CC BY-NC-ND 4.0 · Sleep Sci
DOI: 10.1055/s-0043-1777708
Original Article

Home-based Aerobic Interval Training Combined with Resistance Training Improved Daytime Dysfunction in Adults with Obesity and Sleep-Disordered Breathing

1   Department of Physical Therapy, Walailak University, Thasala District, Nakhon Si Thammarat, Thailand
2   Movement Science and Exercise Research Center-Walailak University (MoveSE-WU), Walailak University, Thasala District, Nakhon Si Thammarat, Thailand
,
Siripan Watanasiripakdee
3   Department of Pulmonary Medicine and Critical Care, Maharaj Nakhon Si Thammarat Hospital, Thasala District, Nakhon Si Thammarat, Thailand
,
Nutjaree Jeenduang
4   Medical Technology, Walailak University, Thasala District, Nakhon Si Thammarat, Thailand
,
Valainipha Habuddha
1   Department of Physical Therapy, Walailak University, Thasala District, Nakhon Si Thammarat, Thailand
2   Movement Science and Exercise Research Center-Walailak University (MoveSE-WU), Walailak University, Thasala District, Nakhon Si Thammarat, Thailand
,
Nitita Piya-amornphan
1   Department of Physical Therapy, Walailak University, Thasala District, Nakhon Si Thammarat, Thailand
2   Movement Science and Exercise Research Center-Walailak University (MoveSE-WU), Walailak University, Thasala District, Nakhon Si Thammarat, Thailand
,
Tipwamol Damchuai
5   Department of Physical Therapy, Maharaj Nakhon Si Thammarat Hospital, Thasala District, Nakhon Si Thammarat, Thailand
› Author Affiliations
Funding Statement The authors are thankful to the Research Institute for Health Science of Walailak University for partially granting the research fund (Research Grant WU-IRG-63-004).

Abstract

Introduction There have been many barriers to exercising at a gym due to the coronavirus disease 2019 (COVID-19) pandemic worldwide. Home-based aerobic interval training (AIT) combined with resistance training (RT) may be helpful for obese adults with sleep-disordered breathing (SDB) to overcome those barriers and improve their subjective sleep disorders. Thus, the present study aimed to examine the effects of home-based AIT combined with RT on subjective sleep disorders in obese adults with SDB.

Material and Methods This study has a one-group pretest-posttest design. Twenty-one adults with obesity and SDB were assigned to perform 8 weeks of AIT combined with RT. Subjective sleep disorder variables including the Pittsburgh Sleep Quality Index (PSQI), Berlin Questionnaire, and Epworth Sleepiness Scale were defined as primary outcomes. Anthropometric variables, physical fitness components, and blood biomarkers were assigned as secondary outcomes. All outcome measurements were examined at baseline and after 8 weeks of training.

Results Daytime dysfunction of PSQI was significantly improved after 8 weeks of the exercise program (p < 0.05). Upper and lower chest expansion and estimated maximum oxygen consumption were significantly increased after 8 weeks of the exercise program (all p < 0.05). None of the blood biomarkers changed after 8 weeks of training.

Conclusion This study suggests that home-based AIT combined with RT effectively alleviates daytime dysfunction and seems to be more helpful in improving global PSQI in adults with obesity. Future studies with a larger sample size, under a controlled trial are recommended to prove the benefits of the exercise program.



Publication History

Received: 09 February 2023

Accepted: 02 August 2023

Article published online:
20 February 2024

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  • References

  • 1 Leinum CJ, Dopp JM, Morgan BJ. Sleep-disordered breathing and obesity: pathophysiology, complications, and treatment. Nutr Clin Pract 2009; 24 (06) 675-687
  • 2 Mirrakhimov AE, Sooronbaev T, Mirrakhimov EM. Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature. BMC Pulm Med 2013; 13: 10
  • 3 Ryan S, Crinion SJ, McNicholas WT. Obesity and sleep-disordered breathing–when two ‘bad guys’ meet. QJM 2014; 107 (12) 949-954
  • 4 Fleming WE, Holty JC, Bogan RK. et al. Use of blood biomarkers to screen for obstructive sleep apnea. Nat Sci Sleep 2018; 10: 159-167
  • 5 Wakabayashi Y, Oka R, Nakaya M. et al. Associations between Sleep-Disordered Breathing and Metabolic Risk Factors beyond Obesity. J Diabetes Res 2018; 2018: 1567683
  • 6 Yoshihisa A, Takeishi Y. Sleep disordered breathing and cardiovascular diseases. J Atheroscler Thromb 2019; 26 (04) 315-327
  • 7 Hudgel DW, Patel SR, Ahasic AM. et al; American Thoracic Society Assembly on Sleep and Respiratory Neurobiology. The role of weight management in the treatment of adult obstructive sleep apnea. an official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med 2018; 198 (06) e70-e87
  • 8 Lins-Filho OL, Pedrosa RP, Gomes JML. 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
  • 9 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 (01) 49-56
  • 10 Kline CE, Crowley EP, Ewing GB. et al. The effect of exercise training on obstructive sleep apnea and sleep quality: a randomized controlled trial. Sleep 2011; 34 (12) 1631-1640
  • 11 Barnes M, Goldsworthy UR, Cary BA, Hill CJ. A diet and exercise program to improve clinical outcomes in patients with obstructive sleep apnea–a feasibility study. J Clin Sleep Med 2009; 5 (05) 409-415
  • 12 Tuomilehto HP, Seppä JM, Partinen MM. et al; Kuopio Sleep Apnea Group. Lifestyle intervention with weight reduction: first-line treatment in mild obstructive sleep apnea. Am J Respir Crit Care Med 2009; 179 (04) 320-327
  • 13 Taheri M, Irandoust K. The exercise-induced weight loss improves self-reported quality of sleep in obese elderly women with sleep disorders. Sleep Hypn 2018; 20 (01) 54-59
  • 14 Fox EL, Bartels RL, Billings CE, Mathews DK, Bason R, Webb WM. Intensity and distance of interval training programs and changes in aerobic power. Med Sci Sports 1973; 5 (01) 18-22
  • 15 Schjerve IE, Tyldum GA, Tjønna AE. et al. Both aerobic endurance and strength training programmes improve cardiovascular health in obese adults. Clin Sci (Lond) 2008; 115 (09) 283-293
  • 16 Jesus ICD, Menezes Junior FJ, Bento PCB, Wiens A, Mota J, Leite N. Effect of combined interval training on the cardiorespiratory fitness in heart failure patients: a systematic review and meta-analysis. Braz J Phys Ther 2020; 24 (01) 8-19
  • 17 Pattyn N, Beulque R, Cornelissen V. Aerobic interval vs. continuous training in patients with coronary artery disease or heart failure: an updated systematic review and meta-analysis with a focus on secondary outcomes. Sports Med 2018; 48 (05) 1189-1205
  • 18 Ramos JS, Dalleck LC, Tjonna AE, Beetham KS, Coombes JS. The impact of high-intensity interval training versus moderate-intensity continuous training on vascular function: a systematic review and meta-analysis. Sports Med 2015; 45 (05) 679-692
  • 19 Karlsen T, Nes BM, Tjønna AE, Engstrøm M, Støylen A, Steinshamn S. High-intensity interval training improves obstructive sleep apnoea. BMJ Open Sport Exerc Med 2017 ;2(1):bmjsem-2016-000155
  • 20 Longlalerng K, Nakeaw A, Charawae AE, Reantong P, Prangyim U, Jeenduang N. Effects of six weeks high-intensity interval training and resistance training in adults with obesity and sleep related breathing disorders. Sleep Sci 2021; 14 (Spec 1): 41-48
  • 21 Zhang XL, Wang W, Xiao Y. members of the Assembly of Sleep Disordered Breathing of the Chinese Thoracic Society. Sleep disordered breathing diagnosis and treatment during the COVID-19 pandemic: A nationwide survey in China. Nat Sci Sleep 2021; 13: 21-30
  • 22 Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320 (7244) 1240-1243
  • 23 Sitasuwan T, Bussaratid S, Ruttanaumpawan P, Chotinaiwattarakul W. Reliability and validity of the Thai version of the Pittsburgh Sleep Quality Index. J Med Assoc Thai 2014; 97 (3, Suppl 3) S57-S67
  • 24 Banhiran W, Assanasen P, Nopmaneejumruslers C, Metheetrairut C. Epworth sleepiness scale in obstructive sleep disordered breathing: the reliability and validity of the Thai version. Sleep Breath 2011; 15 (03) 571-577
  • 25 Suksakorn S, Rattanaumpawan P, Banhiran W, Cherakul N, Chotinaiwattarakul W. Reliability and validity of a Thai version of the Berlin questionnaire in patients with sleep disordered breathing. J Med Assoc Thai 2014; 97 (Suppl. 03) S46-S56
  • 26 Ibáñez V, Silva J, Cauli O. A survey on sleep questionnaires and diaries. Sleep Med 2018; 42: 90-96
  • 27 Adams GM. Exercise Physiology Laboratory Manual. 3rd ed.. Boston: McGraw-Hill; 1998
  • 28 Graham BL, Steenbruggen I, Miller MR. et al. Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med 2019; 200 (08) e70-e88
  • 29 American Colleage of Sports Medicine. ACSM's guidelines for exercise testing and prescription. 9th ed:. Wolters Kluwer, Lippincott Williams & Wilkins; 2014
  • 30 Brandão GS, Gomes GSBF, Brandão GS. et al. Home exercise improves the quality of sleep and daytime sleepiness of elderlies: a randomized controlled trial. Multidiscip Respir Med 2018; 13: 2
  • 31 Servantes DM, Pelcerman A, Salvetti XM. et al. Effects of home-based exercise training for patients with chronic heart failure and sleep apnoea: a randomized comparison of two different programmes. Clin Rehabil 2012; 26 (01) 45-57
  • 32 Teixeira PJ, Carraça EV, Markland D, Silva MN, Ryan RM. Exercise, physical activity, and self-determination theory: a systematic review. Int J Behav Nutr Phys Act 2012; 9 (01) 78
  • 33 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
  • 34 Iftikhar IH, Kline CE, Youngstedt SD. Effects of exercise training on sleep apnea: a meta-analysis. Lung 2014; 192 (01) 175-184
  • 35 Mendelson M, Marillier M, Bailly S. et al. Maximal exercise capacity in patients with obstructive sleep apnoea syndrome: a systematic review and meta-analysis. Eur Respir J 2018; 51 (06) 1702697
  • 36 Jurado-Gámez B, Fernandez-Marin MC, Gómez-Chaparro JL. et al. Relationship of oxidative stress and endothelial dysfunction in sleep apnoea. Eur Respir J 2011; 37 (04) 873-879
  • 37 Bironneau V, Tamisier R, Trzepizur W. et al. Sleep apnoea and endothelial dysfunction: An individual patient data meta-analysis. Sleep Med Rev 2020; 52: 101309
  • 38 Wisløff U, Støylen A, Loennechen JP. et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation 2007; 115 (24) 3086-3094
  • 39 Ramírez-Vélez R, Hernández-Quiñones PA, Tordecilla-Sanders A. et al. Effectiveness of HIIT compared to moderate continuous training in improving vascular parameters in inactive adults. Lipids Health Dis 2019; 18 (01) 42
  • 40 O'Donnell DE, McGuire M, Samis L, Webb KA. General exercise training improves ventilatory and peripheral muscle strength and endurance in chronic airflow limitation. Am J Respir Crit Care Med 1998; 157 (5 Pt 1): 1489-1497
  • 41 Dixon AE, Peters U. The effect of obesity on lung function. Expert Rev Respir Med 2018; 12 (09) 755-767
  • 42 Maniaci A, Iannella G, Cocuzza S. et al. Oxidative stress and inflammation biomarker expression in obstructive sleep apnea patients. J Clin Med 2021; 10 (02) 277