Related Experiment Video
Updated: Aug 26, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Inspiratory muscle training as adjuvant therapy in obstructive sleep apnea: a randomized controlled trial
L M de Azeredo1, L C de Souza2, B L S Guimarães1,3
1Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brasil.
Abstract:
The aim of this randomized controlled trial was to analyze the effects of an inspiratory muscle training (IMT) program on apnea and hypopnea index (AHI), inspiratory muscle strength, sleep quality, and daytime sleepiness in individuals with obstructive sleep apnea (OSA), whether or not they used continuous positive airway pressure (CPAP (+/-) therapy. The intervention group underwent IMT with a progressive resistive load of 40-70% of the maximum inspiratory pressure (PImax) for 30 breaths once a day for 12 weeks. The control group was submitted to a similar protocol, but with at a minimum load of 10 cmH2O. Changes in the AHI were the primary outcome. PImax was measured with a digital vacuometer, daytime somnolence was measured by the Epworth sleepiness scale (ESS), and the quality of sleep by the Pittsburgh Sleep Quality Index (PSQI). CPAP use was treated as a confounder and controlled by stratification resulting in 4 subgroups: IMT-/CPAP-, IMT-/CPAP+, IMT+/CPAP-, and IMT+/CPAP+. Sixty-five individuals were included in the final analysis. Significant variations were found in the 4 parameters measured throughout the study after the intervention in both CPAP- and CPAP+ participants: PImax was increased and AHI was reduced, whereas improvements were seen in both ESS and PSQI. The twelve-week IMT program increased inspiratory muscle strength, substantially reduced AHI, and had a positive impact on sleep quality and daytime sleepiness, whether or not participants were using CPAP. Our findings reinforce the role of an IMT program as an adjunct resource in OSA treatment.
Related Concept Videos
Sleep Apnea
The condition is more prevalent among...
Mechanism of Breathing III: The Accessory Muscles
The respiratory system is a complex network that relies on primary respiratory muscles like the diaphragm, but also involves accessory muscles to enhance lung expansion and airflow during both inhalation and exhalation.
Enhancing Inhalation with Accessory Muscles:
Accessory muscles such as the sternocleidomastoid, scalene, intercostal, and abdominal muscles are crucial when additional respiratory effort is required, such as during deep...
Cardiopulmonary Resuscitation II: ACLS Airway Management
Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
Skeletal Muscle Relaxants: Therapeutic Uses

