Effect of exercise training on sleep apnea: A systematic review and meta-analysis.
Obstructive sleep apnea (OSA) is difficult to manage for those who are intolerant or noncompliant with standard facial mask treatment options. Current treatment options do not address the underlying cause of OSA. Exercise as a treatment option has been found to improve OSA indices.



To assess the efficacy of exercise on apnea/hypopnea index (AHI) in adult patients with OSA via a systematic review and meta-analysis. Additional objectives included evaluation of other indices of OSA and well-being in patients after completing an exercise regimen.



Web of Science, MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials were searched based on a priori criteria of all studies evaluating the effect of an exercise program on various sleep apnea indices. Both PRISMA statement and MOOSE consensus statement were adhered to. Eight Articles (182 participants) were included: a meta-analysis using a random effects model showed, a decrease in AHI (unstandardized mean difference [USMD], -0.536, 95% confidence interval [CI], -0.865 to -0.206, I(2), 20%), reduced Epworth sleepiness scale (ESS) (USMD, -1.246, 95% CI, -2.397 to -0.0953, I(2), 0%), and lower body mass index (BMI) (USMD, -0.0473, 95% CI, -0.0375 to 0.280, I(2), 0%), in patients receiving exercise as treatment. Relative risks (RR) and odds ratios (OR) showed decreases in AHI (OR: 72.33, 95% CI, 27.906 to 187.491, RR: 7.294, 95% CI, 4.072 to 13.065) in patients receiving exercise as treatment.



Among adult patients with OSA, exercise as the sole intervention was associated with improved clinical outcomes.
Center for Biology and Society, Arizona State University, Tempe, AZ, USA.
Kenneth D
KD
Aiello
Center for Biology and Society, Arizona State University, Tempe, AZ, USA.
William G
WG
Caughey
Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ, USA.
Bhargava
B
Nelluri
Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ, USA.
Ashwini
A
Sharma
Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ, USA.
Farouk
F
Mookadam
Department of Family Medicine, Mayo Clinic, Scottsdale, AZ, USA. Electronic address: mookadam.martina@mayo.edu.
Martina
M
Mookadam
D000328:Adult; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation* / Q000379:methods; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064887:Observational Studies as Topic; D017286:Polysomnography / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
Aerobic exercise; Continuous positive airway pressure; Exercise; Exercise program; Meta-analysis; Obstructive sleep apnea; Sleep apnea; Systematic review