Exercise: A Novel Treatment for Obstructive Sleep Apnea

描述（由申请人提供）：阻塞性睡眠呼吸暂停（OSA）是一种常见的睡眠障碍，影响约10%的成年人。这种疾病是一种公共卫生威胁，因为阻塞性睡眠呼吸暂停与认知障碍、睡眠质量受损、心血管疾病、糖尿病和死亡率有关。然而，尽管它对许多健康结果有有害影响，但阻塞性睡眠呼吸暂停的成功治疗方案仍然难以捉摸。手术和鼻腔持续气道正压（nCPAP）治疗是最常见的治疗方法，但这些选择分别受到低成功率和低依从性的困扰。运动被认为是阻塞性睡眠呼吸暂停的潜在补充治疗选择，主要是因为它的减肥效果。然而，令人惊讶的是，对这一领域的调查很少。与美国疾病控制与预防中心的健康保护目标“健康的人在生命的每个阶段”相一致，该提案的目的是“预防成人慢性疾病（即阻塞性睡眠呼吸暂停综合症的后遗症）及其后果”。具体来说，该研究将调查运动作为一种补充或替代治疗阻塞性睡眠呼吸暂停的疗效及其后果。该研究将采用随机实验设计来评估8周阻力和有氧运动计划对OSA严重程度和并发症的影响。具体目的1是评估运动对呼吸暂停低通气指数（AHI）的影响，AHI是衡量OSA严重程度的主要指标。此外，还将评估运动对AHI影响的介质。由于OSA对健康结果的影响是广泛的，Specific Aim 2将评估运动对各种OSA并发症的影响，包括代谢功能、认知表现、白天嗜睡、睡眠质量、心理健康、全身炎症和心血管健康。这项研究的结果将为运动是否是阻塞性睡眠呼吸暂停患者的有效补充或替代治疗方案提供重要和急需的信息。阻塞性睡眠呼吸暂停是一种常见的睡眠障碍和新兴的公共卫生威胁，对心血管健康、代谢功能、认知和心理健康都有有害的影响。运动作为一种减轻这种疾病的严重程度和并发症的治疗选择一直没有得到充分的研究，特别是因为现有的治疗选择并不是最理想的。这项拟议的研究将提供第一个运动对阻塞性睡眠呼吸暂停治疗有效性的对照证据，并将阐明运动疗法是否可以作为一种替代或补充治疗方案。

DESCRIPTION (provided by applicant): Obstructive sleep apnea (OSA) is a common sleep disorder, affecting approximately 10% of adults. The disorder is a public health threat, as OSA has been linked to cognitive impairment, impaired sleep quality, cardiovascular disease, diabetes and mortality. However, despite its harmful impact on numerous health outcomes, successful treatment options for OSA remain elusive. Surgery and nasal continuous positive airway pressure (nCPAP) therapy are the most common treatments, but these options are plagued by dismal success rates and low compliance rates, respectively. Exercise has been considered as a potential supplemental treatment option for OSA, primarily because of its weight loss effects. Surprisingly little investigation into this area has been undertaken, though. Consistent with the CDC Health Protection Goal of "Healthy People in Every Stage of Life," this proposal is designed with the objective of "preventing chronic diseases [i.e., the sequelae of OSA] and their consequences among adults." Specifically, the proposed study will investigate the efficacy of exercise as a complementary or alternative treatment for the treatment of OSA and its consequences. The study will utilize a randomized experimental design to assess the effect of a 8-week resistance and aerobic exercise program on the severity and complications of OSA. Specific Aim 1 is to evaluate the effect of exercise on the apnea-hypopnea index (AHI), the primary measure of OSA severity. Additionally, mediators of the effect of exercise on AHI will be evaluated. Because the effects of OSA on health outcomes are wide- ranging, Specific Aim 2 will evaluate the effect of exercise on a variety of OSA complications, including metabolic function, cognitive performance, daytime sleepiness, sleep quality, psychological health, systemic inflammation, and cardiovascular health. The results of this study will provide important and much needed information on whether exercise is an efficacious supplemental or alternative treatment option for individuals with OSA. Obstructive sleep apnea is a prevalent sleep disorder and emerging public health threat, with harmful consequences on cardiovascular health, metabolic functioning, cognition, and psychological health. Exercise has been understudied as a treatment option for attenuating the severity and complications of this disorder, especially since available treatment options are suboptimal. The proposed study will provide the first controlled evidence of the efficacy of exercise for the management of obstructive sleep apnea, and will shed light on whether exercise therapy can be advanced as an alternative or supplemental treatment option.