title: Effects of exercise training on sleep apnoea in patients with coronary artery disease: a randomised trial.
abstract: Overnight fluid shift from the legs to the neck and lungs may contribute to the pathogenesis of obstructive sleep apnoea (OSA) and central sleep apnoea (CSA). We hypothesised that exercise training will decrease the severity of OSA and CSA in patients with coronary artery disease (CAD) by decreasing daytime leg fluid accumulation and overnight rostral fluid shift.Patients with CAD and OSA or CSA (apnoea-hypopnoea index >15 events per h) were randomised to 4 weeks of aerobic exercise training or to a control group. Polysomnography, with measurement of leg, thoracic and neck fluid volumes and upper-airway cross-sectional area (UA-XSA) before and after sleep, was performed at baseline and follow-up.17 patients per group completed the study. Apnoea-hypopnoea index decreased significantly more in the exercise group than in the control group (31.1±12.9 to 20.5±9.4 versus 28.1±13.5 to 27.0±15.1 events per h, p=0.047), in association with a greater reduction in the overnight change in leg fluid volume (579±222 to 466±163 versus 453±164 to 434±141 mL, p=0.04) and by a significantly greater increase in the overnight change in UA-XSA in the exercise group (p=0.04).In patients with CAD and sleep apnoea, exercise training decreases sleep apnoea severity via attenuation of overnight fluid shift and an increase in UA-XSA.
authors.affiliation: Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, ON, Canada.
authors.forename: Monique
authors.initials: M
authors.lastname: Mendelson
authors.affiliation: Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, ON, Canada Dept of Medicine, University Health Network, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: Owen D
authors.initials: OD
authors.lastname: Lyons
authors.affiliation: Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, ON, Canada Institute of Biomaterial and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Yadollahi
authors.affiliation: Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, ON, Canada Dept of Medicine, University Health Network, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: Toru
authors.initials: T
authors.lastname: Inami
authors.affiliation: Cardiac Rehabilitation and Prevention, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Oh
authors.affiliation: Sleep Research Laboratory, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada Centre for Sleep Medicine and Circadian Biology, University of Toronto, Toronto, ON, Canada Dept of Medicine, University Health Network, Toronto General Hospital, Toronto, ON, Canada douglas.bradley@utoronto.ca.
authors.forename: T Douglas
authors.initials: TD
authors.lastname: Bradley
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications* / Q000534:rehabilitation*; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D018495:Fluid Shifts; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000503:physiopathology* / Q000534:rehabilitation*; D016896:Treatment Outcome