Exercise training improves selected aspects of daytime functioning in adults with obstructive sleep apnea.
OBJECTIVE
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.
Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213, United States. klinec@upmc.edu
Christopher E
CE
Kline
Gary B
GB
Ewing
James B
JB
Burch
Steven N
SN
Blair
J Larry
JL
Durstine
J Mark
JM
Davis
Shawn D
SD
Youngstedt
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D003863:Depression / Q000628:therapy; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017286:Polysomnography; D011788:Quality of Life; D055070:Resistance Training; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D014851:Wakefulness; D055815:Young Adult