Exercise as it relates to Disease/Aerobic exercise as an intervention for sleep apnea

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Sleep apnea is a sleeping disorder characterised by abnormal interruptions in breathing, or instances of unusually low breathing during sleep[1][4]. Obstructive sleep apnea (OSA)is the most common form of sleep apnea effecting 84% of all cases[9]. In OSA, breathing is interrupted by repetitive episodes of upper airway obstruction causing increased respiratory efforts and starving the brain of oxygen[1][8][12]. Approximately 70% of patients with OSA are obese, and 40% of obese individuals have OSA[5]. The risk of OSA rises with increasing body weight, active smoking and age[5][12][14]. This paper will primarily focus on interventions for obstructive sleep apnea and provide recommendations how to manage this particular type of disorder.

Issue[edit | edit source]

OSA decreases the quality and quantity of sleep[4], thus having a detrimental effect on daily functioning and mental health[5][14][15]. Children suffering from OSA can display issues including growth problems, cardiovascular disease, learning and memory problems, and decreased attention[3][4]. Studies have shown that OSA increases the risk of hypertension[2][4][5], obesity[1][2][5], depression[4], cardiovascular disease[1][15], diabetes[7][15], coronary artery disease[4, stroke[5][12][15], accidents[4][12][15], heart attack[4] and sudden death[15]. If left untreated, it can lead to more serious medical conditions[8] and seriously decrease quality of life[9][13].

Signs and Symptoms of Obstructive Sleep Apnea[edit | edit source]

It can be tough to identify OSA on your own, since the most prominent symptoms only occur when you’re asleep. However, you can get around this difficulty by asking a bed partner to observe your sleep habits, or by recording yourself during sleep.

Major signs and symptoms of OSA Other signs and symptoms of OSA
Loud and chronic snoring[2][3][7] Forgetfulness and difficulty concentrating[2][5][8]
Daytime sleepiness or fatigue[3][5][8] Restless or fitful sleep[12]
Choking, snorting, or gasping during sleep[7][12] Loss of libido[8][12]
Morning headaches[5][7][8] Insomnia or nighttime awakenings[3][7][12]
Unusual sleeping positions Anxiety and panic attacks[8][12]
Frequent urination at night[7] Waking up feeling out of breath[7]
Moodiness, irritability, or depression[2][6][12]

Treatment[edit | edit source]

There are various types of treatments available for obstructive sleep apnea:

  • Continuous positive airway pressure (CPAP): Which continuously adjusts pressure in your airway to deliver the amount required to keep the airway open[1][7][8]
  • Cognitive-behavioural therapy (CBT): Which focuses on eliminating stress and tension from the mind and improves sleep hygiene[10]
  • Is surgery an option?:There are numerous of techniques available for treating OSA [5]

Aerobic Exercise[edit | edit source]

Research has shown that aerobic exercise can help reduce the effects of obstructivc sleep apnea by:

  • Decreasing body weight to reduce OSA severity[1][5][8]
  • Decreasing the risk of developing correlated morbidity's[5]
  • Increasing sleep quality and total sleep time[1][11][14]
  • Increasing cardiac and vascular function and in turn, decreasing breathing abnormalities during sleep[13]

These improvements in sleeping patterns effectively lead to: decreases in daytime dysfunction and pre-sleep anxiety[11], increases in mood and quality of life[13][14].

Recommendations[edit | edit source]

Recommendations to manage and reduce the effects of obstructive sleep apnea.

Aerobic Exercise

  • 3–5 days per week for 30–40 minutes at a moderate intensity[6][14]
  • Exercises can include walking, cycling, stair stepping and moderate intensity activities[6]
  • Exercising in the morning has displayed positive effects on nighttime rest, making it easier to fall asleep and improving overall sleep quantity and quality[11]

As OSA is strongly correlated to obesity and hypertension, it is important to ensure that an appropriate training program is created before commencing high intensity exercise. Persons with OSA should complete a pre-training questionnaire, consult a doctor or a healthcare professional prior to commencing a training program.

Other Recommendations

  • Avoid alcohol, sleeping pills, and other sedatives, which can relax throat muscles causing the airway to collapse at night[8]
  • Sleeping on one's side and avoiding the supine position (on your back) can reduce the effects of OSA[8][12]
  • Diet interventions can also improve quality and duration of sleep[14]

Further reading[edit | edit source]

References[edit | edit source]

  1. Alves, E., Lira, F., Santos, R., Tufik, S., & de Mello, M. (2011). Obesity, diabetes and OSAS induce of sleep disorders: exercise as therapy. Lipids In Health And Disease, 10148. doi:10.1186/1476-511X-10-148
  2. Budden, L. (2013). Obstructive Sleep Apnea. Australian Nursing Journal, 21(1), 45.
  3. Caple, C., & Schub, T. (2012). Obstructive Sleep Apnea in Children.
  4. Church, E. J. (2012). Imaging Sleep and Sleep Disorders. Radiologic Technology, 83(6), 585-606.
  5. Gutierrez, C. (2013). Obstructive sleep apnea: A diagnostic and treatment guide. Journal Of Family Practice, 62(10), 565-572.
  6. Igelström, H., Emtner, M., Lindberg, E., & Åsenlöf, P. (2013). Level of Agreement Between Methods for Measuring Moderate to Vigorous Physical Activity and Sedentary Time in People With Obstructive Sleep Apnea and Obesity. Physical Therapy, 93(1), 50-59.
  7. Miller, I. M. (2010). IT'S ALL About the ZZZs. American Fitness, 28(1), 20-24.
  8. New options for treating sleep apnea. (2012). Harvard Men's Health Watch, 17(1), 3.
  9. Obstructive sleep apnea and hypopnea. (2013). Canadian Nursing Home, 24(2), 16-24.
  10. Perfect, M. R. (2010). Cognitive-behavioral therapy and hypnotic relaxation to treat sleep problems in an adolescent with diabetes. Journal Of Clinical Psychology, 66(11), 1205-1215.
  11. Roveda, E., Sciolla, C., Montaruli, A., Calogiuri, G., Angeli, A., & Carandente, F. (2011). Effects of endurance and strength acute exercise on night sleep quality. # International Sportmed Journal,12(3), 113-124.
  12. Schub, T., & Buckley, L. (2012). Obstructive Sleep Apnea in Adults.
  13. Servantes, D., Pelcerman, A., Salvetti, X., Salles, A., de Albuquerque, P., de Salles, F., & ... Filho, J. (2012). Effects of home-based exercise training for patients with chronic heart failure and sleep apnoea: a randomized comparison of two different programmes. Clinical Rehabilitation, 26(1), 45-57. doi:10.1177/0269215511403941
  14. Tan, X., Saarinen, A., Mikkola, T., Tenhunen, J., Martinmäki, S., Rahikainen, A., & ... Cheng, S. (2013). Effects of exercise and diet interventions on obesity-related sleep disorders in men: study protocol for a randomized controlled trial. Trials, 14235. doi:10.1186/1745-6215-14-235
  15. Wells, M., & Vaughn, B. V. (2012). Poor Sleep Challenging the Health of a Nation. Neurodiagnostic Journal, 52(3), 233-249.
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