Effect of exercise on sleep and cardiopulmonary parameters in patients with pulmonary artery hypertension

Pulmonary arterial hypertension (PAH) is considered to be a rare progressive disease resulting from restricted flow through the pulmonary arterial circulation resulting ultimately in right-sided heart failure. Most patients with PAH suffer from sleep disorders, reduced aerobic fitness, and mortality risk despite optimized medical treatment. This study investigated the effect of 12 weeks of aerobic training on sleep quality, sleep efficiency, right ventricular systolic pressure (RVSP), and aerobic fitness in patients with PAH.

Thirty patients with PAH were randomized to two equal groups, training group (A) and control group (B). The Pittsburg sleep quality index (PSQI) questionnaire and a wrist-worn actigraph were used for the assessment of sleep quality and sleep efficiency respectively. RVSP was measured using echocardiography. Cardiopulmonary exercise testing (CPET) assessed maximal heart rate and VO2max. All were measured before and after the study period for both groups. Exercise training was conducted on a bicycle ergometer as an individually-tailored moderate-intensity aerobic training session (60 to 70% of the maximal heart rate reached during the initial exercise test) for 30 to 45 min/day, 3 sessions/week for 12 weeks (36 sessions).

Sleep scores and RVSP showed significant reductions and VO2max-representing the aerobic fitness-showed a significant increase in the group (A) compared with group (B).

These results suggest that aerobic training has a positive effect on three risk factors for mortality in patients with PAH, namely sleep quality, decline in exercise capacity, and right ventricular remodeling.

Clinical trial registered in ClinicalTrials.gov , ID: NCT04337671.