Exercise and Obstructive Sleep Apnoea Syndrome

Emily Hudson (Exercise Physiologist – Burnie)

Obstructive Sleep Apnoea Syndrome (OSAS) is a disorder characterized by prolonged periods of partial (hypopnea) or complete (apnoea) obstruction of the upper airway during sleep and can be seen in figure 1.

Obstructive Sleep Apnea - Image Credit: Alila Medical Media / Shutterstock

Figure 1 Airway Obstruction during Sleep Apnoea (1, 2)

The results of this obstruction include disrupted sleep as well as low oxygen in the tissues (hypoxia), increasing the risk of accidents and reduced quality of life. With this disease being severely under diagnosed, a person may experience symptoms of OSAS from many months or years without a formal diagnosis. Common symptoms can include:

Figure 2 Symptoms of Sleep Apnoea (3, 4)

It is important to discuss the above symptoms with your doctor, because OSAS can be associated with longer term negative cognitive, mental, vascular, and respiratory health outcomes (5).

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Figure 3 Risks of Untreated Sleep Apnoea (5)

Risk Factors and Diagnosis of Obstructive Sleep Apnoea:

While anyone can develop this condition, there are certain lifestyle and other risk factors that increase the risk which include (4):

  • Excess weight
  • High blood pressure
  • Smoking
  • Diabetes
  • Asthma
  • Narrowed airways
  • Sex
  • A family history of OSAS
  • Chronic nasal congestion

Once your doctor has obtained a thorough history of your symptoms, they may refer you to undergo a sleep study (polysomnography), which measures many physiological parameters while you sleep. The sleep study utilizes the Apnoea-Hypopnea Index (AHI) as a tool to understand and diagnose the severity of your sleep apnoea, by counting the number of airway obstructions you have per hour of sleep (6-8).

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Figure 4 Apnoea-Hypopnea Index (7)

Management of Obstructive Sleep Apnoea

Depending on the severity of your OSAS, additional testing may be required. If deemed eligible, you may be fitted with a small mask or nose tube which provides positive airway pressure (PAP) by blowing compressed air into the airway and lungs, effectively propping open the airway for adequate oxygen during sleep (9).

Figure Positive Airway Pressure Device (9)

Despite the success of PAP machines in alleviating OSAS symptoms, unless worn every night, the benefits of PAP machines are not achieved. Common side effects when using PAP machines include (10):

  • Claustrophobia
  • Excessive noise
  • Air leaks
  • Dry mouth
  • Nasal congestion
  • Skin irritation
  • Too much pressure
  • Excess water in tubing

Common management strategies for managing OSAS is to manage the risk factors associated with it, for example excessive weight, high blood pressure and diabetes (4). Additionally, it has been identified that people with OSAS experience altered cardiopulmonary implications, endocrine dysregulation, and cognitive impairment, which when exercising can mean a reduced ability to exercise and lower aerobic and anaerobic capacities (1).

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Figure 6 Benefits of Exercise on OSAS (1)

With this known, exercise plays an integral part in reducing the risk of and managing the symptoms of OSAS. Exercise recommendations need to be tailored to your current level and capacity, and something you can sustain regularly.

If you have Obstructive Sleep Apnoea Syndrome and need help to manage and improve risks and symptoms via exercise, make an appointment with one of our Exercise Physiologists today by calling our Burnie clinic on 64314586.

References

  1. Stavrou, V. T., Astara, K., Tourlakopoulos, K. N., Papayianni, E., Boutlas, S., Vavougios, G. D., Daniil, Z., & Gourgoulianis, K. I. (2021). Obstructive Sleep Apnoea Syndrome: The Effect of Acute and Chronic Responses of Exercise. Frontiers in medicine8, 806924. https://doi.org/10.3389/fmed.2021.806924https://www.news-medical.net/health/Obstructive-Sleep-Apnea-in-Children.aspx
  2. Aftab Z, Anthony A, Rahmat S, et al. (June 24, 2021) An Updated Review on the Relationship of Depressive Symptoms in Obstructive Sleep Apnoea and Continuous Positive Airway Pressure. Cureus 13(6): e15907. doi:10.7759/cureus.15907
  3. https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090
  4. https://www.verywellhealth.com/sleep-apnea-overview-3014774
  5. Hall, K. A., Singh, M., Mukherjee, S., & Palmer, L. J. (2020). Physical activity is associated with reduced prevalence of self-reported obstructive sleep apnoea in a large, general population cohort study. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine16(7), 1179–1187. https://doi.org/10.5664/jcsm.8456
  6. https://www.sleepapnea.org/what-does-ahi-represent/
  7. https://healthysleep.med.harvard.edu/sleep-apnea/diagnosing-osa/testing
  8. https://healthysleep.med.harvard.edu/sleep-apnea/treating-osa/nonsurgical
  9. https://healthysleep.med.harvard.edu/sleep-apnea/treating-osa/pap