Exercise shows therapeutic potential in patients with heart failure, sleep apnoea
Exercise alone proves superior to continuous positive airway pressure (CPAP) treatment in patients with heart failure (HF) and obstructive sleep apnoea (OSA), with the former yielding greater improvements in OSA outcomes particularly because adherence to CPAP is low, according to a study.
The study randomly allocated 65 adult patients with HF and OSA to one of the following treatment groups: no-treatment control (n=18), exercise (n=17), CPAP (n=15) and exercise plus CPAP (n=15). Exercise training consisted of three sessions per week of aerobic and strength exercises for 3 months.
Over 3 months, the mean apnoea-hypopnea index (AHI) decreased moderately in the exercise group (28 to 18 breathing events per hour; p<0.03) and decreased significantly in the CPAP (32 to 8 breathing events per hour; p<0.007) and in the exercise plus CPAP groups (25 to 10 breathing events per hour; p<0.007). No change was observed in the control group.
Meanwhile, outcomes such as peak oxygen consumption, muscle strength and endurance improved only with exercise. Both exercise and CPAP yielded improvements in subjective excessive daytime sleepiness, quality of life and the New York Heart Association functional class.
On the other hand, changes in scores on the 36-item Medical Outcomes Study Short Form Survey and Minnesota Living with Heart Failure Questionnaire were only significant in the exercise groups vs the control group.
The finding that supervised exercise yields improvements in various OSA outcomes have important therapeutic implications in the management of patients with HF and OSA, given that CPAP therapy has been shown to have neutral effect on the said outcomes mainly due to poor adherence, researchers said.