies have shown a favorable effect of supervised exercise training on obstructive sleep apnea (OSA). This meta-analysis was conducted to analyze the data from these studies on the severity of OSA (primary outcome) in adults. Secondary outcomes of interest included body mass index (BMI), sleep efficiency, daytime sleepiness and cardiorespiratory fitness.

Methods: Two independent reviewers searched PubMed and Embase (from inception to March 6, 2013) to identify studies on the effects of supervised exercise training in adults with OSA. Pre- and postexercise training data on our primary and secondary outcomes were extracted.

Results: A total of 5 studies with 6 cohorts that enrolled a total of 129 study participants met the inclusion criteria. The pooled estimate of mean pre- to postintervention (exercise) reduction in AHI was −6.27 events/h (95 % confidence interval [CI] -8.54 to -3.99; p < 0.001). The pooled estimates of mean changes in BMI, sleep efficiency, Epworth sleepiness scale and VO2 peak were -1.37 (95 % CI −2.81 to 0.07; p = 0.06), 5.75 % (95 % CI 2.47-9.03; p = 0.001), -3.3 (95 % CI -5.57 to -1.02; p = 0.004), and 3.93 mL/kg/min (95 % CI 2.44-5.42; p < 0.001), respectively.

Conclusions: This meta-analysis shows a statistically significant effect of exercise in reducing the severity of sleep apnea in patients with OSA with minimal changes in body weight. Additionally, the significant effects of exercise on cardiorespiratory fitness, daytime sleepiness, and sleep efficiency indicate the potential value of exercise in the management of OSA.

Conflict of interest statement

Conflict of interest The authors report no potential conflicts of interest with any companies/organizations whose products or services may be discussed in this article.

Figures

Fig. 1

Flow diagram of articles identified and evaluated during the study selection process

Fig. 2

Forest plot for the change in AHI following exercise. The diamond reflects the 95 % confidence interval of the pooled estimate of mean difference. AHI apnea hypopnea index CI confidence intervals

Fig. 3

Forest plot for the change in BMI following exercise. The diamond reflects the 95 % confidence interval of the pooled estimate of mean difference. BMI body mass index CI confidence intervals

Fig. 4

Forest plot for the change in sleep efficiency following exercise. The diamond reflects the 95 % confidence interval of the pooled estimate of mean difference. SE sleep efficiency CI confidence intervals

Fig. 5

Forest plot for the change in Epworth Sleepiness Scale following exercise. The diamond reflects the 95 % confidence interval of the pooled estimate of mean difference. ESS Epworth Sleepiness Scale CI confidence intervals

Fig. 6

Forest plot for the change in VO2 peak following exercise. The diamond reflects the 95 % confidence interval of the pooled estimate of mean difference. VO2 peak cardiorespiratory fitness measured as peak oxygen consumption in mL/kg/min. CI confidence intervals