Effects of a comprehensive program of physical training and oropharyngeal exercises in patients with obstructive sleep apnea syndrome: A randomized clinical trial

Background: Obstructive sleep apnea syndrome (OSA) consists in repetitive obstruction of the upper airway during sleep. Physical activity, diet control, and oropharyngeal exercises have been associated, separately, with decreased Apnea-Hypopnea Index (AHI). Aim: To investigate, in patients with moderate to severe OSA, the effects of a comprehensive program of physical training, diet control and oropharyngeal exercises in the AHI. Methods: This is a randomized clinical trial in patients with moderate to severe OSA evaluated by polysomnography or respiratory polygraphy. The intervention group (IG) followed eight-weeks urban-walking program, oropharyngeal exercises, diet and sleep recommendations. The control group (CG) followed diet and sleep recommendations. Anthropometrical measurements and six minutes walking test (6MWT) were evaluated. Results: We enrolled 27 patients with a median age of 67 [52-74] years and median AHI of 32 events/h [25-41]. IG patients (n=14) presented a decrease in body weight (86.0 Kg [80.5-90.5] vs 85.3 Kg [77-88.3]; p=0.003), and distance walked during 6MWT (548±84 m vs. 567±85 m; p=0.013). No significant changes were observed in the CG. AHI did not differ in the IG. However, in patients 60 years (n=8) from 31.5 [21-38.8] to 43.5 [24.8-48] events/h (p=0.017). Conclusions: A comprehensive multimodal program reduced body weight and increased the walking distance of patients with moderate to severe OSA. In patients