Respiratory muscle training may improve some symptoms of obstructive sleep apnea

1. In this systematic review and meta-analysis, it was found that in patients with obstructive sleep apnea (OSA), inspiratory muscle training likely had a positive impact on systolic blood pressure and sleepiness, but demonstrated no improvements in apnea-hypopnea index, forced vital capacity, sleep quality, and quality of life, compared to controls.

2. Meanwhile, expiratory muscle training showed some improvements in expiratory muscle strength and sleep quality compared to controls, but no improvements in sleepiness.

Evidence Rating Level: 1 (Excellent)

Obstructive sleep apnea (OSA) is a very common sleep disorder that is associated with several debilitating symptoms which can have a significant effect on quality of life. Previous studies have suggested that respiratory muscle training (RMT) may be an effective way to improve lung function and reduce symptom burden in patients with OSA. However, no systematic review to date has synthesized the findings to determine the overall impact of RMT on OSA symptoms. Therefore, the aim of the present study was to review the evidence regarding the safety and effectiveness of RMT in patients with OSA.

Of 8,931 identified records, 13 studies (n = 432 participants) were included from various sources from database inception to July 1, 2022. Studies were included if they were randomized-controlled trials investigating RMT as a treatment for OSA patients older than 18 years of age. Studies that included patients with unstable disorders, spinal cord injury, or neuromuscular disease were excluded. The review was conducted in accordance with PRISMA guidelines. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (Grade) System. The primary outcome was the impact of RMT on various OSA symptoms.

The results demonstrated that, compared to controls, inspiratory muscle training had a positive impact on factors including systolic blood pressure and sleepiness in OSA patients. However, there was no impact on apnea-hypopnea index, forced vital capacity, sleep quality, and quality of life. Expiratory muscle training exhibited improvements in muscle strength and sleep quality compared to controls, but no improvements in sleepiness. Despite these results, the review was limited by the small sample sizes and short intervention periods of the included studies, which may have impacted the results. Nonetheless, the present study demonstrated that RMT may be beneficial in improving some symptoms experienced by OSA patients.

Click to read the study in Journal of Sleep Research

Image: PD

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