Resistance Training of Inspiratory Muscles After Coronary Artery Disease May Improve Obstructive Sleep Apnea in Outpatient Cardiac Rehabilitation: RICAOS Study
BackgroundObstructive sleep apnea (OSA) affects 5% of the adult population and its prevalence is up to 13 times higher in coronary artery disease (CAD) patients. However, OSA in this population is less symptomatic, leading to lower adherence to positive airway pressure (CPAP). While oropharyngeal ex...
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2022.846532/full |
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| author | Pierre Labeix Pierre Labeix Mathieu Berger Mathieu Berger Amandine Zellag Amandine Zellag Arnauld Garcin Arnauld Garcin Jean-Claude Barthelemy Frederic Roche Frederic Roche David Hupin David Hupin |
| author_facet | Pierre Labeix Pierre Labeix Mathieu Berger Mathieu Berger Amandine Zellag Amandine Zellag Arnauld Garcin Arnauld Garcin Jean-Claude Barthelemy Frederic Roche Frederic Roche David Hupin David Hupin |
| author_sort | Pierre Labeix |
| collection | DOAJ |
| description | BackgroundObstructive sleep apnea (OSA) affects 5% of the adult population and its prevalence is up to 13 times higher in coronary artery disease (CAD) patients. However, OSA in this population is less symptomatic, leading to lower adherence to positive airway pressure (CPAP). While oropharyngeal exercise showed a significant decrease in apnea-hypopnea index (AHI) in patients with moderate OSA, there have been no studies testing the impact of specific inspiratory muscle training (IMT) for these patients. The aim of our study was to assess the effectiveness of IMT on AHI reduction in CAD patients with moderate OSA.MethodsWe included patients with CAD involved in a cardiac rehabilitation program and presenting an AHI between 15 and 30. Patients were randomized in a 1:1 allocation to a control group (CTL – classic training) or an IMT group (classic training + IMT). IMT consisted in 60 deep inspirations a day, 6 days a week, into a resistive load device set at 70% of the maximum inspiratory pressure (MIP). After 6 weeks, we compared AHI, neck circumference, Epworth Sleepiness Scale, Pittsburgh Sleep Quality index, and quality of life with the 12-item Short Form Survey before and after rehabilitation.ResultsWe studied 45 patient (60 ± 9 y, BMI = 27 ± 6 kg.m−2). The IMT group (n = 22) significantly improved MIP ( p < 0.05) and had a significant decrease in AHI by 25% (−6.5 ± 9.5, p = 0.02). In the CTL group (n = 23), AHI decreased only by 3.5% (−0.7 ± 13.1; p = 0.29). Between groups, we found a significant improvement in MIP ( p = 0.003) and neck circumference ( p = 0.01) in favor of the IMT group. However, we did not find any significant improvement of AHI in the IMT group compared to CTL ( p = 0.09).ConclusionA specific IMT during cardiac rehabilitation contributes to reduce significantly AHI in CAD patients with moderate OSA. Magnitude of the decrease in OSA severity could be enhanced according to implementation of specific IMT in this population. |
| first_indexed | 2024-12-22T06:21:09Z |
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| language | English |
| last_indexed | 2024-12-22T06:21:09Z |
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| spelling | doaj.art-a4c297d1b35147b1941020276efb15232022-12-21T18:35:58ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2022-03-011310.3389/fphys.2022.846532846532Resistance Training of Inspiratory Muscles After Coronary Artery Disease May Improve Obstructive Sleep Apnea in Outpatient Cardiac Rehabilitation: RICAOS StudyPierre Labeix0Pierre Labeix1Mathieu Berger2Mathieu Berger3Amandine Zellag4Amandine Zellag5Arnauld Garcin6Arnauld Garcin7Jean-Claude Barthelemy8Frederic Roche9Frederic Roche10David Hupin11David Hupin12SAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, FranceDepartment of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, FranceSAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, FranceCenter for Investigation and Research in Sleep, CHUV and UNIL, Lausanne, SwitzerlandSAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, FranceInfectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne, FranceSAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, FranceInnovation and Pharmacology Clinical Research Unit, University Hospital of Saint-Etienne, Saint-Etienne, FranceSAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, FranceSAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, FranceDepartment of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, FranceSAINBIOSE, U1059 INSERM, University of Lyon, University Jean Monnet, Saint-Etienne, FranceDepartment of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, FranceBackgroundObstructive sleep apnea (OSA) affects 5% of the adult population and its prevalence is up to 13 times higher in coronary artery disease (CAD) patients. However, OSA in this population is less symptomatic, leading to lower adherence to positive airway pressure (CPAP). While oropharyngeal exercise showed a significant decrease in apnea-hypopnea index (AHI) in patients with moderate OSA, there have been no studies testing the impact of specific inspiratory muscle training (IMT) for these patients. The aim of our study was to assess the effectiveness of IMT on AHI reduction in CAD patients with moderate OSA.MethodsWe included patients with CAD involved in a cardiac rehabilitation program and presenting an AHI between 15 and 30. Patients were randomized in a 1:1 allocation to a control group (CTL – classic training) or an IMT group (classic training + IMT). IMT consisted in 60 deep inspirations a day, 6 days a week, into a resistive load device set at 70% of the maximum inspiratory pressure (MIP). After 6 weeks, we compared AHI, neck circumference, Epworth Sleepiness Scale, Pittsburgh Sleep Quality index, and quality of life with the 12-item Short Form Survey before and after rehabilitation.ResultsWe studied 45 patient (60 ± 9 y, BMI = 27 ± 6 kg.m−2). The IMT group (n = 22) significantly improved MIP ( p < 0.05) and had a significant decrease in AHI by 25% (−6.5 ± 9.5, p = 0.02). In the CTL group (n = 23), AHI decreased only by 3.5% (−0.7 ± 13.1; p = 0.29). Between groups, we found a significant improvement in MIP ( p = 0.003) and neck circumference ( p = 0.01) in favor of the IMT group. However, we did not find any significant improvement of AHI in the IMT group compared to CTL ( p = 0.09).ConclusionA specific IMT during cardiac rehabilitation contributes to reduce significantly AHI in CAD patients with moderate OSA. Magnitude of the decrease in OSA severity could be enhanced according to implementation of specific IMT in this population.https://www.frontiersin.org/articles/10.3389/fphys.2022.846532/fullresistive inspiratory muscle trainingobstructive sleep apneacoronary artery diseaseapnea-hypopnea indexcardiac rehabilitationoxygen desaturation index |
| spellingShingle | Pierre Labeix Pierre Labeix Mathieu Berger Mathieu Berger Amandine Zellag Amandine Zellag Arnauld Garcin Arnauld Garcin Jean-Claude Barthelemy Frederic Roche Frederic Roche David Hupin David Hupin Resistance Training of Inspiratory Muscles After Coronary Artery Disease May Improve Obstructive Sleep Apnea in Outpatient Cardiac Rehabilitation: RICAOS Study Frontiers in Physiology resistive inspiratory muscle training obstructive sleep apnea coronary artery disease apnea-hypopnea index cardiac rehabilitation oxygen desaturation index |
| title | Resistance Training of Inspiratory Muscles After Coronary Artery Disease May Improve Obstructive Sleep Apnea in Outpatient Cardiac Rehabilitation: RICAOS Study |
| title_full | Resistance Training of Inspiratory Muscles After Coronary Artery Disease May Improve Obstructive Sleep Apnea in Outpatient Cardiac Rehabilitation: RICAOS Study |
| title_fullStr | Resistance Training of Inspiratory Muscles After Coronary Artery Disease May Improve Obstructive Sleep Apnea in Outpatient Cardiac Rehabilitation: RICAOS Study |
| title_full_unstemmed | Resistance Training of Inspiratory Muscles After Coronary Artery Disease May Improve Obstructive Sleep Apnea in Outpatient Cardiac Rehabilitation: RICAOS Study |
| title_short | Resistance Training of Inspiratory Muscles After Coronary Artery Disease May Improve Obstructive Sleep Apnea in Outpatient Cardiac Rehabilitation: RICAOS Study |
| title_sort | resistance training of inspiratory muscles after coronary artery disease may improve obstructive sleep apnea in outpatient cardiac rehabilitation ricaos study |
| topic | resistive inspiratory muscle training obstructive sleep apnea coronary artery disease apnea-hypopnea index cardiac rehabilitation oxygen desaturation index |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2022.846532/full |
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