The low levels of physical activity observed in OSA patients have been attributed to the fatigue and somnolence they experience, the excess weight, and low energy that characterize the clinical presentation of OSA ( 9) and associated neurocognitive alterations. For instance, adults with OSA are less likely to be active than adults without sleep apnea ( 7) and longitudinal and cross-sectional data suggest a reduced prevalence and incidence of OSA in those who exercise regularly ( 8). These observations are based on case–control studies showing that adults who report low-sleep quality presented lower levels of physical activity than similar adults without sleep complaints ( 6). It has been associated with improved sleep and a bidirectional relationship between sleep and physical activity has been assumed ( 5).
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Physical activity is defined as “any bodily movement produced by the skeletal muscles that results in increased energy expenditure” ( 3) and is currently seen as one of the most powerful health-promoting behaviors ( 4). Sleep fragmentation and chronic intermittent hypoxia induce intermediate mechanisms such as activation of the sympathetic nervous system ( 1), oxidative stress and systemic inflammation which contribute to cardiometabolic morbidity ( 2). Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated episodes of apnea and hypopnea during sleep. Objective measurement of physical activity in routine OSA management and well-designed clinical trials are recommended. Future interventions (including exercise training) focusing on increasing physical activity levels may have important clinical impacts on both OSA severity and the burden of associated co-morbidities. OSA patients present low levels of physical activity and exercise training is associated with improved outcomes. There was a significant decrease in apnea–hypopnea-index following exercise training (mean decrease of 8.9 events/h 95% CI: −13.4 to −4.3 p < 0.01), which was accompanied by a reduction in subjective sleepiness, an increase in VO2peak and no change in BMI.
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For exercise training, six randomized trials were included. The mean number of steps per day across studies was 5,388 (95% CI: 3,831–6,945 p < 0.001), which was by far lower than the recommended threshold of 10,000 steps per day. For objective physical activity levels, eight studies were included. Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of evidence. 4Grenoble Alps University Hospital, Grenoble, FranceĪ systematic review of English and French articles using Pubmed/Medline and Embase included studies assessing objective physical activity levels of obstructive sleep apnea (OSA) patients and exploring the effects of exercise training on OSA severity, body mass index (BMI), sleepiness, and cardiorespiratory fitness.11HP2 Laboratory, University Grenoble Alpes, Grenoble, France.Renaud Tamisier 1,2,4‡ and Jean-Louis Pépin 1,2,4‡