Scientific Investigations
Exercise Training Improves Selected Aspects of Daytime Functioning in Adults with Obstructive Sleep Apnea
http://dx.doi.org/10.5664/jcsm.2022
Christopher E. Kline, Ph.D.1; Gary B. Ewing, M.D.2; James B. Burch, Ph.D.3,4; Steven N. Blair, P.E.D.3,5; J. Larry Durstine, Ph.D.5; J. Mark Davis, Ph.D.5; Shawn D. Youngstedt, Ph.D.4,5,6
1Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA; 2Department of Clinical Services, University of South Carolina School of Medicine, Columbia, SC; 3Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC; 4WJB Dorn VA Medical Center, Columbia, SC; 5Department of Exercise Science, University of South Carolina, Columbia, SC; 6Department of Psychology, University of South Carolina, Columbia, SC
Study Objectives:
To explore the utility of exercise training for improving daytime functioning in adults with obstructive sleep apnea (OSA).
Methods:
Forty-three sedentary and overweight/obese adults aged 18-55 years with at least moderate-severity untreated OSA (apnea-hypopnea index ≥ 15) were randomized to 12 weeks of moderate-intensity aerobic and resistance exercise training (n = 27) or low-intensity stretching control treatment (n = 16). As part of a trial investigating the efficacy of exercise training on OSA severity, daytime functioning was assessed before and following the intervention. Sleepiness, functional impairment due to sleepiness, depressive symptoms, mood, and quality of life (QOL) were evaluated with validated questionnaires, and cognitive function was assessed with a neurobehavioral performance battery. OSA severity was measured with one night of laboratory polysomnography before and following the intervention.
Results:
Compared with stretching control, exercise training resulted in significant improvements in depressive symptoms, fatigue and vigor, and aspects of QOL (p < 0.05). Sleepiness and functional impairment due to sleepiness also were improved following exercise versus control to a similar degree in terms of effect sizes (d > 0.5), though these changes were not statistically significant. No neurobehavioral performance improvements were found. Reduced fatigue following exercise training was mediated by a reduction in OSA severity, but changes in OSA severity did not significantly mediate improvement in any other measure of daytime functioning.
Conclusions:
These data provide preliminary evidence that exercise training may be helpful for improving aspects of daytime functioning of adults with OSA. Larger trials are needed to further verify the observed improvements.
Trial Registration:
Clinicaltrials.gov identification number NCT00956423.
Citation:
Kline CE; Ewing GB; Burch JB; Blair SN; Durstine JL; Davis JM; Youngstedt SD. Exercise training improves selected aspects of daytime functioning in adults with obstructive sleep apnea. J Clin Sleep Med 2012;8(4):357-365.
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