[Physical training of patients with sleep apnea]

It is a common question of sleep apnoea patients in the sleep lab whether they stand a chance to decrease the symptoms and severity of their disease by physical exercise. As far as we know, there is no data about this specific question until now, even though this has been subject to speculation. A few studies, however, report on an improvement of the respiratory drive (and chemoreceptor sensitivity) after physical exercise in athletes. The aim of this study was to prove whether physical exercise in sleep apnoea patients could improve the symptoms of their disease in an open trial.

11 Patients with mild to severe sleep apnoea syndrome (1 f, 10 m, mean age 53.8x) took part in a 6-month period of physical exercise twice a week 2 h each time under the instructions of physical therapists. Before and after the 6mo period a full PSG without CPAP or BIPAP, a bicycle exercise test with lactate profile, echocardiography, blood test, and body weight and body height measurement was performed. Statistical analysis was done using Wilcoxon ranked test and multiple regression analysis.

There was no significant bodyweight reduction in all patients after the 6mo period of physical training, no significant difference in either basal SaO2 nor mean SaO2 and no significant improvement in physical status by the p at 4 mmol lactate on the lactate profile. Echocardiographic changes were not found; there was no significant change in the blood pressure profiles during the bicycle test. No cardiopulmonary problems including exercise-induced high blood pressure were reported during the training period. There was, however, a significant decrease of the RDI (p < 0.05), but no significant change in the REM-sleep % of total sleep time (TST) and the TST itself.

There was an improvement of the sleep apnoea syndrome correlated to a decrease of the RDI in the studied patient population due to a possible increase in the respiratory drive or a stabilised muscle tone ine the upper airways after physical exercise, as reported by other authors, because weight reduction could not be the reason in our patients. Our trial showed that the exercise does not increase the severity of symptoms of sleep apnoea by changing the REM/non REM ratio or for any other reasons. A physical training programme for sleep apnoea patients as an additional treatment should therefore be considered.