Abstract：
OBJECTIVE: We investigated the therapeutic effects of exercise in patients with obstructive sleep apnea (OSA), 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 OSA performing aerobic exercise and/or resistance training. The investigated outcomes included apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), body mass index (BMI), and peak oxygen consumption during exercise (VO2peak). 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/hour, 95% confidence interval [CI]: -9.98 to -4.17, p < 0.00001), ESS (USMD = -2.37, CI: -3.21 to -1.54, p < 0.00001), and BMI (USMD = -0.72 kg/m2, CI: -1.22 to -0.22, p = 0.005) and enhanced VO2peak (USMD = 3.46 mL/kg/min, CI: 1.20 to 5.71, p = 0.003). Subgroup analyses revealed that in continuous positive airway pressure (CPAP)-adherent patients, exercise significantly improved VO2peak but did not reduce AHI and ESS. A trend was observed that combining resistance training with aerobic exercise resulted in greater AHI reduction and VO2peak enhancement. Notably, exercise improved AHI, ESS, BMI, and VO2peak regardless of the baseline AHI or BMI.
CONCLUSIONS: Exercise, including resistance and aerobic training, should be part of treatment for patients with OSA of all severities, regardless of obesity status, and even for those who are already under CPAP.
BACKGROUND: The study protocol was registered with the PROSPERO database (#CRD42023423527).
METHODS: Major databases were searched for randomized controlled trials involving patients with OSA performing aerobic exercise and/or resistance training. The investigated outcomes included apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), body mass index (BMI), and peak oxygen consumption during exercise (VO2peak). 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/hour, 95% confidence interval [CI]: -9.98 to -4.17, p < 0.00001), ESS (USMD = -2.37, CI: -3.21 to -1.54, p < 0.00001), and BMI (USMD = -0.72 kg/m2, CI: -1.22 to -0.22, p = 0.005) and enhanced VO2peak (USMD = 3.46 mL/kg/min, CI: 1.20 to 5.71, p = 0.003). Subgroup analyses revealed that in continuous positive airway pressure (CPAP)-adherent patients, exercise significantly improved VO2peak but did not reduce AHI and ESS. A trend was observed that combining resistance training with aerobic exercise resulted in greater AHI reduction and VO2peak enhancement. Notably, exercise improved AHI, ESS, BMI, and VO2peak regardless of the baseline AHI or BMI.
CONCLUSIONS: Exercise, including resistance and aerobic training, should be part of treatment for patients with OSA of all severities, regardless of obesity status, and even for those who are already under CPAP.
BACKGROUND: The study protocol was registered with the PROSPERO database (#CRD42023423527).
摘要：
目的：我们研究了运动对阻塞性睡眠呼吸暂停（OSA）患者的治疗效果，旨在确定最受益的亚组并确定最佳运动方案。
方法：在主要数据库中搜索涉及OSA患者进行有氧运动和/或阻力训练的随机对照试验。研究结果包括呼吸暂停低通气指数（AHI），Epworth嗜睡量表（ESS），体重指数（BMI），和运动期间的峰值耗氧量（VO2peak）。在运动组和对照组之间比较了干预前和干预后这些参数的未标准化平均差异（USMD）。
结果：纳入了12项研究，涉及526例患者。运动训练显着降低了AHI（USMD=-7.08事件/小时，95%置信区间[CI]：-9.98至-4.17，p<0.00001)，ESS（USMD=-2.37，CI：-3.21至-1.54，p<0.00001），和BMI（USMD=-0.72kg/m2，CI：-1.22至-0.22，p=0.005）和增强的VO2峰（USMD=3.46mL/kg/min，CI：1.20至5.71，p=0.003）。亚组分析显示，在持续气道正压通气（CPAP）粘附患者中，运动显着改善了VO2peak，但并未降低AHI和ESS。观察到的趋势是，将阻力训练与有氧运动相结合会导致AHI降低和VO2峰值增强。值得注意的是,锻炼改善了AHI，ESS,BMI,和VO2peak，无论基线AHI或BMI如何。
结论：运动，包括阻力和有氧训练，应该是所有严重OSA患者治疗的一部分，无论肥胖状况如何，甚至对于那些已经接受CPAP的人来说。
背景：研究方案已在PROSPERO数据库（#CRD42023423527）中注册。
方法：在主要数据库中搜索涉及OSA患者进行有氧运动和/或阻力训练的随机对照试验。研究结果包括呼吸暂停低通气指数（AHI），Epworth嗜睡量表（ESS），体重指数（BMI），和运动期间的峰值耗氧量（VO2peak）。在运动组和对照组之间比较了干预前和干预后这些参数的未标准化平均差异（USMD）。
结果：纳入了12项研究，涉及526例患者。运动训练显着降低了AHI（USMD=-7.08事件/小时，95%置信区间[CI]：-9.98至-4.17，p<0.00001)，ESS（USMD=-2.37，CI：-3.21至-1.54，p<0.00001），和BMI（USMD=-0.72kg/m2，CI：-1.22至-0.22，p=0.005）和增强的VO2峰（USMD=3.46mL/kg/min，CI：1.20至5.71，p=0.003）。亚组分析显示，在持续气道正压通气（CPAP）粘附患者中，运动显着改善了VO2peak，但并未降低AHI和ESS。观察到的趋势是，将阻力训练与有氧运动相结合会导致AHI降低和VO2峰值增强。值得注意的是,锻炼改善了AHI，ESS,BMI,和VO2peak，无论基线AHI或BMI如何。
结论：运动，包括阻力和有氧训练，应该是所有严重OSA患者治疗的一部分，无论肥胖状况如何，甚至对于那些已经接受CPAP的人来说。
背景：研究方案已在PROSPERO数据库（#CRD42023423527）中注册。
