Pulmonary rehabilitation helps patients newly diagnosed with obstructive sleep apnea

Pulmonary rehabilitation (PR) treatment could be a valuable addition to comprehensive therapy in patients with obstructive sleep apnea (OSA) syndrome, according to a new study. The study was presented at the 2015 American Thoracic Society International Conference.

"In our study with 40 newly diagnosed OSA patients and a control group, pulmonary rehabilitation helped reduce body mass index, certain body circumferences, and improve pulmonary function," said researcher Katerina Neumannova, MSc, PhD, Palacky University, Faculty of Physical Culture, Olomouc, Czech Republic.

The classic treatment for patients with OSA is continuous positive airway pressure, often called CPAP or CPAP therapy. Treatment via PR, which is used for conditions such as chronic obstructive pulmonary disease (COPD), has not been thoroughly studied in OSA, even though patients with OSA often have respiratory symptoms associated with a decreased health-related quality of life and a diminished functional capacity.

The study included 40 patients with OSA who were randomly assigned to either the PR group (n=20) or the control group (n=20). All patients involved in the study received CPAP therapy as their apnea/hypopnea index (AHI) was higher than 15.

The PR group had 6 weeks of 60-minute individual rehabilitation sessions twice a week. The sessions consisted of education, exercise training, breathing retraining, respiratory muscle training, and oropharyngeal exercises. At baseline and then after 6 weeks of CPAP-only use or CPAP with the PR, researchers tracked a number of parameters, including pulmonary function, AHI, body mass index (BMI), percentage of body fat; and neck, waist, and hip circumferences.

The final study included 15 patients in the PR group and 20 in the control group, as 5 patients did not complete PR. Although OSA severity was significantly decreased in both groups after the treatment, significant reduction of BMI, neck, waist and hip circumferences was confirmed only in the PR group. That same group also had an improvement in pulmonary function. Patients in both groups had decreased body fat, although body fat loss was higher in the PR group.

"Patients with OSA can benefit from pulmonary rehabilitation treatment," Dr. Neumannova said. "We can determine on a patient-by-patient basis which patients would benefit most from pulmonary rehabilitation based on their individual disease and clinical judgement."