High-intensity interval training improves obstructive sleep apnoea

Trine Karlsen, Bjarne Martens Nes, Arnt Erik Tjønna, Morten Engstrøm, Asbjørn Støylen, Sigurd Steinshamn, Trine Karlsen, Bjarne Martens Nes, Arnt Erik Tjønna, Morten Engstrøm, Asbjørn Støylen, Sigurd Steinshamn

Abstract

Background: Three hours per week of vigorous physical activity is found to be associated with reduced odds of sleep-disordered breathing.

Aim: To investigate whether 12 weeks of high-intensity interval training (HIIT) reduced the apnoea-hypopnea index (AHI) in obese subjects with moderate-to-severe obstructive sleep apnoea.

Methods: In a prospective randomised controlled exercise study, 30 (body mass index 37±6 kg/m2, age 51±9 years) patients with sleep apnoea (AHI 41.5±25.3 events/hour) were randomised 1:1 to control or 12 weeks of supervised HIIT (4×4 min of treadmill running or walking at 90%-95% of maximal heart rate two times per week).

Results: In the HIIT group, the AHI was reduced by 7.5±11.6 events/hour (within-group p<0.05), self-reported sleepiness (Epworth scale) improved from 10.0±3.6 to 7.3±3.7 (between-group p<0.05) and maximal oxygen uptake improved from 28.2±7.4 to 30.2±7.7 mL/kg/min (between-group p<0.05) from baseline to 12 weeks. The AHI, self-reported sleepiness and VO2maxwere unchanged from baseline to 12 weeks in controls (baseline AHI 50.3±25.5 events/hour, Epworth score 5.9±4.3, maximal oxygen uptake 27.0±6.8 mL/kg/min). Body weight remained unchanged in both groups.

Conclusion: Twelve weeks of HIIT improved the AHI and self-reported daytime sleepiness in subjects with obese sleep apnoea without any change in the desaturation index and body weight.

Keywords: CVD risk; HIIT; OSA; VO2max; daytime sleepiness; endurance exercise.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Study flow chart. CON, control group; HIIT, high-intensity interval training.
Figure 2
Figure 2
Change in AHI (A), oxygen desaturation index (C) and oxygen saturation (D) measured by respiratory polygraphy and self-reported daytime sleepiness measured with the Epworth scale (B) from baseline to 12 weeks. *Significant within-group difference from baseline (p≤0.05); **Significant between-group difference after the intervention (p≤0.05). AHI, apnoea–hypopnea index; CON, control group; HIIT, high-intensity interval training.

References

    1. Young T, Peppard PE, Taheri S. Excess weight and sleep-disordered breathing. J Appl Physiol 2005;99:1592–9. 10.1152/japplphysiol.00587.2005
    1. Peppard PE, Young T. Exercise and sleep-disordered breathing: an association independent of body habitus. Sleep 2004;27:480–4.
    1. Igelström H, Emtner M, Lindberg E, et al. . Physical activity and sedentary time in persons with obstructive sleep apnea and overweight enrolled in a randomized controlled trial for enhanced physical activity and healthy eating. Sleep Breath 2013;17:1257–66. 10.1007/s11325-013-0831-6
    1. Tiengo A, Fadini GP, Avogaro A. The metabolic syndrome, diabetes and lung dysfunction. Diabetes Metab 2008;34:447–54. 10.1016/j.diabet.2008.08.001
    1. Fritscher LG, Mottin CC, Canani S, et al. . Obesity and obstructive sleep apnea-hypopnea syndrome: the impact of bariatric surgery. Obes Surg 2007;17:95–9. 10.1007/s11695-007-9012-7
    1. Smith SS, Doyle G, Pascoe T, et al. . Intention to exercise in patients with obstructive sleep apnea. J Clin Sleep Med 2007;3:689–94.
    1. Quan SF, O'Connor GT, Quan JS, et al. . Association of physical activity with sleep-disordered breathing. Sleep Breath 2007;11:149–57. 10.1007/s11325-006-0095-5
    1. Rognmo Ø, Hetland E, Helgerud J, et al. . High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease. Eur J Cardiovasc Prev Rehabil 2004;11:216–22.
    1. Tjønna AE, Lee SJ, Rognmo Ø, et al. . Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: a pilot study. Circulation 2008;118:346–54. 10.1161/CIRCULATIONAHA.108.772822
    1. Leinum CJ, Dopp JM, Morgan BJ. Sleep-disordered breathing and obesity: pathophysiology, complications, and treatment. Nutr Clin Pract 2009;24:675–87. 10.1177/0884533609351532
    1. Sengul YS, Ozalevli S, Oztura I, et al. . The effect of exercise on obstructive sleep apnea: a randomized and controlled trial. Sleep Breath 2011;15:49–56. 10.1007/s11325-009-0311-1
    1. Giebelhaus V, Strohl KP, Lormes W, et al. . Physical exercise as an adjunct therapy in sleep Apnea-An open trial. Sleep Breath 2000;4:173–6. 10.1007/s11325-000-0173-z
    1. Norman JF, Von Essen SG, Fuchs RH, et al. . Exercise training effect on obstructive sleep apnea syndrome. Sleep Res Online 2000;3:121–9.
    1. Ackel-D'Elia C, da Silva AC, Silva RS, et al. . Effects of exercise training associated with continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome. Sleep Breath 2012;16:723–35. 10.1007/s11325-011-0567-0
    1. Iftikhar IH, Kline CE, Youngstedt SD. Effects of exercise training on sleep apnea: a meta-analysis. Lung 2014;192:175–84. 10.1007/s00408-013-9511-3
    1. Pallesen S, Nordhus IH, Omvik S, et al. . Prevalence and risk factors of subjective sleepiness in the general adult population. Sleep 2007;30:619–24.
    1. AASM. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999;22:667–89.
    1. Iber C, Ancoli-Israel S, Chesson A, et al. . Rules, terminology and technical specifications The AASM Manual for the Scoring of Sleep and Associated Events. 1st edn Westchester, IL: American Academy of Sleep Medicine, 2007:1–59.
    1. Ruehland WR, Rochford PD, O'Donoghue FJ, et al. . The new AASM criteria for scoring hypopneas: impact on the apnea hypopnea index. Sleep 2009;32:150–7.
    1. Berry RB, Brooks R, Gamaldo CE. Rules, terminology and technical specifications The AASM Manual for the Scoring of Sleep and Associated Events. 2nd edn Westchester, IL: American Academy of Sleep Medicine, 2012.
    1. Fletcher GF, Ades PA, Kligfield P, et al. . Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation 2013;128:873–934. 10.1161/CIR.0b013e31829b5b44
    1. Whipp K-G. Principles of exercise testing and interpretation including pathophysiology and clinical applications. 5th edn Philadelphia: Lippincott Williams & Wilkins, 2012.
    1. White LH, Bradley TD. Role of nocturnal rostral fluid shift in the pathogenesis of obstructive and central sleep apnoea. J Physiol 2013;591:1179–93. 10.1113/jphysiol.2012.245159
    1. Fitzpatrick M. Leptin and the obesity hypoventilation syndrome: a leap of faith? Thorax 2002;57:1–2. 10.1136/thorax.57.1.1
    1. Phillips BG, Kato M, Narkiewicz K, et al. . Increases in leptin levels, sympathetic drive, and weight gain in obstructive sleep apnea. Am J Physiol Heart Circ Physiol 2000;279:H234–7.
    1. Sanner BM, Kollhosser P, Buechner N, et al. . Influence of treatment on leptin levels in patients with obstructive sleep apnoea. Eur Respir J 2004;23:601–4.
    1. Phipps PR, Starritt E, Caterson I, et al. . Association of serum leptin with hypoventilation in human obesity. Thorax 2002;57:75–6.
    1. Tankersley C, Kleeberger S, Russ B, et al. . Modified control of breathing in genetically obese (ob/ob) mice. J Appl Physiol(1985) 1996;81:716–23.
    1. Bækkerud FH, Solberg F, Leinan IM, et al. . Comparison of three popular exercise modalities on V˙O2max in overweight and obese. Med Sci Sports Exerc 2016;48:491–8. 10.1249/MSS.0000000000000777
    1. Zisko N, Stensvold D, Hordnes-Slagsvold K, et al. . Effect of change in VO2max on daily total energy expenditure in a cohort of norwegian men: a randomized pilot study. Open Cardiovasc Med J 2015;9:50–7. 10.2174/1874192401509010050
    1. Moholdt T, Madssen E, Rognmo Ø, et al. . The higher the better? Interval training intensity in coronary heart disease. J Sci Med Sport 2014;17:506–10. 10.1016/j.jsams.2013.07.007
    1. Kodama S, Saito K, Tanaka S, et al. . Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA 2009;301:2024–35. 10.1001/jama.2009.681
    1. Myers J, Prakash M, Froelicher V, et al. . Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 2002;346:793–801. 10.1056/NEJMoa011858
    1. Lee DC, Sui X, Artero EG, et al. . Long-term effects of changes in cardiorespiratory fitness and body mass index on all-cause and cardiovascular disease mortality in men: the aerobics center longitudinal study. Circulation 2011;124:2483–90. 10.1161/CIRCULATIONAHA.111.038422
    1. Lee S, Kuk JL, Katzmarzyk PT, et al. . Cardiorespiratory fitness attenuates metabolic risk independent of abdominal subcutaneous and visceral fat in men. Diabetes Care 2005;28:895–901. 10.2337/diacare.28.4.895
    1. Lavie CJ, De Schutter A, Milani RV. Healthy obese versus unhealthy lean: the obesity paradox. Nat Rev Endocrinol 2015;11:55–62. 10.1038/nrendo.2014.165
    1. BaHammam AS, Obeidat A, Barataman K, et al. . A comparison between the AASM 2012 and 2007 definitions for detecting hypopnea. Sleep Breath 2014;18:767–73. 10.1007/s11325-014-0939-3
    1. Guilleminault C, Hagen CC, Huynh NT. Comparison of hypopnea definitions in lean patients with known obstructive sleep apnea hypopnea syndrome (OSAHS). Sleep Breath 2009;13:341–7. 10.1007/s11325-009-0253-7

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