Exercise may benefit patients with mild to moderate OSA

Washington, May 7 (ANI): People suffering from mild to moderate form of obstructive sleep apnea (OSA) may benefit from certain tongue and pharyngeal exercises, according to a study.

"It was commonly thought among doctors that strengthening and toning oropharyngeal muscles would have no benefit to the patient during sleep, but a recent study showed that didgeridoo playing helped decrease snoring and OSA. This was a change of paradigm, and indicated that not everything you do during the day is lost during sleep," said Dr. Geraldo Lorenzi-Filho.

During the study, the researchers investigated the effects of exercises on the symptoms of OSA in the first randomised, controlled study to do so. Thirty-one recently-diagnosed patients were evaluated for OSA severity using polysomnography.

Snoring frequency and intensity, daytime sleepiness and sleep quality were assessed using self-reports and validated questionnaires.

The subjects were the randomized to two groups-the exercise group and the control group. Each of the 16 individuals in the exercise group underwent a daily and weekly regimen of tongue and pharyngeal exercises.

There was also a control group of 15 individuals, who underwent a sham treatment regimen involving deep breathing and nasal lavage with a saline solution.

After three months, there were no significant changes to OSA symptoms in the control group, but the treatment group showed significant improvements in lowest oxygen saturation levels in blood, subjective sleepiness, snoring symptoms and quality of sleep scores.

The researchers said while there were no changes in abdominal circumference in either group, neck circumference decreased significantly in the treatment group with no concomitant changes in body mass index.

"These data suggest that the exercises were able to promote remodeling of the upper airways," said Dr. Lorenzi-Filho.

Overall, the treatment groups showed a 40 percent decrease in OSA severity, with 10 the 16 patients who had originally been classified as having moderate OSA being reclassified as having either mild (eight) or no OSA (two).

"This was nearly two thirds of the treatment group, whereas none of the control group were reclassified with a milder disease. This indicates to us that these exercises have significant potential to improve symptoms in sufferers of OSA," said Dr. Lorenzi-Filho.

"The muscles of the upper airways are extremely complex and the mechanisms leading to OSA are far from being well understood. A strong muscle may be working on the wrong direction and not necessarily helping to open the airways. The overall set of exercises we tested target the correct physiology of the upper airway and should promote remodeling of the upper airways," said Dr. Lorenzi-Filho.

The researchers say that the evidence supports that certain exercises do, in fact, aid in remodelling the upper airways in such a way as to reduce OSA symptoms.

Dr. Lorenzi-Filho acknowledges that work is just beginning in this exciting area of research.

"How exactly these exercises work? Do we need all of them or just a few? Do different patients need different set of exercises? What are the exact mechanisms leading to upper airway obstruction?" he asked.

"The answer is we don't know, but these are some of the possible future areas of research," he said.

The study has been published in the American Journal of Respiratory and Critical Care Medicine. (ANI)