TY - JOUR
T1 - Effects of inspiratory muscle training on blood pressure- and sleep-related outcomes in patients with obstructive sleep apnea
T2 - a meta-analysis of randomized controlled trials
AU - Chen, Tzu Ang
AU - Mao, Sheng Ting
AU - Lin, Huei Chen
AU - Liu, Wen Te
AU - Tam, Ka Wai
AU - Tsai, Cheng Yu
AU - Kuan, Yi Chun
N1 - Funding Information:
This study was supported by Taipei Medical University, Shuang Ho Hospital, and the Center for Evidence-Based Health Care (Department of Medical Research, Shuang Ho Hospital). In addition, this manuscript was edited by Wallace Academic Editing. We thank Professor E. Fiona Bailey, University of Arizona, for providing raw data to perform our meta-analysis.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - Blood pressure
KW - Inspiratory muscle training
KW - Meta-analysis
KW - Obstructive sleep apnea
KW - Sleep disorder
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U2 - 10.1007/s11325-022-02773-1
DO - 10.1007/s11325-022-02773-1
M3 - Article
C2 - 36576599
AN - SCOPUS:85145036873
SN - 1520-9512
VL - 27
SP - 1953
EP - 1966
JO - Sleep and Breathing
JF - Sleep and Breathing
IS - 5
ER -