Effect of exercise training on heart rate variability in patients with obstructive sleep apnea: A randomized controlled trial

Berger, Mathieu; Raffin, Jérémy; Pichot, Vincent; Hupin, David; Garet, Martin; Labeix, Pierre; Costes, Frédéric; Barthélémy, Jean‐Claude; Roche, Frédéric

doi:10.1111/sms.13447

Cited by 21 publications

(21 citation statements)

References 44 publications

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“…Cardiac autonomic functions of the patients were then measured using the method of heart rate variability. Patients in the exercise treatment group also revealed statistically significant improvements [31].…”

Section: Discussionmentioning

confidence: 88%

The Impact of Auricular Vagus Nerve Stimulation on Pain and Life Quality in Patients with Fibromyalgia Syndrome

Kutlu

Özden

Alptekin

et al. 2020

BioMed Research International

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The purpose of this study is to evaluate the impact of auricular vagus nerve stimulation, applied in conjunction with an exercise treatment program, on pain and life quality in patients with fibromyalgia syndrome (FMS). To achieve the study objectives, 60 female patients between the ages 18 and 50, with diagnosed FMS according to the American College of Rheumatology (ACR) 2010 diagnostic criteria, were randomly divided into 2 groups of 30. The first group was assigned 20 sessions of a home-based exercise program, while the second group was assigned 20 sessions of auricular vagus nerve stimulation and 20 sessions of a home-based exercise program. Patients were assessed before and after the treatments using the Visual Analog Scale (VAS) for pain, Beck Depression Scale for depression, Beck Anxiety Scale for anxiety, Fibromyalgia Impact Questionnaire (FIQ) for functional evaluation, and Short Form-36 (SF-36) for life quality. In this randomized controlled trial, comparisons within the groups revealed that both groups had statistically significant improvements in pain, depression, anxiety, functionality, and life quality scores (p < 0:05), while comparisons across the groups revealed that the group experiencing the vagus nerve stimulation had no statistically significant differences between the baseline scores, except for those of SF-36's subparameters of physical function, social functionality, and pain. In fact, comparisons across the groups after the interventions revealed that the group experiencing the vagus nerve stimulation had better scores but not statistically significant. From analysis of this data, we observed that vagus nerve stimulation in FMS treatment did not give additional benefit together with exercise, except for three subparameters of SF-36. It was identified that further studies which separately investigate the effects of vagus nerve stimulation and exercise on FMS with longer follow-up periods and an increased number of patients are needed.

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Section: Discussionmentioning

confidence: 88%

The Impact of Auricular Vagus Nerve Stimulation on Pain and Life Quality in Patients with Fibromyalgia Syndrome

Kutlu

Özden

Alptekin

et al. 2020

BioMed Research International

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“…Medium to long‐term aerobic training, at a minimum frequency of three times a week, has been shown to prevent the unwanted decline in nighttime HRV parameters in patients with moderate OSA, due to a decrease in sympathetic nerve activity (Berger et al., 2019; Kline et al., 2013; Ueno‐Pardi et al., 2017). Studies conducted in patients with OSA and heart failure have shown, through microneurography, that exercise training can decrease sympathetic nerve activity following a 4‐month training program, at a frequency of three times a week (Ueno‐Pardi et al., 2017).…”

Section: Discussionmentioning

confidence: 99%

“…A similar outcome was reported when older adults suffering from uncontrolled hypertension were compared to healthy ones, with no changes having been detected in HF following an 8‐month resistance training intervention in either group (Wanderley et al., 2013). Although it is not yet quite clear whether physical exercise can improve or even prevent the cardiac autonomic dysfunction observed in OSA (Yang et al., 2018), recent evidence suggests that regular physical activity might prevent an unwanted decline in nighttime HRV parameters in moderate OSA patients (Berger et al., 2019). But whether the sympathovagal balance in such patients can be affected by acute or short‐term physical exercise remains to be established.…”

Section: Introductionmentioning

confidence: 99%

Effects of short‐term aerobic training versus CPAP therapy on heart rate variability in moderate to severe OSA patients

et al. 2021

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We compared the effects of 2‐month CPAP or exercise training (ET) therapies on the autonomic balance in moderate to severe obstructive sleep apnea (OSA) through heart rate variability (HRV) analysis. Thirty‐nine OSA patients were divided into CPAP (n = 18) and ET (n = 21) groups, being further split into hypertensive and non‐hypertensive subgroups. All patients were submitted to continuous ECG recordings for HRV analysis. Hemodynamic parameters were recorded by oscillometry. Excessive daytime sleepiness and sleep quality were assessed through the Epworth Sleepiness Scale and the Pittsburgh questionnaire, respectively. ET decreased systolic arterial pressure in hypertensive and non‐hypertensive participants when compared to baseline values, whereas diastolic arterial pressure was decreased only in non‐hypertensive ones. CPAP had no effect over hemodynamic parameters in either subgroup. ET significantly increased the HRV parameters SDNN and pNN50 in non‐hypertensive participants, while reducing the LF/HF ratio in both subgroups. CPAP significantly decreased SDNN in both subgroups. ET significantly decreased excessive daytime sleepiness in both subgroups, but did not affect sleep quality. CPAP significantly improved sleep quality in both subgroups, although global scores were still those of poor sleepers, while excessive daytime sleepiness was normalized only in hypertensive patients. In conclusion, while short‐term ET modulated different HRV parameters, leading to a predominant vagal tone in the cardiac sympathovagal balance and decreasing blood pressure in moderate to severe OSA, short‐term CPAP had next to no effect in these parameters. We believe ET should be considered as an adjunct interventional strategy in the conservative management of hypertensive or non‐hypertensive OSA patients.

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“…Furthermore, several interventional studies have shown that supervised exercise programs are beneficial to OSA severity by reducing apnea‐hypopnea index (AHI), excessive daytime sleepiness, and improving quality of life (QoL) 6‐8 . The EXESAS study, a randomized controlled study, confirmed similar results in patients suffering moderate OSA engaged in a 9‐month supervised community physical activity program 9,10 …”

Section: Introductionmentioning

confidence: 86%

“…This was a 12‐month prospective observational follow‐up study following the EXESAS randomized controlled trial (NCT02463890) 9,10 . This follow‐up study was performed at the University Hospital of Saint‐Etienne, France, between September 2016 and August 2018.…”

Section: Methodsmentioning

confidence: 99%

Longer‐term effects of supervised physical activity on obstructive sleep apnea and subsequent health consequences

Berger

Barthélémy

Garet

et al. 2021

Scandinavian Med Sci Sports

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Although recent trials have shown promising benefits of exercise on obstructive sleep apnea (OSA) severity, the long‐term effect of these interventions remains unknown. The aim of this study was to assess the effect of a 9‐month community physical activity program on OSA severity one year later in free‐living conditions. OSA patients, previously included in a 9‐month randomized controlled trial (EXESAS study) evaluating the effects of supervised community physical activity on OSA severity, were invited to participate in an extra one‐year observational study. Twenty‐eight patients completed the study. Although OSA severity did not significantly worsen over the real‐life period (9 to 21 months of follow‐up), reductions in apnea‐hypopnea index (AHI) and oxygen desaturation index were no longer significant after 21 months of follow‐up compared to baseline (baseline AHI: 22.2 ± 6.3 /h; 9 months: 16.3 ± 6.4 /h; 21 months: 18.7 ± 8.9 /h). Benefits observed at 9 months on daytime sleepiness and mental health were preserved at 21 months, whereas cardiorespiratory fitness slightly decreased. Per‐protocol analysis revealed that patients who stopped exercise at 9 months had worsened OSA severity compared to those who continued exercise during the real‐life period (AHI: +9.0 ± 8.8 vs. −1.3 ± 5.3 /h; p < .01). In conclusion, our study suggested that improvements in OSA severity remain transient and is dependent on long‐term adherence to regular physical activity practice.

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Effect of exercise training on heart rate variability in patients with obstructive sleep apnea: A randomized controlled trial

Cited by 21 publications

References 44 publications

The Impact of Auricular Vagus Nerve Stimulation on Pain and Life Quality in Patients with Fibromyalgia Syndrome

The Impact of Auricular Vagus Nerve Stimulation on Pain and Life Quality in Patients with Fibromyalgia Syndrome

Effects of short‐term aerobic training versus CPAP therapy on heart rate variability in moderate to severe OSA patients

Longer‐term effects of supervised physical activity on obstructive sleep apnea and subsequent health consequences

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