title: Comparison of the effects of continuous positive airway pressure, oral appliance and exercise training in obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  There are several treatments for obstructive sleep apnea syndrome, such as weight loss, use of an oral appliance and continuous positive airway pressure, that can be used to reduce the signs and symptoms of obstructive sleep apnea syndrome. Few studies have evaluated the effectiveness of a physical training program compared with other treatments. The aim of this study was to assess the effects of physical exercise on subjective and objective sleep parameters, quality of life and mood in obstructive sleep apnea patients and to compare these effects with the effects of continuous positive airway pressure and oral appliance treatments.
  
  
  METHODS
  Male patients with moderate to severe obstructive sleep apnea and body mass indices less than 30 kg/m2 were randomly assigned to three groups: continuous positive airway pressure (n = 9), oral appliance (n = 9) and physical exercise (n = 7). Polysomnographic recordings, blood samples and daytime sleepiness measurements were obtained prior to and after two months of physical exercise or treatment with continuous positive airway pressure or an oral appliance. Clinicaltrials.gov: NCT01289392 RESULTS: After treatment with continuous positive airway pressure or an oral appliance, the patients presented with a significant reduction in the apnea-hypopnea index. We did not observe changes in the sleep parameters studied in the physical exercise group. However, this group presented reductions in the following parameters: T leukocytes, very-low-density lipoprotein and triglycerides. Two months of exercise training also had a positive impact on subjective daytime sleepiness.
  
  
  CONCLUSIONS
  Our results suggest that isolated physical exercise training was able to modify only subjective daytime sleepiness and some blood measures. Continuous positive airway pressure and oral appliances modified the apnea-hypopnea index.
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Departamento de Psicobiologia, São PauloSP, Brazil.
authors.forename: Teresa Cristina Barros
authors.initials: TC
authors.lastname: Schütz
authors.forename: Thays Crosara Abrahão
authors.initials: TC
authors.lastname: Cunha
authors.forename: Thais
authors.initials: T
authors.lastname: Moura-Guimaraes
authors.forename: Gabriela Pontes
authors.initials: GP
authors.lastname: Luz
authors.forename: Carolina
authors.initials: C
authors.lastname: Ackel-D'Elia
authors.forename: Eduardo da Silva
authors.initials: Eda S
authors.lastname: Alves
authors.forename: Gilberto
authors.initials: G
authors.lastname: Pantiga
authors.forename: Marco Tulio de
authors.initials: MT
authors.lastname: Mello
authors.forename: Sergio
authors.initials: S
authors.lastname: Tufik
authors.forename: Lia
authors.initials: L
authors.lastname: Bittencourt
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D003748:Dental Equipment; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011788:Quality of Life; D012016:Reference Values; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012894:Sleep Stages; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
references.citation: Thorax. 2007 Apr;62(4):354-9
references.pmid: 17121868
references.citation: Cochrane Database Syst Rev. 2001;(1):CD002875
references.pmid: 11279768
references.citation: Pneumologie. 1997 Aug;51 Suppl 3:779-82
references.pmid: 9340640
references.citation: Am J Respir Crit Care Med. 2002 Sep 1;166(5):743-8
references.pmid: 12204875
references.citation: Sleep. 2006 Mar;29(3):375-80
references.pmid: 16553024
references.citation: Am J Respir Crit Care Med. 2004 Sep 15;170(6):656-64
references.pmid: 15201136
references.citation: J Clin Sleep Med. 2005 Oct 15;1(4):374-80
references.pmid: 17564405
references.citation: Sleep. 1992 Apr;15(2):173-84
references.pmid: 11032543
references.citation: Chest. 2011 Dec;140(6):1511-1516
references.pmid: 21636666
references.citation: Sleep Res Online. 2000;3(3):121-9
references.pmid: 11382910
references.citation: J Appl Physiol (1985). 1991 Aug;71(2):404-9
references.pmid: 1718935
references.citation: J Physiol. 1991 Jun;437:257-67
references.pmid: 1890634
references.citation: Sleep Breath. 2000;4(4):173-176
references.pmid: 11894204
references.citation: Am J Respir Crit Care Med. 2002 Mar 15;165(6):773-80
references.pmid: 11897643
references.citation: Cochrane Database Syst Rev. 2006 Jan 25;(1):CD004435
references.pmid: 16437488
references.citation: Sleep. 1993 Dec;16(8):748-59
references.pmid: 8165390
references.citation: Sleep. 2006 Feb;29(2):240-3
references.pmid: 16494092
references.citation: Sleep Breath. 2011 Jan;15(1):49-56
references.pmid: 19898884
references.citation: Sleep Breath. 2012 Sep;16(3):723-35
references.pmid: 21805226
references.citation: Am J Respir Crit Care Med. 2001 Aug 15;164(4):608-13
references.pmid: 11520724
references.citation: Chest. 1996 May;109(5):1269-75
references.pmid: 8625679
references.citation: Sleep Med Rev. 2004 Dec;8(6):443-57
references.pmid: 15556377
references.citation: Sleep. 2006 Feb;29(2):244-62
references.pmid: 16494093
references.citation: Curr Opin Pulm Med. 2006 Nov;12(6):409-13
references.pmid: 17053489
references.citation: Sleep. 1999 Aug 1;22(5):667-89
references.pmid: 10450601