Purpose: Obstructive sleep apnea (OSA) is frequently accompanied by hypertension, resulting in cardiovascular comorbidities. Continuous positive airway pressure is a standard therapy for OSA but has poor adherence. Inspiratory muscle training (IMT) may reduce airway collapsibility and sympathetic output, which may decrease OSA severity and blood pressure. In this meta-analysis of randomized controlled trials (RCTs), we evaluated the efficacy of IMT in patients with OSA. Methods: We searched PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov databases for relevant RCTs published before November 2022. Results: Seven RCTs with a total of 160 patients with OSA were included. Compared with the control group, the IMT group exhibited significantly lower systolic and diastolic blood pressure (mean difference [MD]: − 10.77 and − 4.58 mmHg, respectively), plasma catecholamine levels (MD: − 128.64 pg/mL), Pittsburgh Sleep Quality Index (MD: − 3.06), and Epworth Sleepiness Scale score (MD: − 4.37). No significant between-group differences were observed in the apnea–hypopnea index, forced vital capacity (FVC), ratio of forced expiratory volume in 1 s to FVC, or adverse effects. The data indicate comprehensive evidence regarding the efficacy of IMT for OSA. However, the level of certainty (LOC) remains low. Conclusion: IMT improved blood pressure- and sleep-related outcomes without causing adverse effects and may thus be a reasonable option for lowering blood pressure in patients with OSA. However, additional studies with larger sample sizes and rigorous study designs are warranted to increase the LOC.

Original languageEnglish
Pages (from-to)1953-1966
Number of pages14
JournalSleep and Breathing
Issue number5
Publication statusAccepted/In press - 2022


  • Blood pressure
  • Inspiratory muscle training
  • Meta-analysis
  • Obstructive sleep apnea
  • Sleep disorder

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology


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