By Tracy Hartley, PT, DPT
Do you have difficulty sleeping? Are you drowsy even after you are fully awake? Do you snore or does your spouse accuse you of snoring? If you answered yes to any or all of these, you may also be suffering from Obstructive Sleep Apnea (OSA).
OSA is the most common type of sleep apnea. OSA is a condition that is described as the blocking of the upper airway during sleep resulting in pauses in the breathing pattern. This causes decreases in oxygen levels in the blood. The condition interrupts normal, important sleep patterns leaving its victims drowsy, fatigued, and unable to fully participate in life the next day. It is often accompanied by snoring. Here is an example of heavy snoring with periods of apnea: iStock_000006881421Wav44100
OSA treatment typically includes one or more of the following:
- Continuous Positive Airway Pressure, or CPAP (or APAP or VPAP), machine that is worn during sleep hours that uses positive air pressure to open the airway.
- Mandibular Advancement Splint or MAS which is similar to an athletic mouth guard that holds the jaw slightly open and forward to allow the tongue to move forward away from the airway.
- Pharmacological approaches have been variable with success but not without dealing with adverse side effects, some dangerous. That’s why none have FDA approval for OSA.
- Surgical intervention of the upper airway that has evolved over the past few years to be more highly selective of the type of procedure.
- Compression stockings worn during the day. A trial showed improved apnea scores thought to be as a result of less pooling of fluid in the legs that travels upward during sleep.
- Positioning in a 30 degree upper body elevation or in side-lying during sleep to reduce the gravitational forces on the upper airway.
Hold on a second. That’s not all you can do for those restless nights. Is there another option? If you’ve read this column before, I bet you know the answer. Can exercise really improve sleep apnea?
A recent randomly controlled trial looked at exercise and its effect on sleep apnea. Forty-three sedentary, overweight subjects with moderately severe OSA were randomly placed into one of two groups. The first group performed moderate intensity exercise (interval training article) 4 days per week, and strength training 2 days per week. The second group did flexibility exercises. The trial lasted 12 weeks. The vigorous exercise group performed 35 minutes of aerobic exercise and a general resistance training program. The following is a summary of the study’s findings:
- The exercise group reported significant improvements in sleep qualities measured using the Pittsburgh Sleep Quality Index.
- The exercise group also reported significant improvements in sleep qualities and apnea measured using the Apnea-hypopnea index. The flexibility group showed a decline in scores.
- The exercise group showed improved measurements in a critical phase of sleep.
- The exercise group achieved a significantly better blood oxygen saturation rate.
- All of these were achieved without a significant decrease in body weight for either group.
There you have it! This study clearly showed a positive relationship between moderate exercise and improved obstructive sleep apnea and quality of sleep in sedentary subjects. Exercise can be an effective treatment in moderately improving your sleep! If you suffer from sleep apnea, see your medical doctor and ask if exercise may be safe and effective for you.