Skip to main content
Top
Published in: Sleep and Breathing 3/2012

01-09-2012 | Original Article

Effects of exercise training associated with continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome

Authors: Carolina Ackel-D’Elia, Antonio Carlos da Silva, Rogério Santos Silva, Eveli Truksinas, Bolivar Saldanha Sousa, Sérgio Tufik, Marco Túlio de Mello, Lia Rita Azeredo Bittencourt

Published in: Sleep and Breathing | Issue 3/2012

Login to get access

Abstract

Purpose

The aim of this study was to evaluate the effects of a 2-month exercise training associated with continuous positive airway pressure (CPAP) treatment on the subjective and objective sleep measurements, quality of life, and mood in moderate to severe obstructive sleep apnea syndrome (OSAS) patients.

Methods

Male patients were randomized into two treatment groups: CPAP (n = 19) and CPAP + exercise (n = 13). All patients completed 1 month of sleep hygiene, 2 months of treatment (CPAP or CPAP + exercise), and 1 week of washout (no treatment). Fletcher and Luckett sleep questionnaire, Epworth sleepiness scale, sleep diaries, polysomnography, SF-36 inventory of quality of life, Profile of Mood States (POMS) questionnaire, neck circumference, and body composition were evaluated. CPAP + exercise group also underwent cardiopulmonary exercise test before and after treatment.

Results

Both treatments were effective in improving subjective sleepiness but CPAP + exercise treatment was more effective in maintaining this improvement after washout. No significant differences were found in most of the sleep parameters studied in both groups. CPAP + exercise group showed lower values of tension and fatigue on POMS and higher values of physical functioning, general health perception, and vitality on SF-36 after treatment.

Conclusions

A 2-month exercise training associated with CPAP treatment for OSAS patients has a positive impact on subjective daytime sleepiness, quality of life (physical functioning and general health perception), and mood state (tension and fatigue).
Literature
1.
go back to reference American Academy of Sleep Medicine (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definitions and measurements techniques in clinical research. The report of an American Academy of Sleep Medicine task force. Sleep 22:667–689 American Academy of Sleep Medicine (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definitions and measurements techniques in clinical research. The report of an American Academy of Sleep Medicine task force. Sleep 22:667–689
2.
go back to reference Conrad I, Ancoli-Israel S, Chesson AL (2007) The American Academy of Sleep Medicine manual for the scoring of sleep and associated events: rules, terminology and technical specifications. American Academy of Sleep Medicine, Westchester Conrad I, Ancoli-Israel S, Chesson AL (2007) The American Academy of Sleep Medicine manual for the scoring of sleep and associated events: rules, terminology and technical specifications. American Academy of Sleep Medicine, Westchester
3.
go back to reference Norman JF, Von Essen SG, Fuchs RH, McElligott M (2000) Exercise training effect on obstructive sleep apnea syndrome. Sleep Res Online 3:121–129PubMed Norman JF, Von Essen SG, Fuchs RH, McElligott M (2000) Exercise training effect on obstructive sleep apnea syndrome. Sleep Res Online 3:121–129PubMed
4.
go back to reference Aguillard RN, Riedel BW, Lichstein KL, Grieve FG, Johnson CT, Noe SL (1998) Daytime functioning in obstructive sleep apnea patients: exercise tolerance, subjective fatigue, and sleepiness. Appl Psychophysiol Biofeedback 23:207–217PubMedCrossRef Aguillard RN, Riedel BW, Lichstein KL, Grieve FG, Johnson CT, Noe SL (1998) Daytime functioning in obstructive sleep apnea patients: exercise tolerance, subjective fatigue, and sleepiness. Appl Psychophysiol Biofeedback 23:207–217PubMedCrossRef
5.
go back to reference Ozturk L, Metin G, Çuhadaroglu Ç, Utkusavas A, Tutluoglu B (2005) Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. Tuberkuloz vê Toraks Dergisi 53:10–18 Ozturk L, Metin G, Çuhadaroglu Ç, Utkusavas A, Tutluoglu B (2005) Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea. Tuberkuloz vê Toraks Dergisi 53:10–18
6.
go back to reference Pan WS, Yuan YD, Zhang LT, Hao ST, Yang HS, Wang BF, Ma JY (2005) The change and significance of the cardiopulmonary exercise test parameters in patients with obstructive sleep apnea–hypopnea syndrome. Zhonghua Jie He He Hu Xi Za Zhi 28:769–772PubMed Pan WS, Yuan YD, Zhang LT, Hao ST, Yang HS, Wang BF, Ma JY (2005) The change and significance of the cardiopulmonary exercise test parameters in patients with obstructive sleep apnea–hypopnea syndrome. Zhonghua Jie He He Hu Xi Za Zhi 28:769–772PubMed
7.
go back to reference Lin CC, Hsieh WY, Chou CS, Liaw SF (2006) Cardiopulmonary exercise testing in obstructive sleep apnea syndrome. Respir Physiol Neurobiol 150:27–34PubMedCrossRef Lin CC, Hsieh WY, Chou CS, Liaw SF (2006) Cardiopulmonary exercise testing in obstructive sleep apnea syndrome. Respir Physiol Neurobiol 150:27–34PubMedCrossRef
8.
go back to reference Alameri H, Al-Kabab Y, BaHammam A (2010) Submaximal exercise in patients with severe obstructive sleep apnea. Sleep Breath 14:145–151PubMedCrossRef Alameri H, Al-Kabab Y, BaHammam A (2010) Submaximal exercise in patients with severe obstructive sleep apnea. Sleep Breath 14:145–151PubMedCrossRef
9.
go back to reference Bittencourt LR, Moura SM, Bagnato MC, Gregorio LC, Tufik S, Nery LE (1998) Assessment of ventilatory neuromuscular drive in patients with obstructive sleep apnea. Braz J Med Biol Res 31:505–513PubMedCrossRef Bittencourt LR, Moura SM, Bagnato MC, Gregorio LC, Tufik S, Nery LE (1998) Assessment of ventilatory neuromuscular drive in patients with obstructive sleep apnea. Braz J Med Biol Res 31:505–513PubMedCrossRef
10.
go back to reference Moura SMT, Bittencourt LR, Bagnato MC, Lucas SR, Tufik S, Nery LE (2001) Acute effect of nasal continuous positive air pressure on the ventilatory control of patients with obstructive sleep apnea. Respiration 68:243–249PubMedCrossRef Moura SMT, Bittencourt LR, Bagnato MC, Lucas SR, Tufik S, Nery LE (2001) Acute effect of nasal continuous positive air pressure on the ventilatory control of patients with obstructive sleep apnea. Respiration 68:243–249PubMedCrossRef
11.
go back to reference Gay P, Weaver T, Loube D, Iber C (2006) Positive Airway Pressure Task Force, Standards of Practice Committee, American Academy of Sleep Medicine. Evaluation of positive airway pressure treatment for sleep related breathing disorders in adults. Sleep 29:381–401PubMed Gay P, Weaver T, Loube D, Iber C (2006) Positive Airway Pressure Task Force, Standards of Practice Committee, American Academy of Sleep Medicine. Evaluation of positive airway pressure treatment for sleep related breathing disorders in adults. Sleep 29:381–401PubMed
12.
go back to reference Kushida CA, Littner MR, Hirshkowitz M, Morgenthaler TI, Alessi CA, Bailey D, Boehlecke B, Brown TM, Coleman J Jr, Friedman L, Kapen S, Kapur VK, Kramer M, Lee-Chiong T, Owens J, Pancer JP, Swick TJ, Wise MS (2006) American Academy of Sleep Medicine. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 29:375–380PubMed Kushida CA, Littner MR, Hirshkowitz M, Morgenthaler TI, Alessi CA, Bailey D, Boehlecke B, Brown TM, Coleman J Jr, Friedman L, Kapen S, Kapur VK, Kramer M, Lee-Chiong T, Owens J, Pancer JP, Swick TJ, Wise MS (2006) American Academy of Sleep Medicine. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 29:375–380PubMed
13.
go back to reference Edward SD, Walker EW, Gregg JM, Zedalis D, Herbert WG (2001) Effects of short-term PAP treatment on endurance exercise performance in obstructive sleep apnea patients. Sleep Med 2:145–151CrossRef Edward SD, Walker EW, Gregg JM, Zedalis D, Herbert WG (2001) Effects of short-term PAP treatment on endurance exercise performance in obstructive sleep apnea patients. Sleep Med 2:145–151CrossRef
14.
go back to reference Alonso-Fernández A, García-Río F, Arias MA, Mediano O, Pino JM, Martinez I, Villamor J (2006) Obstructive sleep apnoea–hypoapnoea syndrome reversibly depresses cardiac response to exercise. Eur Heart J 27:207–215PubMedCrossRef Alonso-Fernández A, García-Río F, Arias MA, Mediano O, Pino JM, Martinez I, Villamor J (2006) Obstructive sleep apnoea–hypoapnoea syndrome reversibly depresses cardiac response to exercise. Eur Heart J 27:207–215PubMedCrossRef
15.
go back to reference Przybylowski T, Bielicki P, Kumor M, Hildebrand K, Maskey-Warzechowska M, Wiwala J, Kosciuch J, Korczyniski P, Chazan R (2006) Influence of nasal continuous positive airway pressure on response to exercise in patients with obstructive sleep apnea syndrome. Pneumonol Alergol Pol 74:39–44PubMed Przybylowski T, Bielicki P, Kumor M, Hildebrand K, Maskey-Warzechowska M, Wiwala J, Kosciuch J, Korczyniski P, Chazan R (2006) Influence of nasal continuous positive airway pressure on response to exercise in patients with obstructive sleep apnea syndrome. Pneumonol Alergol Pol 74:39–44PubMed
16.
go back to reference Duchna HW, Hauptmeier B, Orth M, Schultze-Werninghaus G, Schafer T (2007) Daytime ventilatory efficiency in obstructive sleep apnea syndrome—influence of CPAP-therapy. Pneumologie 61:509–516PubMedCrossRef Duchna HW, Hauptmeier B, Orth M, Schultze-Werninghaus G, Schafer T (2007) Daytime ventilatory efficiency in obstructive sleep apnea syndrome—influence of CPAP-therapy. Pneumologie 61:509–516PubMedCrossRef
17.
go back to reference Nowinski A, Bielen P, Jonczak L, Sliwinski P (2007) Influence of treatment with continuous positive airway pressure on respiratory muscle function and physical fitness in patients with obstructive sleep apnoea and overlap syndrome. Pneumonol Alergol Pol 75:46–56PubMed Nowinski A, Bielen P, Jonczak L, Sliwinski P (2007) Influence of treatment with continuous positive airway pressure on respiratory muscle function and physical fitness in patients with obstructive sleep apnoea and overlap syndrome. Pneumonol Alergol Pol 75:46–56PubMed
18.
go back to reference Shneerson J, Wright J (2001) Lifestyle modification for obstructive sleep apnea. Cochrane Database Syst Rev 1:CD002875PubMed Shneerson J, Wright J (2001) Lifestyle modification for obstructive sleep apnea. Cochrane Database Syst Rev 1:CD002875PubMed
19.
go back to reference Smith PL, Gold AR, Meyers DA, Haponik EF, Bleecker ER (1985) Weight loss in mildly to moderately obese patients with obstructive sleep apnea. Ann Intern Med 103:850–855PubMed Smith PL, Gold AR, Meyers DA, Haponik EF, Bleecker ER (1985) Weight loss in mildly to moderately obese patients with obstructive sleep apnea. Ann Intern Med 103:850–855PubMed
20.
go back to reference Noseda A, Kempenaers C, Kerkhofs M, Houben JJ, Linkowski P (1996) Sleep apnea after 1 year domiciliary nasal-continuous positive airway pressure and attempted weight reduction. Chest 109:138–143PubMedCrossRef Noseda A, Kempenaers C, Kerkhofs M, Houben JJ, Linkowski P (1996) Sleep apnea after 1 year domiciliary nasal-continuous positive airway pressure and attempted weight reduction. Chest 109:138–143PubMedCrossRef
21.
go back to reference Lojander J, Mustajoki P, Ronka S, Mecklin P, Maasilta P (1998) A nurse-managed weight reduction programme for obstructive sleep apnoea syndrome. J Intern Med 244:251–255PubMedCrossRef Lojander J, Mustajoki P, Ronka S, Mecklin P, Maasilta P (1998) A nurse-managed weight reduction programme for obstructive sleep apnoea syndrome. J Intern Med 244:251–255PubMedCrossRef
22.
go back to reference Netzer N, Lormes W, Giebelhaus V, Halle M, Keul J, Mattys H, Lehmann M (1997) Physical training of patients with sleep apnea. Pneumologie 51:779–782PubMed Netzer N, Lormes W, Giebelhaus V, Halle M, Keul J, Mattys H, Lehmann M (1997) Physical training of patients with sleep apnea. Pneumologie 51:779–782PubMed
23.
go back to reference Giebelhaus V, Strohl KP, Lormes W, Lehmann M, Netzer N (2000) Physical exercise as an adjunct therapy in sleep apnea—an open trial. Sleep Breath 4:173–176PubMed Giebelhaus V, Strohl KP, Lormes W, Lehmann M, Netzer N (2000) Physical exercise as an adjunct therapy in sleep apnea—an open trial. Sleep Breath 4:173–176PubMed
24.
go back to reference Sengul YS, Ozalevli S, Oztura I, Itil O, Baklan B (2009) The effect of exercise on obstructive sleep apnea: a randomized and controlled trial. Sleep Breath 15:49–56PubMedCrossRef Sengul YS, Ozalevli S, Oztura I, Itil O, Baklan B (2009) The effect of exercise on obstructive sleep apnea: a randomized and controlled trial. Sleep Breath 15:49–56PubMedCrossRef
25.
go back to reference Ueno LM, Drager LF, Rodrigues ACT, Rondon MUPB, Braga AMFW, Mathias W, Krieger EM, Barretto ACP, Middlekauff HR, Lorenzi-Filho G, Negrão CE (2009) Effects of exercise training in patients with chronic heart failure and sleep apnea. Sleep 32(5):637–647PubMed Ueno LM, Drager LF, Rodrigues ACT, Rondon MUPB, Braga AMFW, Mathias W, Krieger EM, Barretto ACP, Middlekauff HR, Lorenzi-Filho G, Negrão CE (2009) Effects of exercise training in patients with chronic heart failure and sleep apnea. Sleep 32(5):637–647PubMed
26.
go back to reference Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 10:141–146PubMed Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 10:141–146PubMed
27.
go back to reference American College of Sports Medicine (2000) ACSM’s guidelines for exercise testing and prescription, 6th edn. Williams & Wilkins, Baltimore American College of Sports Medicine (2000) ACSM’s guidelines for exercise testing and prescription, 6th edn. Williams & Wilkins, Baltimore
28.
go back to reference Johns MW (1991) A new method of measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14:540–545PubMed Johns MW (1991) A new method of measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14:540–545PubMed
29.
go back to reference McArdle N, Devereux G, Heidarnejad H, Engleman HM, Mackay TW, Douglas NJ (1999) Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Crit Care Med 159:1108–1114 McArdle N, Devereux G, Heidarnejad H, Engleman HM, Mackay TW, Douglas NJ (1999) Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Crit Care Med 159:1108–1114
30.
go back to reference Issa FG, Sullivan CE (1982) Alcohol, snoring and sleep apnea. J Neurol Neurosurg Psychiatry 45:353–359PubMedCrossRef Issa FG, Sullivan CE (1982) Alcohol, snoring and sleep apnea. J Neurol Neurosurg Psychiatry 45:353–359PubMedCrossRef
31.
go back to reference Zarcone VP Jr (2000) Sleep Hygiene. In: Kryger MH, Roth T, Dement WC (eds) Principles and practice of sleep medicine. Elsevier Saunders, Philadelphia Zarcone VP Jr (2000) Sleep Hygiene. In: Kryger MH, Roth T, Dement WC (eds) Principles and practice of sleep medicine. Elsevier Saunders, Philadelphia
32.
go back to reference Fletcher EC, Lucket RA (1991) The effect of positive reinforcement on hourly compliance in nasal continuous positive airway pressure users with obstructive sleep apnea. Am Rev Respir Dis 143:936–941PubMed Fletcher EC, Lucket RA (1991) The effect of positive reinforcement on hourly compliance in nasal continuous positive airway pressure users with obstructive sleep apnea. Am Rev Respir Dis 143:936–941PubMed
33.
go back to reference McHorney CA, Ware JE Jr, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263PubMedCrossRef McHorney CA, Ware JE Jr, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263PubMedCrossRef
34.
go back to reference McNair DM, Lorr M, Droppleman LF (1971) Profile of mood states. Educational and Industrial Testing Service, San Diego McNair DM, Lorr M, Droppleman LF (1971) Profile of mood states. Educational and Industrial Testing Service, San Diego
35.
go back to reference Rechtschaffen A, Kales A (1968) A manual of standardized technology, techniques and scoring system for sleep stages of human subjects. Brain Information Service/Brain Research Institute, UCLA, Los Angeles Rechtschaffen A, Kales A (1968) A manual of standardized technology, techniques and scoring system for sleep stages of human subjects. Brain Information Service/Brain Research Institute, UCLA, Los Angeles
36.
go back to reference American Sleep Disorders Association (1992) Atlas Task Force—EEG arousals: scoring rules and examples. Sleep 15:174–184 American Sleep Disorders Association (1992) Atlas Task Force—EEG arousals: scoring rules and examples. Sleep 15:174–184
37.
go back to reference American Sleep Disorders Association (1993) Atlas Task Force—recording and scoring leg movements. Sleep 16:749–759 American Sleep Disorders Association (1993) Atlas Task Force—recording and scoring leg movements. Sleep 16:749–759
38.
go back to reference Strading JR, Crosby JH (1991) Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle age men. Thorax 46:85–90CrossRef Strading JR, Crosby JH (1991) Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle age men. Thorax 46:85–90CrossRef
39.
go back to reference Dempster P, Aitkens S (1995) A new air displacement method for the determination of human body composition. Med Sci Sports Exerc 27:1692–1697PubMed Dempster P, Aitkens S (1995) A new air displacement method for the determination of human body composition. Med Sci Sports Exerc 27:1692–1697PubMed
40.
go back to reference Siri WE (1961) Body composition from fluid spaces and density: analysis of methods. In: Henschel A (ed) Techniques for measuring body composition. National Academy of Sciences, National Research Council, Washington DC Siri WE (1961) Body composition from fluid spaces and density: analysis of methods. In: Henschel A (ed) Techniques for measuring body composition. National Academy of Sciences, National Research Council, Washington DC
41.
go back to reference Jackson AS, Pollock ML (1978) Generalized equations for predicting body density of men. Br J Nutr 40:457–504CrossRef Jackson AS, Pollock ML (1978) Generalized equations for predicting body density of men. Br J Nutr 40:457–504CrossRef
42.
go back to reference Wasserman K (1987) Determinants and detection of anaerobic threshold and consequences of exercise above it. Circulation 76(6 Pt 2):VI29–VI39PubMed Wasserman K (1987) Determinants and detection of anaerobic threshold and consequences of exercise above it. Circulation 76(6 Pt 2):VI29–VI39PubMed
43.
go back to reference Hong S, Dimsdale JE (2003) Physical activity and perception of energy and fatigue in obstructive sleep apnea. Med Sci Sports Exerc 35(7):1088–1092PubMedCrossRef Hong S, Dimsdale JE (2003) Physical activity and perception of energy and fatigue in obstructive sleep apnea. Med Sci Sports Exerc 35(7):1088–1092PubMedCrossRef
44.
45.
go back to reference Engleman HM, Martin SE, Deary IJ, Douglas NJ (1997) Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome. Thorax 52:114–119PubMedCrossRef Engleman HM, Martin SE, Deary IJ, Douglas NJ (1997) Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome. Thorax 52:114–119PubMedCrossRef
46.
go back to reference Engleman HM, Martin SE, Kingshott RN, Mackay TW, Deary IJ, Douglas NJ (1998) Randomised placebo controlled trial of daytime function after continuous positive airway pressure (CPAP) therapy for the sleep apnoea/hypopnoea syndrome. Thorax 53:341–345PubMedCrossRef Engleman HM, Martin SE, Kingshott RN, Mackay TW, Deary IJ, Douglas NJ (1998) Randomised placebo controlled trial of daytime function after continuous positive airway pressure (CPAP) therapy for the sleep apnoea/hypopnoea syndrome. Thorax 53:341–345PubMedCrossRef
47.
go back to reference Ballester E, Badia JR, Hernandez L, Carrasco E, de Pablo J, Fornas C, Rodriguez-Roisin R, Montserrat JM (1999) Evidence of the effectiveness of continuous positive airway pressure in the treatment of sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 159:495–501PubMed Ballester E, Badia JR, Hernandez L, Carrasco E, de Pablo J, Fornas C, Rodriguez-Roisin R, Montserrat JM (1999) Evidence of the effectiveness of continuous positive airway pressure in the treatment of sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 159:495–501PubMed
48.
go back to reference Jenkinson C, Davies RJ, Mullins R, Stradling JR (1999) Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial. Lancet 353:2100–2105PubMedCrossRef Jenkinson C, Davies RJ, Mullins R, Stradling JR (1999) Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial. Lancet 353:2100–2105PubMedCrossRef
49.
go back to reference Jokic R, Klimaszewski A, Crossley M, Sridhar G, Fitzpatrick MF (1999) Positional treatment vs continuous positive airway pressure in patients with positional obstructive sleep apnea syndrome. Chest 115:771–781PubMedCrossRef Jokic R, Klimaszewski A, Crossley M, Sridhar G, Fitzpatrick MF (1999) Positional treatment vs continuous positive airway pressure in patients with positional obstructive sleep apnea syndrome. Chest 115:771–781PubMedCrossRef
50.
go back to reference Lojander J, Kajaste S, Maasilta P, Partinen M (1999) Cognitive function and treatment of obstructive sleep apnea syndrome. J Sleep Res 8:71–76PubMedCrossRef Lojander J, Kajaste S, Maasilta P, Partinen M (1999) Cognitive function and treatment of obstructive sleep apnea syndrome. J Sleep Res 8:71–76PubMedCrossRef
51.
go back to reference Dimsdale JE, Loredo JS, Profant J (2000) Effect of continuous positive airway pressure on blood pressure: a placebo trial. Hypertension 35:144–147PubMedCrossRef Dimsdale JE, Loredo JS, Profant J (2000) Effect of continuous positive airway pressure on blood pressure: a placebo trial. Hypertension 35:144–147PubMedCrossRef
52.
go back to reference Hack M, Davies RJ, Mullins R, Choi SJ, Ramdassingh-Dow S, Jenkinson C, Stradling JR (2000) Randomised prospective parallel trial of therapeutic versus subtherapeutic nasal continuous positive airway pressure on simulated steering performance in patients with obstructive sleep apnoea. Thorax 55:224–231PubMedCrossRef Hack M, Davies RJ, Mullins R, Choi SJ, Ramdassingh-Dow S, Jenkinson C, Stradling JR (2000) Randomised prospective parallel trial of therapeutic versus subtherapeutic nasal continuous positive airway pressure on simulated steering performance in patients with obstructive sleep apnoea. Thorax 55:224–231PubMedCrossRef
53.
go back to reference Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jenkinson C, Stradling JR, Davies RJ (2002) Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 359:204–210PubMedCrossRef Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jenkinson C, Stradling JR, Davies RJ (2002) Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 359:204–210PubMedCrossRef
54.
go back to reference Barnes M, McEvoy RD, Banks S, Tarquinio N, Murray CG, Vowles N, Pierce RJ (2004) Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med 170:656–664PubMedCrossRef Barnes M, McEvoy RD, Banks S, Tarquinio N, Murray CG, Vowles N, Pierce RJ (2004) Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. Am J Respir Crit Care Med 170:656–664PubMedCrossRef
55.
go back to reference Redline S, Adams N, Strauss ME, Roebuck T, Winters M, Rosenberg C (1998) Improvement of mild sleep-disordered breathing with CPAP compared with conservative therapy. Am J Respir Crit Care Med 157:858–865PubMed Redline S, Adams N, Strauss ME, Roebuck T, Winters M, Rosenberg C (1998) Improvement of mild sleep-disordered breathing with CPAP compared with conservative therapy. Am J Respir Crit Care Med 157:858–865PubMed
56.
go back to reference Loredo JS, Ancoli-Israel S, Dimsdale JE (1999) Effect of continuous positive airway pressure vs placebo continuous positive airway pressure on sleep quality in obstructive sleep apnea. Chest 116:1545–1549PubMedCrossRef Loredo JS, Ancoli-Israel S, Dimsdale JE (1999) Effect of continuous positive airway pressure vs placebo continuous positive airway pressure on sleep quality in obstructive sleep apnea. Chest 116:1545–1549PubMedCrossRef
57.
go back to reference Yu BH, Ancoli-Israel S, Dimsdale JE (1999) Effect of CPAP treatment on mood states in patients with sleep apnea. J Psychiatr Res 33:427–432PubMedCrossRef Yu BH, Ancoli-Israel S, Dimsdale JE (1999) Effect of CPAP treatment on mood states in patients with sleep apnea. J Psychiatr Res 33:427–432PubMedCrossRef
58.
go back to reference Bardwell WA, Ancoli-Israel S, Berry CC, Dimsdale JE (2001) Neuropsychological effects of one-week continuous positive airway pressure treatment in patients with obstructive sleep apnea: a placebo-controlled study. Psychosom Med 63:579–584PubMed Bardwell WA, Ancoli-Israel S, Berry CC, Dimsdale JE (2001) Neuropsychological effects of one-week continuous positive airway pressure treatment in patients with obstructive sleep apnea: a placebo-controlled study. Psychosom Med 63:579–584PubMed
59.
go back to reference Henke KG, Grady JJ, Kuna ST (2001) Effect of nasal continuous positive airway pressure on neuropsychological function in sleep apnea–hypopnea syndrome. A randomized, placebo-controlled trial. Am J Respir Crit Care Med 163:911–917PubMed Henke KG, Grady JJ, Kuna ST (2001) Effect of nasal continuous positive airway pressure on neuropsychological function in sleep apnea–hypopnea syndrome. A randomized, placebo-controlled trial. Am J Respir Crit Care Med 163:911–917PubMed
60.
go back to reference Monasterio C, Vidal S, Duran J, Ferrer M, Carmona C, Barbé F, Mayos M, Gonzalez-Mangado N, Juncadella M, Navarro A, Barreira R, Capote F, Mayoralas LR, Peces-Barba G, Alonso J, Montserrat JM (2001) Effectiveness of continuous positive airway pressure in mild sleep apnea–hypopnea syndrome. Am J Respir Crit Care Med 164:939–943PubMed Monasterio C, Vidal S, Duran J, Ferrer M, Carmona C, Barbé F, Mayos M, Gonzalez-Mangado N, Juncadella M, Navarro A, Barreira R, Capote F, Mayoralas LR, Peces-Barba G, Alonso J, Montserrat JM (2001) Effectiveness of continuous positive airway pressure in mild sleep apnea–hypopnea syndrome. Am J Respir Crit Care Med 164:939–943PubMed
61.
go back to reference Ziegler MG, Mills PJ, Loredo JS, Ancoli-Israel S, Dimsdale JE (2001) Effect of continuous positive airway pressure and placebo treatment on sympathetic nervous activity in patients with obstructive sleep apnea. Chest 120:887–893PubMedCrossRef Ziegler MG, Mills PJ, Loredo JS, Ancoli-Israel S, Dimsdale JE (2001) Effect of continuous positive airway pressure and placebo treatment on sympathetic nervous activity in patients with obstructive sleep apnea. Chest 120:887–893PubMedCrossRef
62.
go back to reference Becker HF, Jerrentrup A, Ploch T, Grote L, Penzel T, Sullivan CE, Peter JH (2003) Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 107:68–73PubMedCrossRef Becker HF, Jerrentrup A, Ploch T, Grote L, Penzel T, Sullivan CE, Peter JH (2003) Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 107:68–73PubMedCrossRef
63.
go back to reference Engleman HM, Martin SE, Deary IJ, Douglas NJ (1994) Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome. Lancet 343:572–575PubMedCrossRef Engleman HM, Martin SE, Deary IJ, Douglas NJ (1994) Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome. Lancet 343:572–575PubMedCrossRef
64.
go back to reference Engleman HM, Kingshott RN, Wraith PK, Mackay TW, Deary IJ, Douglas NJ (1999) Randomized placebo-controlled crossover trial of continuous positive airway pressure for mild sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 159:461–467PubMed Engleman HM, Kingshott RN, Wraith PK, Mackay TW, Deary IJ, Douglas NJ (1999) Randomized placebo-controlled crossover trial of continuous positive airway pressure for mild sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 159:461–467PubMed
65.
go back to reference Barbé F, Mayoralas LR, Duran J, Masa JF, Maimó A, Montserrat JM, Monasterio C, Bosch M, Ladaria A, Rubio M, Rubio R, Medinas M, Hernandez L, Vidal S, Douglas NJ, Agustí AG (2001) Treatment with continuous positive airway pressure is not effective in patients with sleep apnea but no daytime sleepiness. a randomized, controlled trial. Ann Intern Med 134:1015–1023PubMed Barbé F, Mayoralas LR, Duran J, Masa JF, Maimó A, Montserrat JM, Monasterio C, Bosch M, Ladaria A, Rubio M, Rubio R, Medinas M, Hernandez L, Vidal S, Douglas NJ, Agustí AG (2001) Treatment with continuous positive airway pressure is not effective in patients with sleep apnea but no daytime sleepiness. a randomized, controlled trial. Ann Intern Med 134:1015–1023PubMed
66.
go back to reference Montserrat JM, Ferrer M, Hernandez L, Farré R, Vilagut G, Navajas D, Badia JR, Carrasco E, De Pablo J, Ballester E (2001) Effectiveness of CPAP treatment in daytime function in sleep apnea syndrome: a randomized controlled study with an optimized placebo. Am J Respir Crit Care Med 164:608–613PubMed Montserrat JM, Ferrer M, Hernandez L, Farré R, Vilagut G, Navajas D, Badia JR, Carrasco E, De Pablo J, Ballester E (2001) Effectiveness of CPAP treatment in daytime function in sleep apnea syndrome: a randomized controlled study with an optimized placebo. Am J Respir Crit Care Med 164:608–613PubMed
67.
go back to reference Barnes M, Houston D, Worsnop CJ, Neill AM, Mykytyn IJ, Kay A, Trinder J, Saunders NA, Douglas McEvoy R, Pierce RJ (2002) A randomized controlled trial of continuous positive airway pressure in mild obstructive sleep apnea. Am J Respir Crit Care Med 165:773–780PubMed Barnes M, Houston D, Worsnop CJ, Neill AM, Mykytyn IJ, Kay A, Trinder J, Saunders NA, Douglas McEvoy R, Pierce RJ (2002) A randomized controlled trial of continuous positive airway pressure in mild obstructive sleep apnea. Am J Respir Crit Care Med 165:773–780PubMed
68.
go back to reference Profant J, Ancoli-Israel S, Dimsdale JE (2003) A randomized, controlled trial of 1 week of continuous positive airway pressure treatment on quality of life. Heart Lung 32:52–58PubMedCrossRef Profant J, Ancoli-Israel S, Dimsdale JE (2003) A randomized, controlled trial of 1 week of continuous positive airway pressure treatment on quality of life. Heart Lung 32:52–58PubMedCrossRef
69.
go back to reference American Thoracic Society and American College of Chest Physicians (2003) ATS/ACCP statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 167:211–277CrossRef American Thoracic Society and American College of Chest Physicians (2003) ATS/ACCP statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 167:211–277CrossRef
Metadata
Title
Effects of exercise training associated with continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome
Authors
Carolina Ackel-D’Elia
Antonio Carlos da Silva
Rogério Santos Silva
Eveli Truksinas
Bolivar Saldanha Sousa
Sérgio Tufik
Marco Túlio de Mello
Lia Rita Azeredo Bittencourt
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
Sleep and Breathing / Issue 3/2012
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-011-0567-0

Other articles of this Issue 3/2012

Sleep and Breathing 3/2012 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine