About
Scope & Aims
Editorial office
Editorial board
Ethical standards and procedures
Abstracting and indexing
Contact
Articles & Issues
Current issue
Articles in press
Archive
For Authors
General rules
Ethics in publishing
Guide for authors
Templates
Publication charge
For Reviewers
Our reviewers
Ethics in publishing
Guide for reviewers
Books and Events
Books
Events
ORIGINAL PAPER
Comparative effects of moderate-intensity interval training on sleep quality and functional capacity in atrial fibrillation patients with two types of sleep apnea
1
Department of Physical Therapy for Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy,
Cairo University, Cairo, Egypt
2
Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
3
Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Melbourne Australia
4
Department of Physical Therapy for Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy, Beni-Suef University, Beni Suef, Egypt
Submission date: 2022-07-16
Acceptance date: 2022-11-09
Publication date: 2024-03-25
Physiother Quart. 2024;32(1):93-99
KEYWORDS
sleep apnoeaatrial fibrillationmoderate-intensity interval trainingsleep qualityfunctional capacity6-minute walk distance
TOPICS
cardiovascular system cardiologyrespiratory system pulmunologyphysical activity and sports of handicapped
ABSTRACT
Introduction:
This study aimed to examine the effects of moderate-intensity interval training (MIIT) on the quality of sleep and functional capacity in atrial fibrillation (AF) patients with different presentations of sleep apnoea after coronary artery bypass graft (CABG) surgery.
Methods:
18 participants with AF and sleep apnoea aged 45–65 years were assigned into two groups: AF with obstructive sleep apnoea group (group A, n1 = 9) and AF with mixed sleep apnoea group (group B, n2 = 9). Both groups received MIIT for ten weeks (3 sessions / week) and medical treatment (i.e., Continuous Positive Airway Pressure and drug therapy). Exclusion criteria were unstable cardiac comorbidities and neurological/musculoskeletal limitations to exercise intervention. Outcome measures included sleep parameters collected from the actigraphy, overall sleep quality rating domain of the Pittsburgh Sleep Quality Index (PSQI), and six-minute walk distance (6-MWD).
Results:
Significant changes were present in the means of all outcomes in group A (p < 0.05) and two outcomes (i.e., cut points & 6-MWD) in group B compared to baseline (p < 0.05). Also, there were significant differences in the absolute mean changes from baseline (∆) between the two groups, in favour of group A, in sleep latency (p < 0.001), total sleep duration (p = 0.026), sleep efficiency (p < 0.001), overall sleep quality rating item of the PSQI (p = 0.001), and 6-MWD (p = 0.008).
Conclusions:
MIIT can be a supplementary therapeutic intervention that could contribute to greater positive changes in sleep quality and functional capacity in AF patients with obstructive sleep apnoea rather than in AF patients with mixed sleep apnoea post-CABG. MIIT could enhance the functional capacity independent of improving sleep quality in patients with AF and mixed sleep apnoea post-CABG.
This study aimed to examine the effects of moderate-intensity interval training (MIIT) on the quality of sleep and functional capacity in atrial fibrillation (AF) patients with different presentations of sleep apnoea after coronary artery bypass graft (CABG) surgery.
Methods:
18 participants with AF and sleep apnoea aged 45–65 years were assigned into two groups: AF with obstructive sleep apnoea group (group A, n1 = 9) and AF with mixed sleep apnoea group (group B, n2 = 9). Both groups received MIIT for ten weeks (3 sessions / week) and medical treatment (i.e., Continuous Positive Airway Pressure and drug therapy). Exclusion criteria were unstable cardiac comorbidities and neurological/musculoskeletal limitations to exercise intervention. Outcome measures included sleep parameters collected from the actigraphy, overall sleep quality rating domain of the Pittsburgh Sleep Quality Index (PSQI), and six-minute walk distance (6-MWD).
Results:
Significant changes were present in the means of all outcomes in group A (p < 0.05) and two outcomes (i.e., cut points & 6-MWD) in group B compared to baseline (p < 0.05). Also, there were significant differences in the absolute mean changes from baseline (∆) between the two groups, in favour of group A, in sleep latency (p < 0.001), total sleep duration (p = 0.026), sleep efficiency (p < 0.001), overall sleep quality rating item of the PSQI (p = 0.001), and 6-MWD (p = 0.008).
Conclusions:
MIIT can be a supplementary therapeutic intervention that could contribute to greater positive changes in sleep quality and functional capacity in AF patients with obstructive sleep apnoea rather than in AF patients with mixed sleep apnoea post-CABG. MIIT could enhance the functional capacity independent of improving sleep quality in patients with AF and mixed sleep apnoea post-CABG.
REFERENCES (39)
1.
Pistoia F, Sacco S, Tiseo C, Degan D, Ornello R, Carolei A. The Epidemiology of Atrial Fibrillation and Stroke. Cardiol Clin. 2016; 34(2):255–268; doi: 10.1016/j.ccl.2015.12.002.
2.
Odutayo A, Wong CX, Hsiao AJ, Hopewell S, Altman DG, Emdin CA. Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis. BMJ. 2016;354:i4482; doi: 10.1136/bmj.i4482.
3.
Kadhim K, Middeldorp ME, Elliott AD, Agbaedeng T, Gallagher C, Malik V, et al. Prevalence and assessment of sleep-disordered breathing in patients with atrial fibrillation: a systematic review and meta-analysis. Can J Cardiol. 2021;37(11):1846–1856; doi: 10.1016/j.cjca.2021.09.026.
4.
Traaen GM, Øverland B, Aakerøy L, Hunt TE, Bendz C, Sande L, et al. Prevalence, risk factors, and type of sleep apnea in patients with paroxysmal atrial fibrillation. IJC Heart Vasc. 2020;26:100447; doi: 10.1016/j.ijcha.2019.100447.
5.
Goudis CA, Ketikoglou DG. Obstructive sleep and atrial fibrillation: pathophysiological mechanisms and therapeutic implications. Int J Cardiol. 2017;230:293–300; doi: 10.1016/j.ijcard.2016.12.120.
6.
Sanchez AM, Germany R, Lozier MR, Schweitzer MD, Kosseifi S, Anand R. Central sleep apnea and atrial fibrillation: a review on pathophysiological mechanisms and therapeutic implications. IJC Heart Vasc. 2020;30:100527; doi: 10.1016/j.ijcha.2020.100527.
7.
Tietjens JR, Claman D, Kezirian EJ, De Marco T, Mirzayan A, Sadroonri B.,et al. Obstructive sleep apnea in cardiovascular disease: a review of the literature and proposed multidisciplinary clinical management strategy. J Am Heart Assoc. 2019;8(1):e010440; doi: 10.1161/JAHA.118.010440.
8.
Rattray B, Argus C, Martin K, Northey J, Driller M. Is it time to turn our attention toward central mechanisms for post-exertional recovery strategies and performance?. Front Physiol. 2015;6:79; doi: 10.3389/fphys.2015.00079.
9.
Stavrou VT, Astara K, Tourlakopoulos KN, Papayianni E, Boutlas S, Vavougios GD, et al. Obstructive sleep apnea syndrome: the effect of acute and chronic responses of exercise. Front Med. 2021;8:806924; doi: 10.3389/fmed.2021.806924.
10.
Wang F, Boros S. The effect of physical activity on sleep quality: a systematic review. Eur J Physiother. 2021;23(1):11–8; doi: 10.1080/21679169.2019.1623314.
11.
Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5):373–498; doi: 10.1093/eurheartj/ehaa612.
12.
Yamamoto U, Mohri M, Shimada K, Origuchi H, Miyata K, Ito K, et al. Six-month aerobic exercise training ameliorates central sleep apnea in patients with chronic heart failure. J Card Fail. 2007;13(10):825–829; doi: 10.1016/j.cardfail.2007.08.001.
13.
Ueno LM, Drager LF, Rodrigues ACT, Rondon MUPB, Braga AMFW, Mathias W, et al. Effects of exercise training in patients with chronic heart failure and sleep apnea. Sleep. 2009;32(5):637–47; doi: 10.1093/sleep/32.5.637.
14.
Mendelson M, Lyons OD, Yadollahi A, Inami T, Oh P, Bradley TD. Effects of exercise training on sleep apnoea in patients with coronary artery disease: a randomised trial. Eur Respir J. 2016;48(1):142–150; doi: 10.1183/13993003.01897-2015.
15.
Loboda D, Stepanik M, Golba A, Dzierzawa M, Szajerska-Kurasiewicz A, Simionescu K et al. The beneficial impact of cardiac rehabilitation on obstructive sleep apnea in patients with coronary artery disease. J Clin Sleep Med. 2021;17(3):403–412; doi: 10.5664/jcsm.8900.
16.
Morgenthaler T, Alessi C, Friedman L, Owens J, Kapur V, Boehlecke B, et al. Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: an update for 2007. Sleep. 2007;30(4):519–529; doi: 10.1093/sleep/30.4.519.
17.
Atef H, Abdeen H. Effect of exercise on sleep and cardiopulmonary parameters in patients with pulmonary artery hypertension. Sleep Breath. 2021;25(4):1953–1960; doi: 10.1007/s11325-020-02286-9.
18.
Atef H, Helmy Z, Farghaly A. Effect of different types of exercise on sleep deprivation and functional capacity in middle aged patients after coronary artery bypass grafting. Sleep Sci. 2020;13(2):113–118; doi: 10.5935/1984-0063.20190136.
19.
Fekedulegn D, Andrew ME, Shi M, Violanti JM, Knox S, Innes KE. Actigraphy-based assessment of sleep parameters. Ann Work Expo Health. 2020;64(4):350–367; doi: 10.1093/annweh/wxaa007.
20.
Reed DL, Sacco WP. Measuring sleep efficiency: what should the denominator be?. J Clin Sleep Med. 2016;12(2):263–266; doi: 10.5664/jcsm.5498.
21.
Trost SG, Loprinzi PD, Moore R, Pfeiffer KA. Comparison of accelerometer cut points for predicting activity intensity in youth. Med Sci Sports Exerc. 2011;43(7):1360–1368; doi: 10.1249/MSS.0b013e318206476e.
22.
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213; doi: 10.1016/0165-1781(89)90047-4.
23.
Suleiman KH, Yates BC, Berger AM, Pozehl B, Meza J. Translating the Pittsburgh Sleep Quality Index into Arabic. West J Nurs Res. 2010;32(2):250–268; doi: 10.1177/0193945909348230.
24.
Agarwala P, Salzman SH. Six-Minute Walk Test: clinical role, technique, coding, and reimbursement. Chest. 2020;157(3):603–11; doi: 10.1016/j.chest.2019.10.014.
25.
American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. 10th ed. Philadelphia: Lippincott Williams and Wilkins; 2016.
26.
Coswig VS, Barbalho M, Raiol R, Del Vecchio FB, Ramirez-Campillo R, Gentil P. Effects of high vs moderate-intensity intermittent training on functionality, resting heart rate and blood pressure of elderly women. J Transl Med. 2020;18(1):88; doi: 10.1186/s12967-020-02261-8.
27.
Morgan CJ. Use of proper statistical techniques for research studies with small samples. Am J Physiol Lung Cell Mol Physiol. 2017;313(5):L873–L877; doi: 10.1152/ajplung.00238.2017.
28.
Aiello KD, Caughey WG, Nelluri B, Sharma A, Mookadam F, Mookadam M. Effect of exercise training on sleep apnea: a systematic review and meta-analysis. Respir Med. 2016;116:85–92; doi: 10.1016/j.rmed.2016.05.015.
29.
Lins-Filho OL, Pedrosa RP, Gomes JML, Moraes SLD, Vasconcelos BCE, Lemos CAA et al. Effect of exercise training on subjective parameters in patients with obstructive sleep apnea: a systematic review and meta-analysis. Sleep Med. 2020;69:1–7; doi: 10.1016/j.sleep.2019.12.022.
30.
Hall KA, Singh M, Mukherjee S, Palmer LJ. Physical activity is associated with reduced prevalence of self-reported obstructive sleep apnea in a large, general population cohort study. J Clin Sleep Med. 2020;16(7):1179–87; doi: 10.5664/jcsm.8456.
31.
Sengul YS, Ozalevli S, Oztura I, Itil O, Baklan B. The effect of exercise on obstructive sleep apnea: a randomized and controlled trial. Sleep Breath. 2011;15:49–56; doi: 10.1007/s11325-009-0311-1.
32.
Araújo CEL, Ferreira-Silva R, Gara EM, Goya TT, Guerra RS, Matheus L et al. Effects of exercise training on autonomic modulation and mood symptoms in patients with obstructive sleep apnea. Braz J Med Biol Res. 2021;54(5):e10543; doi: 10.1590/1414-431X202010543.
33.
Yang H, Liu Y, Zheng H, Liu G, Mei A. Effects of 12 weeks of regular aerobic exercises on autonomic nervous system in obstructive sleep apnea syndrome patients. Sleep Breath. 2018;22(4):1189–95; doi: 10.1007/s11325-018-1736-1.
34.
Bughin F, Desplan M, Mestejanot C, Picot MC, Roubille F, Jaffuel D et al. Effects of an individualized exercise training program on severity markers of obstructive sleep apnea syndrome: a randomised controlled trial. Sleep Med. 2020;70:33–42; doi: 10.1016/j.sleep.2020.02.008.
35.
Newman AB, Foster G, Givelber R, Nieto FJ, Redline S, Young T. Progression and regression of sleep-disordered breathing with changes in weight. The sleep heart health study. Arch Intern Med. 2005;165(20):2408–13; doi: 10.1001/archinte.165.20.2408.
36.
Lee-Iannotti JK, Parish JM. Exercise as a treatment for sleep apnea. J Clin Sleep Med. 2020;16(7):1005–6; doi: 10.5664/jcsm.8582.
37.
Andrade FMD, Pedrosa RP. The role of physical exercise in obstructive sleep apnea. J Bras Pneumol. 2016;42(6):457–464; doi: 10.1590/S1806-37562016000000156.
38.
Torres-Castro R, Vasconcello-Castillo L, Puppo H, Cabrera-Aguilera I, Otto-Yáñez M, Rosales-Fuentes J et al. Effects of exercise in patients with obstructive sleep apnoea. Clocks Sleep. 2021;3(1):227–35; doi: 10.3390/clockssleep3010013.
39.
Alves EdS, Ackel-D’Elia C, Luz GP, Cunha TCA, Carneiro G, Tufik S et al. Does physical exercise reduce excessive daytime sleepiness by improving inflammatory profiles in obstructive sleep apnea patients. Sleep Breath. 2013;17(2):505–10; doi: 10.1007/s11325-012-0729-8.
Share
RELATED ARTICLE
| eISSN: | 2544-4395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
