Effects of combined exercise training with sleep education in older adults with obstructive sleep apnea: protocol for a randomized clinical trial

Felipe Fank; Regiana Santos Artismo; Marcos Gonçalves de Santana; Andrea Maculano Esteves; Darlan Laurício Matte; Giovana Zarpellon Mazo

doi:10.3389/fpsyg.2024.1322545

Effects of combined exercise training with sleep education in older adults with obstructive sleep apnea: protocol for a randomized clinical trial

Front Psychol. 2024 Feb 15:15:1322545. doi: 10.3389/fpsyg.2024.1322545. eCollection 2024.

Authors

Felipe Fank¹, Regiana Santos Artismo², Marcos Gonçalves de Santana³, Andrea Maculano Esteves⁴, Darlan Laurício Matte², Giovana Zarpellon Mazo¹

Affiliations

¹ Laboratory of Gerontology, Health and Sports Sciences Center, Santa Catarina State University, Florianopolis, Brazil.
² Teaching, Research and Extension Center in Physiotherapy in the Pre- and Post-Operation of Major Surgeries, Health and Sports Sciences Center, Santa Catarina State University, Florianopolis, Brazil.
³ Health Sciences Unit, Federal University of Jatai, Jatai, Brazil.
⁴ Laboratory of Sleep and Exercise, School of Applied Sciences, State University of Campinas, Campinas, Brazil.

Abstract

Background: Obstructive sleep apnea (OSA) is a common disorder that affects approximately 1 billion people worldwide. Advanced age is a significant risk factor. Various treatment options have been explored to reduce the severity of OSA symptoms and physical exercise has emerged as a potential alternative therapy. Therefore, this study aims to investigate the effects of a combined exercise program with sleep education on sleep quality and on the severity of OSA in older adults.

Methods: This is a randomized clinical trial with two parallel groups that will involve individuals of both genders aged between 60 and 79 years who have an apnea-hypopnea index (AHI) of more than 15 events per hour and who have not received or are currently undergoing treatment for OSA. Older adults who have engaged in regular exercise in the last six months and individuals with contraindications to exercise will be excluded. The study will assess outcomes related to OSA, including AHI, oxygen desaturation index, minimum and mean oxyhemoglobin saturation, sleep efficiency, sleep latency, and the type of respiratory events. Additionally, sleep quality-related outcomes, daytime sleepiness, physical activity, physical fitness, aerobic capacity, cognitive status, anthropometric measures, and health-related quality of life will be analyzed. Participants will be randomized to two groups: a combined exercise group (involving both resistance and aerobic training) with sleep education, and a control group that will receive only educational recommendations for managing OSA. The intervention will last 12 weeks and will consist of three sessions per week, totaling 36 exercise sessions. Sample size calculation indicates a minimum number of 36 participants.

Discussion: If the hypothesis is confirmed, this clinical trial will indicate an effective non-pharmacological intervention for treating OSA in older adults. This intervention could be used as an adjunct to existing approaches designed to improve OSA management.

Clinical trail registration: Brazil Clinical Trials Registry (ReBEC), identifier RBR-9hk6pgz.

Keywords: aerobic exercise; combined training; obstructive sleep apnea; older adults; sleep hygiene; strength training.

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article. This study was financed in part by the Coordination for the Improvement of Higher Education Personnel - Brazil (CAPES) - Finance Code 001.