title: Does physical exercise reduce excessive daytime sleepiness by improving inflammatory profiles in obstructive sleep apnea patients?
abstract: BACKGROUND
  Obstructive sleep apnea syndrome (OSAS) is associated with a variety of long-term consequences such as high rates of morbidity and mortality, due to excessive diurnal somnolence as well as cardiovascular and metabolic diseases. Obesity, recurrent episodes of upper airway obstruction, progressive hypoxemia, and sleep fragmentation during sleep cause neural, cardiovascular, and metabolic changes. These changes include activation of peripheral sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, insulin sensitivity, and inflammatory cytokines alterations, which predispose an individual to vascular damage.
  
  
  CONCLUSIONS
  Previous studies proposed that OSAS modulated the expression and secretion of inflammatory cytokines from fat and other tissues. Independent of obesity, patients with OSAS exhibited elevated levels of C-reactive protein, tumor necrosis factor-α and interleukin-6, which are associated with sleepiness, fatigue, and the development of a variety of metabolic and cardiovascular diseases. OSAS and obesity are strongly associated with each other and share many common pathways that induce chronic inflammation. Previous studies suggested that the protective effect of exercise may be partially attributed to the anti-inflammatory effect of regular exercise, and this effect was observed in obese patients. Although some studies assessed the effects of physical exercise on objective and subjective sleep parameters, the quality of life, and mood in patients with OSAS, no study has evaluated the effects of this treatment on inflammatory profiles. In this review, we cited some studies that directed our opinion to believe that since OSAS causes increased inflammation and has excessive daytime sleepiness as a symptom and being that physical exercise improves inflammatory profiles and possibly OSAS symptoms, it must be that physical exercise improves excessive daytime sleepiness due to its improvement in inflammatory profiles.
authors: Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo-UNIFESP, São Paulo, CEP: 04020-050, Brazil.
authors: Eduardo da Silva
authors: Eda S
authors: Alves
authors: Carolina
authors: C
authors: Ackel-D'Elia
authors: Gabriela Pontes
authors: GP
authors: Luz
authors: Thays Crosara Abrahão
authors: TC
authors: Cunha
authors: Gláucia
authors: G
authors: Carneiro
authors: Sergio
authors: S
authors: Tufik
authors: Lia Rita Azeredo
authors: LR
authors: Bittencourt
authors: Marco Tulio
authors: MT
authors: de Mello
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D045422:Continuous Positive Airway Pressure; D006970:Disorders of Excessive Somnolence / Q000097:blood* / Q000628:therapy*; D015444:Exercise / Q000502:physiology*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D009765:Obesity / Q000097:blood / Q000628:therapy; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000628:therapy*
chemical_list: D018836:Inflammation Mediators