Obstructive Sleep Apnea Syndrome, Objectively Measured Physical Activity and Exercise Training Interventions: A Systematic Review and Meta-Analysis
Open accessAbstract
A systematic review of English and French articles using Pubmed/Medline and Embase included studies assessing objectively-measured physical activity levels of OSA patients and exploring the effects of exercise training on OSA severity, body mass index, sleepiness and cardiorespiratory fitness (VO2peak). Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence. For objectively-measured physical activity levels, 8 studies were included. The mean number of steps per day across studies was 5,388 (95% CI: 3,831 to 6,945; p<0.001), which was by far lower than the recommended threshold of 10,000 steps per day. For exercise training, 6 randomized trials were included. There was a significant decrease in apnea-hypopnea-index following exercise training (mean decrease of 8.9 events/h; 95% CI: -13.4 to -4.3; p<0.01), which was accompanied by a reduction in subjective sleepiness, an increase in VO2peak and no change in BMI. OSA patients present low levels of physical activity and exercise training is associated with improved outcomes. Future interventions (including exercise training) focusing on increasing physical activity levels may have important clinical impacts on both OSA severity and the burden of associated co-morbidities. Objective measurement of physical activity in routine OSA management and well-designed clinical trials are recommended.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Self-reported physical activity or exercise interventions may have potential beneficial effects to lower the incidence of depression and lower the severity of obstructive sleep apnea and associated comorbidities.
“Finally, self-reported physical activity or exercise interventions may have potential beneficial effects to lower the incidence of depression20 and lower the severity of obstructive sleep apnea and associated comorbidities21.”
From Association of step counts over time with the risk of chronic disease in the All of Us Research Program (2022) · cites this paper as [21]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · cited 1× · see citing works
“An I2 index higher than 60% reflects increasing heterogeneity (28).”
BackgroundToprak, Ö., Kurt, H., Sarı, Y., Şarkış, C., Us, H., & Kırık, A. (2017) · Kidney & Blood Pressure Research · doi:10.1159/000468530 · Cited by 29,769 · see citing works
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164 · see citing works
Conducting Meta-Analyses in <i>R</i> with the <b>metafor</b> Package
Viechtbauer, W. (2010) · Journal of Statistical Software · doi:10.18637/jss.v036.i03 · Cited by 20,464 · see citing works
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · BMJ · doi:10.1136/bmj.b2700 · Cited by 17,648 · see citing works
Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996) · Controlled Clinical Trials · doi:10.1016/0197-2456(95)00134-4 · Cited by 17,582 · cited 2× · see citing works
“methodological Quality assessment The quality of the studies was peer-reviewed by Monique Mendelson and Mathieu Marillier using a modified version of the Newcastle-Ottawa Scale (NOS) for observational studies (23) and the Jadad scale for randomized trials (24).”
MethodChobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L., Jones, D. W., Materson, B. J., Oparil, S., Wright, J. T., et al. (2003) · Hypertension · doi:10.1161/01.hyp.0000107251.49515.c2 · Cited by 13,271 · cited 1× · see citing works
“9 reduction in diastolic blood pressure in hypertensive patients (72).”
BackgroundZhang, Q., Wang, C., Zheng, M., Li, Y., Li, J., Zhang, L., Shang, X., & Yan, C. (2014) · Cerebrovascular Diseases · doi:10.1159/000369778 · Cited by 11,609 · see citing works
(1985) · Europe PMC (PubMed Central) · Cited by 9,143 · see citing works
(2007) · Circulation · doi:10.1161/circulationaha.107.185649 · Cited by 6,545 · cited 1× · see citing works
“Spontaneous Physical activity and OSa Based on a systematic review and meta-analysis of the reported findings, OSA patients present low levels of objectively measured physical activity when compared with public health physical activity guidelines (15, 34).”
ResultIncreased Prevalence of Sleep-Disordered Breathing in Adults
Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hla, K. M. (2013) · American Journal of Epidemiology · doi:10.1093/aje/kws342 · Cited by 4,618 · cited 2× · see citing works
“For instance, adults with OSA are less likely to be active than adults without sleep apnea (7) and longitudinal and cross-sectional data suggest a reduced prevalence and incidence of OSA in those who exercise regularly (8).”
BackgroundMethodDong, Y., Hao, L., Shi, Z., Wang, G., Zhang, Z., & Han, C. (2013) · Urologia Internationalis · doi:10.1159/000351405 · Cited by 4,557 · see citing works
Kodama, S. (2009) · JAMA · doi:10.1001/jama.2009.681 · Cited by 3,035 · cited 1× · see citing works
“This improvement is noteworthy as it is associated with a significant survival benefit (66).”
BackgroundDONNELLY, J. E., BLAIR, S. N., JAKICIC, J. M., MANORE, M. M., RANKIN, J. W., & SMITH, B. K. (2009) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181949333 · Cited by 2,658 · cited 3× · see citing works
“Regular physical activity has been associated with body weight maintenance (11), with reductions in blood pressure (12), and with the prevention of cardiovascular disease (13), therefore it may constitute a useful means to reduce cardiovascular and metabolic risk factors and co-morbidities associated with OSA.”
BackgroundRandom-effects model for meta-analysis of clinical trials: An update
DerSimonian, R., & Kacker, R. (2007) · Contemporary Clinical Trials · doi:10.1016/j.cct.2006.04.004 · Cited by 2,374 · cited 1× · see citing works
“org February 2018 | Volume 9 | Article 73 meta-analysis model was used in each case to combine weighted mean differences (27).”
MethodEckel, R. H., Jakicic, J. M., Ard, J. D., de Jesus, J. M., Miller, N. H., Hubbard, V. S., Lee, I.-M., Lichtenstein, A. H., Loria, C. M., Millen, B. E., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437740.48606.d1 · Cited by 2,261 · cited 1× · see citing works
“Regular exercise is considered a cornerstone in the prevention and management of hypertension and cardiovascular disease (71).”
BackgroundEstimating effect sizes from pretest-posttest-control group designs
Morris, S. B. (2008) · Organizational Research Methods · doi:10.1177/1094428106291059 · Cited by 2,133 · cited 1× · see citing works
“Lastly, we calculated the mean exercise traininginduced change in AHI, Epworth sleepiness scale, VO2peak, and BMI in the intervention group compared with the control group (26).”
MethodCPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea
McEvoy, R. D., Antic, N. A., Heeley, E., Luo, Y., Ou, Q., Zhang, X., Mediano, O., Chen, R., Drager, L. F., Liu, Z., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1606599 · Cited by 2,101 · cited 1× · see citing works
“This result is clinically significant since CPAP does not prevent cardiovascular events in patients with moderateto-severe OSA and established cardiovascular disease (68) and emphasizes the potential role of exercise as an adjunct treatment to CPAP.”
BackgroundThe Hazards of Scoring the Quality of Clinical Trials for Meta-analysis
Jüni, P. (1999) · JAMA · doi:10.1001/jama.282.11.1054 · Cited by 1,981 · cited 1× · see citing works
“Studies with scores above the median were classified as highquality studies (25).”
BackgroundBoulé, N. G., Haddad, E., Kenny, G. P., Wells, G. A., & Sigal, R. J. (2001) · JAMA · doi:10.1001/jama.286.10.1218 · Cited by 1,889 · see citing works
Obstructive sleep apnoea syndrome
Lévy, P., Kohler, M., McNicholas, W. T., Barbé, F., McEvoy, R. D., Somers, V. K., Lavie, L., & Pépin, J.-L. (2015) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2015.15 · Cited by 1,235 · see citing works
Self-citationThe Technology of Accelerometry-Based Activity Monitors: Current and Future
CHEN, K. Y., & BASSETT, D. R. (2005) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000185571.49104.82 · Cited by 996 · cited 1× · see citing works
“Therefore, these data are not always comparable between devices (55).”
BackgroundWarren, J. M., Ekelund, U., Besson, H., Mezzani, A., Geladas, N., & Vanhees, L. (2010) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/hjr.0b013e32832ed875 · Cited by 587 · cited 1× · see citing works
“The signal obtained can then be transformed into an estimate of energy expenditure, summarized as activity counts, or expressed as steps per day (54).”
BackgroundRevisiting "How Many Steps Are Enough?"
Tudor-Locke, C. E., Hatano, Y., Pangrazi, R. P., & Kang, M. (2008) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31817c7133 · Cited by 511 · cited 3× · see citing works
“The number of steps per day of OSA patients was compared with a threshold value of 10,000 steps per day (15).”
BackgroundMethodResultHow many days of monitoring predict physical activity and sedentary behaviour in older adults?
Hart, T. L., Swartz, A. M., Cashin, S. E., & Strath, S. J. (2011) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-8-62 · Cited by 469 · cited 1× · see citing works
“While it has been shown that at least 3 days is sufficient in the elderly (57), it seems that in younger patients a full week of monitoring is advisable due to variations in weekly patterns.”
BackgroundIncreasing Physical Activity With Mobile Devices: A Meta-Analysis
Fanning, J., Mullen, S. P., & McAuley, E. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.2171 · Cited by 457 · cited 1× · see citing works
“Recent data on the use of mobile devices for increasing physical activity has shown that these platforms are effective means for influencing physical activity behavior (83).”
BackgroundCornelissen, V. A., & Fagard, R. H. (2005) · Journal of Hypertension · doi:10.1097/00004872-200502000-00003 · Cited by 439 · cited 1× · see citing works
“Regular physical activity has been associated with body weight maintenance (11), with reductions in blood pressure (12), and with the prevention of cardiovascular disease (13), therefore it may constitute a useful means to reduce cardiovascular and metabolic risk factors and co-morbidities associated with OSA.”
BackgroundINTERSALT study findings. Public health and medical care implications
Stamler, J., Rose, G., Stamler, R., Elliott, P., Dyer, A., & Marmot, M. (1989) · Hypertension · doi:10.1161/01.hyp.14.5.570 · Cited by 426 · cited 1× · see citing works
“A reduction of this magnitude in blood pressure is clinically relevant since a 5 mmHg reduction in population average resting systolic blood pressure can reduce all-cause mortality by approximately 7% (73).”
BackgroundA Meta-Analysis of Pedometer-Based Walking Interventions and Weight Loss
Richardson, C. R., Newton, T. L., Abraham, J. J., Sen, A., Jimbo, M., & Swartz, A. M. (2008) · The Annals of Family Medicine · doi:10.1370/afm.761 · Cited by 421 · cited 1× · see citing works
“New generations of physical activity monitors have the potential to provide direct feedback to the patient, which has yielded encouraging results when used in combination with goal setting in various patient populations, such as COPD (84) and obesity (85).”
BackgroundMyofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis
Camacho, M., Certal, V., Abdullatif, J. D., Zaghi, S., Ruoff, C. M., Capasso, R., & Kushida, C. A. (2015) · SLEEP · doi:10.5665/sleep.4652 · Cited by 420 · cited 1× · see citing works
“The AHI reduction observed following exercise training in the present study is lower than results obtained in previous meta-analyses examining the effects of weight loss (61), bariatric surgery (62), oropharyngeal exercises (63), oral mandibular appliances and CPAP (64) on OSA severity.”
ResultEffects of Surgical Weight Loss on Measures of Obstructive Sleep Apnea: A Meta-Analysis
Greenburg, D. L., Lettieri, C. J., & Eliasson, A. H. (2009) · The American Journal of Medicine · doi:10.1016/j.amjmed.2008.10.037 · Cited by 399 · cited 1× · see citing works
“The AHI reduction observed following exercise training in the present study is lower than results obtained in previous meta-analyses examining the effects of weight loss (61), bariatric surgery (62), oropharyngeal exercises (63), oral mandibular appliances and CPAP (64) on OSA severity.”
ResultSleep Apnea and Cardiovascular Disease
Kasai, T., Floras, J. S., & Bradley, T. D. (2012) · Circulation · doi:10.1161/circulationaha.111.070813 · Cited by 383 · see citing works
Kline, C. E. (2014) · American Journal of Lifestyle Medicine · doi:10.1177/1559827614544437 · Cited by 364 · cited 2× · see citing works
“It has been associated with improved sleep and a bidirectional relationship between sleep and physical activity has been assumed (5).”
BackgroundMethodKline, C. E., Crowley, E., Ewing, G. B., Burch, J. B., Blair, S. N., Durstine, J. L., Davis, J. M., & Youngstedt, S. D. (2011) · SLEEP · doi:10.5665/sleep.1422 · Cited by 358 · cited 2× · see citing works
“Other potential mechanisms which have been suggested to explain the observed decrease in OSA severity following exercise training include increased strength and fatigue resistance of the upper airway dilators, decreased nasal resistance, and increased respiratory stability through deeper sleep (16).”
BackgroundPatient-centered activity monitoring in the self-management of chronic health conditions
Chiauzzi, E. J., Rodarte, C., & DasMahapatra, P. (2015) · BMC Medicine · doi:10.1186/s12916-015-0319-2 · Cited by 342 · see citing works
Tamisier, R., Pépin, J. L., Rémy, J., Baguet, J. P., Taylor, J. A., Weiss, J. W., & Lévy, P. (2011) · European Respiratory Journal · doi:10.1183/09031936.00204209 · Cited by 323 · cited 5× · see citing works
“Sleep fragmentation and chronic intermittent hypoxia induce intermediate mechanisms such as activation of the sympathetic nervous system (1), oxidative stress and systemic inflammation which contribute to cardiometabolic morbidity (2).”
BackgroundMethodInfluentialSelf-citationDaily physical activity assessment with accelerometers: new insights and validation studies
Plasqui, G., Bonomi, A. G., & Westerterp, K. R. (2013) · Obesity Reviews · doi:10.1111/obr.12021 · Cited by 315 · cited 1× · see citing works
“, as close as possible to the center of mass) (56).”
BackgroundBrage, S., Ekelund, U., Brage, N., Hennings, M. A., Froberg, K., Franks, P. W., & Wareham, N. J. (2007) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00092.2006 · Cited by 303 · cited 1× · see citing works
“Lastly, to improve the accuracy and precision of physical activity measures, it has been suggested to combine heart rate monitoring with accelerometer-based data (58).”
Sleep apnoea and the brain: a complex relationship
Rosenzweig, I., Glasser, M., Polšek, D., Leschziner, G. D., Williams, S., & Morrell, M. J. (2015) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(15)00090-9 · Cited by 278 · cited 1× · see citing works
“The low levels of physical activity observed in OSA patients have been attributed to the fatigue and somnolence they experience, the excess weight, and low energy that characterize the clinical presentation of OSA (9) and associated neurocognitive alterations [see for review: (10)].”
BackgroundDrager, L. F., Brunoni, A. R., Jenner, R., Lorenzi-Filho, G., Bensenor, I. M., & Lotufo, P. A. (2015) · Thorax · doi:10.1136/thoraxjnl-2014-205361 · Cited by 277 · cited 2× · see citing works
“Hence, the reversal of OSA using CPAP may potentially result in a small but significant increase of BMI and body weight (49), which may contribute to limiting the increase in physical activity levels.”
BackgroundDemeyer, H., Louvaris, Z., Frei, A., Rabinovich, R. A., de Jong, C., Gimeno-Santos, E., Loeckx, M., Buttery, S. C., Rubio, N., Van der Molen, T., et al. (2017) · Thorax · doi:10.1136/thoraxjnl-2016-209026 · Cited by 256 · cited 2× · see citing works
“For example, one study in 343 patients with COPD showed that the mean number of steps per day was approximately 5,000 (37).”
BackgroundEffects of Exercise Training on Sleep Apnea: A Meta-analysis
IFTIKHAR, I. H., Kline, C. E., & Youngstedt, S. D. (2013) · Lung · doi:10.1007/s00408-013-9511-3 · Cited by 249 · see citing works
Way, K. L., Hackett, D. A., Baker, M. K., & Johnson, N. A. (2016) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2016.40.4.253 · Cited by 245 · cited 1× · see citing works
“Exercise has also been shown to improve glycemic control (74) and insulin sensitivity (75) in patients with type 2 diabetes.”
BackgroundSchuler, G. C., Adams, V., & Goto, Y. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht111 · Cited by 244 · cited 1× · see citing works
“Regular physical activity has been associated with body weight maintenance (11), with reductions in blood pressure (12), and with the prevention of cardiovascular disease (13), therefore it may constitute a useful means to reduce cardiovascular and metabolic risk factors and co-morbidities associated with OSA.”
BackgroundAssociation of physical activity and human sleep disorders
Sherrill, D. L., Kotchou, K., & Quan, S. F. (1998) · Archives of Internal Medicine · doi:10.1001/archinte.158.17.1894 · Cited by 244 · cited 3× · see citing works
“For each reference, the following variables were systematically extracted and entered into a summary table: (1) author, year; (2) participants; (3) AHI cutoff; (4) sample size; (5) age; (6) BMI; (7) study design; (8) outcomes; and (9) main findings.”
BackgroundMethodObstructive Sleep Apnea and Type 2 Diabetes: Is There a Link?
Pamidi, S., & Tasali, E. (2012) · Frontiers in Neurology · doi:10.3389/fneur.2012.00126 · Cited by 231 · cited 1× · see citing works
“This is important because it has been shown that OSA is associated with insulin resistance, glucose intolerance, and type 2 diabetes, independent of obesity (76).”
BackgroundPedometers to enhance physical activity in COPD: a randomised controlled trial
I, L. M., Horta, P., Espinoza, J., Aguilera, M., Balmaceda, N., Castro, A., Ruiz, M., Orlando Díaz, P., & Hopkinson, N. S. (2014) · European Respiratory Journal · doi:10.1183/09031936.00084514 · Cited by 223 · cited 6× · see citing works
“A large multicenter randomized trial in patients with COPD evaluating a semiautomated tele-coaching intervention using a pedometer and an application installed on a smartphone showed significant increases in physical activity levels (37).”
BackgroundInfluentialIntermittent Hypoxia Exacerbates Metabolic Effects of Diet‐Induced Obesity
Drager, L. F., Li, J., Reinke, C., Bevans‐Fonti, S., Jun, J. C., & Polotsky, V. Y. (2011) · Obesity · doi:10.1038/oby.2011.240 · Cited by 208 · see citing works
Sharples, L. D., Clutterbuck-James, A. L., Glover, M. J., Bennett, M. S., Chadwick, R., Pittman, M. A., & Quinnell, T. G. (2016) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2015.05.003 · Cited by 202 · cited 1× · see citing works
“The AHI reduction observed following exercise training in the present study is lower than results obtained in previous meta-analyses examining the effects of weight loss (61), bariatric surgery (62), oropharyngeal exercises (63), oral mandibular appliances and CPAP (64) on OSA severity.”
ResultJullian‐Desayes, I., Joyeux‐Faure, M., Tamisier, R., Launois, S. H., Borel, A., Levy, P. A., & Pépin, J. (2014) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2014.07.004 · Cited by 195 · cited 1× · see citing works
“This is surprising given that CPAP, the first line treatment of OSA has a limited impact on cardiometabolic risk factors (69) while as exercise training has a well-documented effect on a number of cardiometabolic risk factors in non-OSA patients (70).”
BackgroundSelf-citationCook, D. J., Thompson, J. E., Prinsen, S. K., Dearani, J. A., & Deschamps, C. C. (2013) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2013.05.092 · Cited by 193 · see citing works
Interventions to modify physical activity in patients with COPD: a systematic review
Mantoani, L. C., Rubio, N., McKinstry, B., MacNee, W., & Rabinovich, R. (2016) · European Respiratory Journal · doi:10.1183/13993003.01744-2015 · Cited by 186 · cited 4× · see citing works
“Furthermore, physical activity coaching interventions which can include accurate assessment and feedback of physical activity levels, individualized physical activity goals and/or tailored motivational messages have shown promise in COPD for maintaining physical activity levels (52).”
BackgroundResultInfluentialObstructive Sleep Apnea: A Cluster Analysis at Time of Diagnosis
Bailly, S., Destors, M., Grillet, Y., Richard, P., Stach, B., Vivodtzev, I., Timsit, J., Levy, P. A., Tamisier, R., & Pépin, J. (2016) · PLoS ONE · doi:10.1371/journal.pone.0157318 · Cited by 185 · cited 1× · see citing works
“Future investigations should aim to define specific rehabilitation strategies for the different OSA phenotypes (65).”
BackgroundSelf-citationThe effect of exercise on obstructive sleep apnea: a randomized and controlled trial
Şengül, Y. S., Özalevli, S., Öztura, İ., İtil, O., & Baklan, B. (2009) · Sleep And Breathing · doi:10.1007/s11325-009-0311-1 · Cited by 183 · see citing works
The National Physical Activity Plan: A Call to Action From the American Heart Association
Kraus, W. E., Bittner, V., Appel, L. J., Blair, S. N., Church, T. S., Després, J., Franklin, B. A., Miller, T. D., Pate, R. R., Taylor‐Piliae, R. E., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000203 · Cited by 161 · cited 5× · see citing works
“eligibility criteria The following criteria were required for selection: (1) original research investigations; (2) conducted in humans; (3) conducted in adults; (4) include patients diagnosed with OSA of at least mild severity (AHI ≥ 5 events/h) based on polysomnography (PSG) or polygraphy.”
BackgroundMethodInfluentialAssociation of physical activity with sleep-disordered breathing
Quan, S. F., O’Connor, G. T., Quan, J. S., Redline, S. S., Resnick, H. E., Shahar, E., Siscovick, D. S., & Sherrill, D. L. (2007) · Sleep And Breathing · doi:10.1007/s11325-006-0095-5 · Cited by 154 · cited 1× · see citing works
“Even if undiagnosed OSA may be present in some of the overweight/obese patients investigated in this previous study due to the relationship between weight status and risk of OSA (36), the average steps per day reported was over 1,000 steps higher than the mean values obtained in the present meta-analysis.”
ResultThe Effects of Exercise Training on the Traditional Lipid Profile and Beyond
Gordon, B., Chen, S., & Durstine, J. L. (2014) · Current Sports Medicine Reports · doi:10.1249/jsr.0000000000000073 · Cited by 143 · cited 1× · see citing works
“However, a substantial decrease in TC and LDL-C and significant improvement in HDL-C levels are observed when a reduction in body weight following exercise training is achieved (77).”
BackgroundDepartment of Clinical and Digital Health Sciences, C. O. A. H. S., Coughlin, S. S., & Stewart, J. (2016) · Journal of Environment and Health Science · doi:10.15436/2378-6841.16.1123 · Cited by 137 · cited 1× · see citing works
“in OSaS Low-cost wearable devices and mobile devices that assist individuals in monitoring their physical activity levels and becoming more active have become more widespread (78).”
BackgroundMendelson, M., Lyons, O. D., Yadollahi, A., Inami, T., OH, P. I., & Bradley, T. D. (2016) · European Respiratory Journal · doi:10.1183/13993003.01897-2015 · Cited by 136 · cited 5× · see citing works
“Furthermore, one study included patients with coronary artery disease and OSA (22) and in another study over 60% of the patients were in secondary prevention (20), therefore it is possible that physical”
BackgroundInfluentialSelf-citationEffect of exercise training on sleep apnea: A systematic review and meta-analysis
Aiello, K. D., Caughey, W. G., Nelluri, B. K., Sharma, A. K., Mookadam, F., & Mookadam, M. (2016) · Respiratory Medicine · doi:10.1016/j.rmed.2016.05.015 · Cited by 133 · cited 1× · see citing works
“The results obtained suggest that exercise training can reduce the severity of OSA by 28% and improve symptoms of sleepiness and VO2peak, in the absence of any change of BMI, which supports the results of two previous meta-analysis’ (59, 60).”
ResultWearable Systems for Monitoring Mobility-Related Activities in Chronic Disease: A Systematic Review
Allet, L., Knols, R. H., Shirato, K., & de Bruin, E. D. (2010) · Sensors · doi:10.3390/s101009026 · Cited by 118 · see citing works
Program Participation and Physical Activity Maintenance after Cardiac Rehabilitation
Bock, B. C., Carmona-Barros, R., Esler, J. L., & Tilkemeier, P. L. (2003) · Behavior Modification · doi:10.1177/0145445502238692 · Cited by 110 · cited 3× · see citing works
“, >12 weeks) may have greater impacts on physical activity levels (52, 53).”
BackgroundResultWest, S. D., Kohler, M., Nicoll, D. J., & Stradling, J. R. (2009) · Sleep Medicine · doi:10.1016/j.sleep.2008.11.007 · Cited by 97 · cited 2× · see citing works
“The availability of physical activity monitors has made the objective evaluation of physical activity in OSA patients possible in various contexts such as in response to CPAP (17, 20, 48) and during rehabilitation programs (22, 33).”
BackgroundDiamanti, C., Manali, E. D., Ginieri-Coccossis, M., Vougas, K. N., Cholidou, K., Markozannes, E., Bakakos, P., Liappas, I., & Alchanatis, M. (2013) · Sleep And Breathing · doi:10.1007/s11325-013-0815-6 · Cited by 96 · cited 1× · see citing works
“The availability of physical activity monitors has made the objective evaluation of physical activity in OSA patients possible in various contexts such as in response to CPAP (17, 20, 48) and during rehabilitation programs (22, 33).”
BackgroundEffects of dietary weight loss on obstructive sleep apnea: a meta-analysis
Anandam, A., Akinnusi, M., Kufel, T., Porhomayon, J., & El-Solh, A. A. (2013) · Sleep and Breathing · doi:10.1007/s11325-012-0677-3 · Cited by 95 · see citing works
Cardiopulmonary exercise testing in obstructive sleep apnea syndrome
Lin, C.-C., Hsieh, W., Chou, C.-S., & Liaw, S. (2005) · Respiratory Physiology & Neurobiology · doi:10.1016/j.resp.2005.01.008 · Cited by 93 · see citing works
Servantes, D. M., Pelcerman, A., Salvetti, X. M., Salles, A. F., de Albuquerque, P. F., de Salles, F. C. A., Lopes, C., de Mello, M. T., Almeida, D. R., & Filho, J. A. O. (2011) · Clinical Rehabilitation · doi:10.1177/0269215511403941 · Cited by 87 · see citing works
Thorup, C. B., Hansen, J., Grønkjær, M., Andreasen, J. J., Nielsen, G. N., Sørensen, E. E., & Dinesen, B. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5191 · Cited by 87 · cited 1× · see citing works
“In 64 patients with coronary artery disease, mean number of steps per day was 5,191 ± 3,198 (38).”
BackgroundPhysical Activity and Perception of Energy and Fatigue in Obstructive Sleep Apnea
Hong, S., & Dimsdale, J. E. (2003) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000074566.94791.24 · Cited by 83 · cited 2× · see citing works
“For each reference, the following variables were systematically extracted and entered into a summary table: (1) author, year; (2) participants; (3) AHI cutoff; (4) sample size; (5) age; (6) BMI; (7) study design; (8) outcomes; and (9) main findings.”
BackgroundMethodObstructive sleep apnoea–hypoapnoea syndrome reversibly depresses cardiac response to exercise
Alonso‐Fernández, A., Rio, F. G., Arias, M. A., Mediano, O., Pino, J. M., Martínez, I., & Villamor, J. (2005) · European Heart Journal · doi:10.1093/eurheartj/ehi621 · Cited by 79 · see citing works
Cardiorespiratory Fitness and Obstructive Sleep Apnea Syndrome in Morbidly Obese Patients
Vanhecke, T. E., Franklin, B. A., Zalesin, K. C., Sangal, R. B., deJong, A., Agrawal, V., & McCullough, P. A. (2008) · CHEST Journal · doi:10.1378/chest.08-0567 · Cited by 78 · see citing works
Obstructive Sleep Apnea Is Associated with Impaired Exercise Capacity: A Cross-Sectional Study
Beitler, J. R., Awad, K. M., Bakker, J. P., Edwards, B. A., DeYoung, P. N., Djonlagic, I. E., Forman, D. E., Quan, S. F., & Malhotra, A. (2014) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.4200 · Cited by 78 · see citing works
Desplan, M., Mercier, J. G., Sabaté, M., Ninot, G., Prefaut, C., & Dauvilliers, Y. A. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2013.09.023 · Cited by 77 · cited 3× · see citing works
“The availability of physical activity monitors has made the objective evaluation of physical activity in OSA patients possible in various contexts such as in response to CPAP (17, 20, 48) and during rehabilitation programs (22, 33).”
BackgroundAckel-D’Elia, C., da Silva, A. C., Silva, R. S., Truksinas, E., Sousa, B. S., Tufik, S. B., de Mello, M. T., & Bittencourt, L. (2011) · Sleep And Breathing · doi:10.1007/s11325-011-0567-0 · Cited by 74 · see citing works
Mendelson, M., Vivodtzev, I., Tamisier, R., Laplaud, D., Dias-Domingos, S., Baguet, J.-P., Moreau, L., Koltes, C., Chavez, L., De Lamberterie, G., et al. (2014) · Sleep · doi:10.5665/sleep.4186 · Cited by 72 · cited 2× · see citing works
“The availability of physical activity monitors has made the objective evaluation of physical activity in OSA patients possible in various contexts such as in response to CPAP (17, 20, 48) and during rehabilitation programs (22, 33).”
BackgroundSelf-citationHigh energy expenditure masks low physical activity in obesity
DeLany, J. P., Kelley, D. E., Hames, K. C., Jakicic, J. M., & Goodpaster, B. H. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.172 · Cited by 71 · cited 1× · see citing works
“A recent paper examining physical activity levels in patients with varying levels of obesity found that physical activity levels tended to be lower with increasing obesity (35).”
BackgroundÜçok, K., Ayçiçek, A., Sezer, M., Genç, A., Akkaya, M., Çağlar, V., Fidan, F., & Unlu, M. (2008) · Lung · doi:10.1007/s00408-008-9128-0 · Cited by 58 · see citing works
Hargens, T. A., Guill, S. G., Zedalis, D., Gregg, J. M., Nickols‐Richardson, S. M., & Herbert, W. G. (2008) · SLEEP · doi:10.1093/sleep/31.1.104 · Cited by 57 · see citing works
Verwimp, J., Ameye, L., & Bruyneel, M. (2013) · Sleep And Breathing · doi:10.1007/s11325-012-0796-x · Cited by 49 · cited 1× · see citing works
“(19) found that only AHI in rapid-eye-movement sleep was independently associated with steps per day after controlling for age and BMI.”
BackgroundSubjective and Objective Appraisal of Activity in Adults with Obstructive Sleep Apnea
Chasens, E. R., Sereika, S. M., Houze, M. P., & Strollo, P. J. (2011) · Journal of Aging Research · doi:10.4061/2011/751819 · Cited by 41 · cited 5× · see citing works
“Int J Obes (Lond) (2013) 37(7):1006–11.”
BackgroundMethodInfluentialDoes Obstructive Sleep Apnea Impair the Cardiopulmonary Response to Exercise?
Rizzi, C. F., Cintra, F. D., Mello-Fujita, L., Rios, L. F., Mendonca, E. T., Feres, M. C., Tufik, S., & Poyares, D. R. (2013) · SLEEP · doi:10.5665/sleep.2542 · Cited by 40 · see citing works
Activity Monitoring in Chronic Obstructive Pulmonary Disease
Benzo, R. (2009) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0b013e3181be7a3c · Cited by 39 · see citing works
Igelström, H., Emtner, M., Lindberg, E., & Åsenlöf, P. (2013) · Sleep And Breathing · doi:10.1007/s11325-013-0831-6 · Cited by 36 · see citing works
Bamberga, M., Rizzi, M., Gadaleta, F., Grechi, A., Baiardini, R., & Fanfulla, F. (2015) · Respiratory Medicine · doi:10.1016/j.rmed.2015.02.010 · Cited by 33 · see citing works
Igelström, H., Margareta, E., Eva, L., & Åsenlöf, P. (2013) · Sleep And Breathing · doi:10.1007/s11325-013-0929-x · Cited by 24 · see citing works
Mendelson, M., Tamisier, R., Laplaud, D., Dias-Domingos, S., Baguet, J.-P., Moreau, L., Koltes, C., Chavez, L., Lamberterie, G. D., Hérengt, F., et al. (2013) · Respiratory Care · doi:10.4187/respcare.02948 · Cited by 24 · cited 16× · see citing works
“(22) Exercise group 17 31.1 (12.9) 63.8 (8.0) 28.6 (4.5) 16 (94) 5 Control group 17 28.1 (13.5) 59.6 (11.8) 26.2 (3.9) 14 (82) AHI, apnea–hypopnea index; BMI, body mass index. aData presented by author as mean ± standard error, which we converted to mean ± SD for the statistical analysis.”
BackgroundInfluentialSelf-citationSharples, L. D., & Quinnell, T. G. (2015) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2015.08.001 · Cited by 6 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [67]American College of Sports Medicine. ACSM’s Metabolic Calculations Handbook. Philadelphia, PA: Lippincott Williams & Wilkins (2006).
Cited by
Sorted by citations
Dauvilliers, Y. A., Verbraecken, J. A., Partinen, M., Hedner, J. A., Saaresranta, T., Georgiev, O. B., Tiholov, R., Lecomte, I., Tamisier, R., Levy, P. A., et al. (2020) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201907-1284oc · Cited by 268 · see citing works
Self-citationMaster, H., Annis, J., Huang, S., Beckman, J. A., Ratsimbazafy, F., Marginean, K., Carroll, R., Natarajan, K., Harrell, F. E., Roden, D. M., et al. (2022) · Nature Medicine · doi:10.1038/s41591-022-02012-w · Cited by 221 · see citing works
Kline, C. E., Hillman, C. H., Sheppard, B. B., Tennant, B., Conroy, D. E., Macko, R. F., Márquez, D. X., Petruzzello, S. J., Powell, K. E., & Erickson, K. I. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101489 · Cited by 144 · see citing works
Muscle quality index is associated with trouble sleeping: a cross-sectional population based study
You, Y., Chen, Y., Zhang, Q., Yan, N., Ning, Y., & Cao, Q. (2023) · BMC Public Health · doi:10.1186/s12889-023-15411-6 · Cited by 121 · see citing works
“Sleep duration was assessed by interview and was categorized into three groups: < 7 h for short duration, [7, 9) hours for normal duration, and ≥ 9 h for long duration.”
BackgroundMethodMultimodal Remote Monitoring of High Cardiovascular Risk Patients With OSA Initiating CPAP
Pépin, J., Jullian‐Desayes, I., Sapène, M., Treptow, E. C., Joyeux‐Faure, M., Benmerad, M., Bailly, S., Grillet, Y., Stach, B., Richard, P., et al. (2018) · CHEST Journal · doi:10.1016/j.chest.2018.11.007 · Cited by 80 · see citing works
Self-citationWouters, E. F. �., Posthuma, R., Koopman, M., Liu, W.-Y., Sillen, M. J. H., Hajian, B., Sastry, M., Spruit, M. A., & Franssen, F. M. E. (2020) · Expert Review of Respiratory Medicine · doi:10.1080/17476348.2020.1700796 · Cited by 78 · see citing works
“Rostral fluid shift from the lower body, improvement in upper airway function and improvement of body composition have been suggested as causal factors [198].”
BackgroundLegault, J., Thompson, C., Martineau‐Dussault, M., André, C., Baril, A., Villar, G. M., Carrier, J., & Gosselin, N. (2021) · Brain Sciences · doi:10.3390/brainsci11060706 · Cited by 74 · see citing works
“A systematic review of physical activity and OSA suggests that apneic patients often display low levels of physical activity, possibly due to the fatigue and daytime sleepiness characteristics of OSA [81].”
BackgroundChee, M. W. L., Baumert, M., Scott, H., Cellini, N., Goldstein, C. A., Baron, K. G., Imtiaz, S. A., Penzel, T., & Kushida, C. A. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106506 · Cited by 73 · see citing works
Amiri, S., Hasani, J., & Satkin, M. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.05.013 · Cited by 69 · see citing works
Novel avenues to approach non-CPAP therapy and implement comprehensive obstructive sleep apnoea care
Pépin, J., Eastwood, P. R., & Eckert, D. J. (2021) · European Respiratory Journal · doi:10.1183/13993003.01788-2021 · Cited by 67 · see citing works
Self-citationMendelson, M., Marillier, M., Bailly, S., Flore, P., Borel, J., Vivodtzev, I., Doutreleau, S., Tamisier, R., Pépin, J., & Vergès, S. (2018) · European Respiratory Journal · doi:10.1183/13993003.02697-2017 · Cited by 61 · see citing works
Self-citationThe Sleep Revolution project: the concept and objectives
Arnardóttir, E. S., Íslind, A. S., Óskarsdóttir, M., Olafsdottir, K. A., August, E., Jónasdóttir, L., Hrubos‐Strøm, H., Saavedra, J. M., Grote, L., Hedner, J. A., et al. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13630 · Cited by 58 · see citing works
“, 2020, 2021) and 12 other studies (Mendelson et al., 2018) have shown that the AHI improves after intervention with these exercise programmes.”
BackgroundMethodInfluentialEffects of Exercise on Patients with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis
Peng, J., Yuan, Y., Zhao, Y., & Ren, H. C. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191710845 · Cited by 55 · see citing works
“95, slightly lower than the results of previous meta-analyses [21,35].”
ResultLins-Filho, O., Pedrosa, R. P., Gomes, J. M. D. L., de Moraes, S. L. D., Vasconcelos, B. C. D. E., Lemos, C. A. A., & Pellizzer, E. P. (2020) · Sleep Medicine · doi:10.1016/j.sleep.2019.12.022 · Cited by 52 · see citing works
Hadjiyannakis, S., Ibrahim, Q. I., Li, J., Ball, G. D. C., Buchholz, A., Hamilton, J. K., Zenlea, I. S., Ho, J., Legault, L., Laberge, A., et al. (2019) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(19)30056-2 · Cited by 49 · see citing works
Torres‐Castro, R., Vilaró, J., Martí, J.-D., Garmendia, O., Gimeno‐Santos, E., Romano‐Andrioni, B., Embid, C., & Montserrat, J. M. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8030361 · Cited by 34 · see citing works
“The literature describes the diminution of IAH independent of the reduction of weight [15,16].”
BackgroundLiu, Y., Yang, L., Stampfer, M. J., Redline, S. S., Tworoger, S. S., & Huang, T. (2021) · European Respiratory Journal · doi:10.1183/13993003.00606-2021 · Cited by 35 · see citing works
Obstructive sleep apnoea-hypopnoea syndrome: state of the art
Tondo, P., Fanfulla, F., Sabato, R., Scioscia, G., Barbaro, M. P. F., & Lacedonia, D. (2022) · Minerva Medica · doi:10.23736/s0026-4806.22.08190-3 · Cited by 32 · see citing works
Berger, M., Kline, C. E., Cepeda, F. X., Rizzi, C. F., Chapelle, C., Laporte, S., Hupin, D., Raffin, J., Costes, F., Hargens, T. A., et al. (2019) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2019.03.002 · Cited by 32 · see citing works
Obstructive Sleep Apnea Syndrome: The Effect of Acute and Chronic Responses of Exercise
Stavrou, V. T., Astara, K., Tourlakopoulos, K. N., Papayianni, E., Boutlas, S., Vavougios, G. D., Daniil, Z. D., & Gourgoulianis, K. I. (2021) · Frontiers in Medicine · doi:10.3389/fmed.2021.806924 · Cited by 30 · see citing works
Frange, C., Franco, A. M., Brasil, E. L., Hirata, R. P., Lino, J. A., Mortari, D. M., Ykeda, D. S., Leocádio-Miguel, M. A., D’Aurea, C. V. R., Silva, L. O. E., et al. (2022) · Sleep Science · doi:10.5935/1984-0063.20220083 · Cited by 30 · see citing works
Bughin, F., Desplan, M., Mestejanot, C., Picot, M., Roubille, F., Jaffuel, D., Mercier, J. G., Jaussent, I., & Dauvilliers, Y. A. (2020) · Sleep Medicine · doi:10.1016/j.sleep.2020.02.008 · Cited by 28 · see citing works
Effects of Exercise in Patients with Obstructive Sleep Apnoea
Torres‐Castro, R., Vasconcello‐Castillo, L., Homero Puppo, G., Cabrera-Aguilera, I., Otto‐Yáñez, M., Rosales‐Fuentes, J., & Vilaró, J. (2021) · Clocks & Sleep · doi:10.3390/clockssleep3010013 · Cited by 29 · see citing works
“The potential mechanisms are (1) rostral fluid shift, (2) increased strength and fatigue resistance of the upper airway dilators, decreased nasal resistance, and increased respiratory stability through deeper sleep, (3) body composition modification and changes in fat mass distribution, and (4) changes in sleep effici…”
BackgroundInfluentialJurado-García, A., Molina‐Recio, G., Collado, N. F., Palomares-Muriana, A., Gómez-González, A. M., Márquez-Pérez, F. L., & Gámez, B. J. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17176334 · Cited by 27 · see citing works
“The average number of steps per day was similar to the 5388 average steps described in a meta-analysis involving subjects with OSAS and a walking program [22], ranging from the 7734 steps per day reported by Mendelson et al.”
ResultExercise capacity and comorbidities in patients with obstructive sleep apnea
Vitacca, M., Paneroni, M., Braghiroli, A., Balbi, B., Aliani, M., Guido, P., Fanfulla, F., Pertosa, M., Ceriana, P., Zampogna, E., et al. (2020) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8258 · Cited by 26 · see citing works
An Update on Obstructive Sleep Apnea for Atherosclerosis: Mechanism, Diagnosis, and Treatment
Chen, J., Lin, S., & Zeng, Y. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.647071 · Cited by 29 · see citing works
Lins-Filho, O., Aguiar, J. L. P., de Almeida, J. R. V., Germano-Soares, A. H., Ritti‐Dias, R. M., da Silva, M. J., & Pedrosa, R. P. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.08.027 · Cited by 25 · see citing works
“This reduction is smaller than that observed in studies using CPAP[52] 328 and similar to that in studies using exercise training [11, 53].”
Júnior, J. C. N. N., de Andrade, A. D., de Andrade, E. A. M., Andrade, M. D. A., Ribeiro, A. S. V., Pedrosa, R. P., Ferreira, A. P. D. L., & de Lima, A. M. J. (2020) · Nature and Science of Sleep · doi:10.2147/nss.s269360 · Cited by 21 · see citing works
“In turn, fluid accumulation in the intravascular and interstitial spaces during the day is minimized which consequently reduces liquid displacement during sleep.(5) Furthermore, another possible cause for decreasing the severity of the disease associated with exercise can be explained by Table 1 Characteristics of the…”
Backgroundde Azeredo, L. M., de Souza, L. C., Guimarães, B., Puga, F. P., Behrens, N., & Lugon, J. R. (2022) · Brazilian Journal of Medical and Biological Research · doi:10.1590/1414-431x2022e12331 · Cited by 20 · see citing works
“When assessing aspects related to daily sleepiness, we identified a statistically significant reduction in ESS scores in CPAP users who were not trained, a finding that can be attributed to the CPAP therapy itself (11,26).”
BackgroundUnfolding the role of exercise in the management of sleep disorders
Giannaki, C. D., Sakkas, G. K., Hadjigeorgiou, G. M., Manconi, M., & Bargiotas, P. (2024) · European Journal of Applied Physiology · doi:10.1007/s00421-024-05556-6 · Cited by 20 · see citing works
“Second, exercise can result in improved cardiovascular health and respiratory function, enhancing sleep stability (i.e. regularity in sleep duration, timing, and quality) and respiration (Mendelson et al. 2018).”
BackgroundMethodLi, J., Sawaragi, T., & Horiguchi, Y. (2021) · SICE Journal of Control Measurement and System Integration · doi:10.1080/18824889.2021.1894040 · Cited by 20 · see citing works
Lin, C.-F. J., Ho, N., Hsu, W.-L., Lin, C.-H., Wang, Y., & Wang, Y. (2024) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.11310 · Cited by 21 · see citing works
“15,32,33,36,61 Among the studies enrolled in our analysis, 3 reported significant BMI reduction after exercise 17,25,27 , whereas 5 did not.”
InfluentialPaolucci, T., Ferrillo, M., Pezzi, L., Agostini, F., Matteo, A. D., Prosperi, P., Mangone, M., Bernetti, A., Spacone, A., & Alessandro de, S. I. R. E. (2023) · Journal of Oral Rehabilitation · doi:10.1111/joor.13456 · Cited by 19 · see citing works
Preventive medicine in obstructive sleep apnea—a systematic review and a call to action
Correa, E. J., Conti, D. M., Gozal, D., & O’Connor-Reina, C. (2024) · SLEEP · doi:10.1093/sleep/zsae164 · Cited by 16 · see citing works
Larsson, S. C., Hållström, E., Michaëlsson, K., & Titova, O. E. (2025) · Scientific Reports · doi:10.1038/s41598-025-10991-2 · Cited by 15 · see citing works
Update on obstructive sleep apnea for neuro-ophthalmology
Fraser, C. L. (2018) · Current Opinion in Neurology · doi:10.1097/wco.0000000000000630 · Cited by 14 · see citing works
Mendelson, M., Inami, T., Lyons, O. D., Alshaer, H., Marzolini, S., OH, P. I., & Bradley, T. D. (2020) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8124 · Cited by 14 · see citing works
Self-citationTang, R., Pan, J., Huang, Y., & Ren, X. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.10.026 · Cited by 13 · see citing works
Exercise Intolerance in Untreated OSA
Elbehairy, A. F., Geneidy, N. M., Hoshy, M. S. E., El-Sanhoury, D., Elfeky, M. K., Elhameed, A. A., Horsley, A. R., O’Donnell, D. E., Abd-Elwahab, N. H., & Mahmoud, M. I. (2022) · CHEST Journal · doi:10.1016/j.chest.2022.09.027 · Cited by 13 · see citing works
Ozcan, B., Blachot‐Minassian, B., Paradis, S., Mazière, L., Chambion-Diaz, M., Bouyon, S., Pépin, J., Pialoux, V., Arnaud, C., Moinard, C., et al. (2022) · Antioxidants · doi:10.3390/antiox11122326 · Cited by 13 · see citing works
Self-citationFitton, J., Nguyen, D. P., Lechat, B., Scott, H., Toson, B., Manners, J., Dunbar, C., Sansom, K., Pinilla, L., Hudson, A. L., et al. (2025) · Communications Medicine · doi:10.1038/s43856-025-01226-6 · Cited by 13 · see citing works
“We also used the WSA to derive the nightly apnoea-hypopnoeaindex(AHI)toconsiderobstructivesleepapnoeaseverityinour analysesasapotentiallyimportantsleepconfounder 60,61 .”
Berger, M., Barthélemy, J., Garet, M., Raffin, J., Labeix, P., Roche, F., & Hupin, D. (2021) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.13961 · Cited by 12 · see citing works
Torres‐Lopez, L. V., Cadenas‐Sánchez, C., Migueles, J. H., Adelantado‐Renau, M., Plaza‐Florido, A., Solis‐Urra, P., Molina‐García, P., & Ortega, F. B. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9051544 · Cited by 12 · see citing works
“Indeed, low physical activity (PA) levels [33] and exercise capacity [34] have been associated to OSA.”
BackgroundFigard, C., Messaoud, R. B., Baillieul, S., Joyeux‐Faure, M., Destors, M., Tamisier, R., Khouri, C., & Pépin, J. (2025) · EClinicalMedicine · doi:10.1016/j.eclinm.2025.103529 · Cited by 11 · see citing works
“20 These discrepancies highlight the need for future studies to control for physical activity when examining BMI-related outcomes in OSA management.”
Self-citationGupta, A., Kaur, J., Shukla, G., Bhullar, K. K., Lamo, P., Biju, K., Agarwal, A., Srivastava, A. K., & Sharma, G. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.04.020 · Cited by 14 · see citing works
Cardiorespiratory fitness and long‐term risk of sleep apnea: A national cohort study
Crump, C., Sundquist, J., Winkleby, M. A., & Sundquist, K. (2019) · Journal of Sleep Research · doi:10.1111/jsr.12851 · Cited by 11 · see citing works
“Self‐ reported high physical activity or exercise has been associated with improved symptoms and outcomes in patients with existing OSA, irrespective of weight loss (Aiello et al., 2016; Iftikhar, Kline, & Youngstedt, 2014; Mendelson et al., 2018).”
BackgroundDobrosielski, D. A., Kubitz, K. A., Park, H.-J., Patil, S. P., & Papandreou, C. (2021) · Translational Sports Medicine · doi:10.1002/tsm2.254 · Cited by 11 · see citing works
Chen, J., Chen, J., & Wang, Y.-C. (2024) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2024.01.012 · Cited by 10 · see citing works
Pépin, J., Attias, D., Baillieul, S., Messaoud, R. B., Béquignon, É., Gagnadoux, F., Gentina, T., Heinzer, R. C., Patout, M., Perrin, C., et al. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106522 · Cited by 11 · see citing works
Self-citationSloan, R. A., Kim, Y., Sawada, S. S., Asakawa, A., Blair, S. N., & Finkelstein, E. A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17041337 · Cited by 10 · see citing works
“Correspondingly, recent meta-analyses of RCTs in sleep apnea patients showed that exercise training concomitantly improves CRF and reduces sleep apnea severity and improves SQ without significant changes in BMI in adults who get low amounts of MVPA [31,32].”
Influence of Regular Physical Activity on Sleep
McGranahan, M. J., & O’Connor, P. J. (2024) · Current topics in behavioral neurosciences · doi:10.1007/7854_2024_503 · Cited by 11 · see citing works
Brupbacher, G., Gerger, H., Wechsler, M., Zander-Schellenberg, T., Straus, D., Porschke, H., Gerber, M., von Känel, R., & Schmidt‐Trucksäss, A. (2019) · Systematic Reviews · doi:10.1186/s13643-019-1018-4 · Cited by 10 · see citing works
Costa, I. O. M., da Cunha, M. O., Bussi, M. T., Cassettari, A. J., Zancanella, E., & Bagarollo, M. F. (2024) · Sleep And Breathing · doi:10.1007/s11325-024-03034-z · Cited by 8 · see citing works
Relationship Between Obstructive Sleep Apnea and Sports—Systematic Review and Meta-Analysis
Revuelta, L. M., Fraile, J. F., Zubizarreta‐Macho, Á., Galindo, A. B. L., & Blanco, P. A. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13226814 · Cited by 8 · see citing works
Ferreira, S. T. B. P., Brasileiro-Santos, M. D. S., Teixeira, J. B., Rabello, M. C. D. S., de Lorena, V. M. B., Farah, B. Q., Silva, T. N. S., & de Lima, A. M. J. (2021) · Sleep And Breathing · doi:10.1007/s11325-021-02364-6 · Cited by 8 · see citing works
“However, physical training is a low-cost and easy-to-adopt supplementary therapeutic option to treat patients with sleep disorders [3, 4].”
BackgroundSilva, H., Mantoani, L. C., Aguiar, W. F., Gonçalves, A. F. L., Silva, T. G., Zamboti, C. L., Ribeiro, M. S. M., Probst, V. S., Pitta, F. D. O., & Camillo, C. A. (2023) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2022.2160679 · Cited by 8 · see citing works
“Studies in different populations have already shown that subjects with obstructive sleep apnea pre-sent low levels of PADL (Mendelson et al., 2018).”
BackgroundBlack, J. K., Phillips, A. C., Tahrani, A. A., & Balanos, G. M. (2020) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-020-00195-8 · Cited by 8 · see citing works
Rhodes, S., Waters, D. L., Brockway, B., & Skinner, M. (2020) · Journal of Primary Health Care · doi:10.1071/hc19102 · Cited by 8 · see citing works
What should the recommendations be for lifestyle factors in obstructive sleep apnea?
Huang, T. (2022) · Expert Review of Respiratory Medicine · doi:10.1080/17476348.2022.2099377 · Cited by 7 · see citing works
Pawar, M., Venkatesan, P., Mysore, S., & Bhat, G. (2025) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-025-09436-3 · Cited by 6 · see citing works
“In the current standpoint, different forms of exercise training involving aerobic exercises and resisted exercises, are emphasized as an adjunct to the traditional CPAP treat-ment for OSA [14].”
Justribó-Manion, C., Romero, E. A. S., Cuenca-Zaldívar, J.-N., Cerdà-Ribó, A., Felipe-Spada, N., Aliberas, J. T., & Padrós-Augé, J. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.108665 · Cited by 9 · see citing works
Spörndly-Nees, S., Åsenlöf, P., Lindberg, E., Emtner, M., & Igelström, H. (2020) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8322 · Cited by 6 · see citing works
“For example, Mendelson et al 9 highlight the need to include analysis of patients with OSA who are the most likely to succeed with the exercise training.”
Łoboda, D., Stepanik, M., Gołba, A., Dzierzawa, M., Szajerska-Kurasiewicz, A., Simionescu, K., Turski, M., Kucia-Kuzma, S., Durmała, J., & Golba, K. S. (2020) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8900 · Cited by 6 · see citing works
“In all these analyses, 19 – 22 AHI reduction was accompanied by an improvement in terms of daytime sleepiness, sleep ef fi ciency, and/or quality of life, which is an added value to the exercise program.”
Physical activity: the key to cardiometabolic risk reduction in obstructive sleep apnoea
Mendelson, M., & Flore, P. (2018) · European Respiratory Journal · doi:10.1183/13993003.01775-2018 · Cited by 6 · see citing works
Self-citationHou, Y., Cui, E., Lim, K. O., Chow, L. S., Howell, M. J., Ikramuddin, S., & Zhang, R. (2026) · Communications Medicine · doi:10.1038/s43856-025-01372-x · Cited by 5 · see citing works
Harding, C. D., Holloway, B. M., DeYoung, P. N., Kwan, C., Djonlagic, I. E., Ancoli‐Israel, S., Banks, S. J., & Malhotra, A. (2025) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.11648 · Cited by 5 · see citing works
“For example, day-time sleepiness in apneic patients can affect physical activity, 45 which is a protective factor against cognitive decline.”
Bughin, F., Mendelson, M., Jaffuel, D., Pépin, J., Gagnadoux, F., Goutorbe, F., Abril, B., Ayoub, B., Aranda, A., Alagha, K., et al. (2023) · Digital Health · doi:10.1177/20552076231167009 · Cited by 5 · see citing works
“21 Exercise training reduces the severity of OSAS and improves daytime sleepiness 22,23 while weight loss interventions improve BP, insulin resistance, hypertriglyceridemia and in fl ammation in obese patients with severe OSAS.”
BackgroundSelf-citationLatrille, C., Chapel, B., Héraud, N., Bughin, F., Hayot, M., & Boiché, J. (2023) · Digital Health · doi:10.1177/20552076221150744 · Cited by 5 · see citing works
“This limited number of studies integrating the outcome of PA is surprising insofar as CPAP, as the first-line treatment of OSA, has a limited impact on cardiometabolic risk factors, whereas exercise training has a well-documented effect on numerous cardiometabolic risk factors.(11) In individuals with chronic disease,…”
BackgroundInfluentialToward Patient-Centric Digital Monitoring of Obstructive Sleep Apnea: Mixed Methods Study
Timmis, J. K., Schorr, K. A., Yüksel, R., van den Broek, T., Overeem, S., Smid, D. J., van den Brink, W. J., & Haring, N. L. (2025) · Journal of Medical Internet Research · doi:10.2196/82460 · Cited by 4 · see citing works
Obstruktive Schlafapnoe – Einfluss auf kardiovaskuläres System und Kognition
Schneider, G. (2023) · Laryngo-Rhino-Otologie · doi:10.1055/a-1963-9957 · Cited by 4 · see citing works
“In OSA patients, the negative effects add up through a cycle of daytime sleepiness, fatigue, and reduction in physical activity and weight gain [109].”
BackgroundTkáčová, R. (2018) · Medical Hypotheses · doi:10.1016/j.mehy.2018.08.012 · Cited by 4 · see citing works
Kubitz, K. A., Park, H.-J., Patil, S. P., Papandreou, C., & Dobrosielski, D. A. (2022) · Sleep and Biological Rhythms · doi:10.1007/s41105-022-00433-1 · Cited by 4 · see citing works
“, sleep fragmentation and hypoxemia) are improved with exercise training [14].”
BackgroundKnowlden, A. P., Winchester, L. J., MacDonald, H. V., Geyer, J. D., & Higginbotham, J. C. (2024) · JMIR Formative Research · doi:10.2196/54792 · Cited by 4 · see citing works
Exploring Exercise Interventions for Obstructive Sleep Apnea: A Scoping Review
Themistocleous, I.-C., Hadjisavvas, S., Papamichael, E., Michailidou, C., Efstathiou, M. A., & Stefanakis, M. (2025) · Journal of Functional Morphology and Kinesiology · doi:10.3390/jfmk10030253 · Cited by 4 · see citing works
“The therapeutic exercise section included 14 studies, involving RCTs [65–70], single-arm studies [71], non-RCT studies [72], and meta-analyses [64,73–77].”
Sleep and obesity—known interactions and open questions
Schmickl, C. N., Gomez, R., Sunwoo, B. Y., Mesarwi, O. A., Kumar, A., & Malhotra, A. (2026) · Journal of Clinical Sleep Medicine · doi:10.1007/s44470-026-00130-7 · Cited by 3 · see citing works
“Recent meta-analyses showed that exercise training can significantly improve OSA severity, with reductions in apnea–hypopnea index (AHI) by 5.2 to 8.9 events per hour despite no improvement in BMI [101, 102].”
InfluentialActivités physiques et réadaptation respiratoire
Chéhère, B., Pernot, J., & Costes, F. (2021) · Revue des Maladies Respiratoires · doi:10.1016/j.rmr.2021.09.004 · Cited by 3 · see citing works
Obstructive sleep apnea and its relation with temporomandibular disorders: A narrative review
Ab‐Ghani, Z., Zwiri, A. M. A., Husein, A., Phaik, K. S., Kassim, N. K., Zainal, S. A., & Samsudin, A. (2020) · Journal of international oral health · doi:10.4103/jioh.jioh_246_19 · Cited by 3 · see citing works
“Journal of International Oral Health ¦ Volume 12 ¦ Issue 1 ¦ January‐February 2020 11 and enhances the ventilation drive.[37,38] Although CPAP is considered as the gold standard treatment option for the patients with OSA,[39] a major drawback is the interface, that is, mask and inadequate adherence of the equipment.”
BackgroundBeatty, C., Landry, S. A., Lee, J., Joosten, S. A., Turton, A., O’Driscoll, D. M., Wong, A., Thomson, L. D. J., Edwards, B. A., & Hamilton, G. S. (2020) · Sleep and Biological Rhythms · doi:10.1007/s41105-020-00291-9 · Cited by 3 · see citing works
Lifestyle Behaviour and Obstructive Sleep Apnea (OSA): An Association Study Among Young Adults
Jyothi, R. K., Mathangi, D. C., & Chellaiyan, V. G. (2022) · National Journal of Community Medicine · doi:10.55489/njcm.13062022628 · Cited by 3 · see citing works
Karkala, A., Baxevanidis, A., Chasiotou, A., Siopi, D., Mameletzi, D. N., Kouidi, E. J., Chloros, D. A., Pitsiou, G., & Boutou, A. (2024) · Sleep And Breathing · doi:10.1007/s11325-024-03148-4 · Cited by 3 · see citing works
“However, on a recent meta-analysis on OSAS patients, CPAP use did not exert any effect on their physical activity [ 20].”
da Fonseca, M. A., Moreira, A. K. S., Lima, R. B. D. S., Oliveira, M. D. A., Santos‐de‐Araújo, A. D., Rêgo, A. S., Penha, L. R. L. N., Ferreira, P. R., Gonçalves, M. C., & Dibai, D. B. (2021) · Revista da Associação Médica Brasileira · doi:10.1590/1806-9282.20210232 · Cited by 3 · see citing works
Obstructive sleep apnoea and exercise functional capacity: time to move?
Farré, N., & Lorenzi‐Filho, G. (2018) · European Respiratory Journal · doi:10.1183/13993003.01031-2018 · Cited by 3 · see citing works
Hnatiak, J., Galkova, L. Z., Winnige, P., Baťalík, L., Dosbaba, F., Ludka, O., & Krejčí, J. (2023) · Biomedical Papers · doi:10.5507/bp.2023.022 · Cited by 3 · see citing works
Olagunju, A., Yamani, N., Unzek, S., Lee‐Iannotti, J. K., Mookadam, F., & Mookadam, M. (2022) · Journal of Clinical Exercise Physiology · doi:10.31189/2165-6193-11.3.80 · Cited by 2 · see citing works
González-Devesa, D., Sánchez-Lastra, M. A., Pérez-Fernández, P., Diz-Gómez, J. C., & Ayán, C. (2024) · Sleep And Breathing · doi:10.1007/s11325-024-03176-0 · Cited by 2 · see citing works
“…On a final note, it’s worth noting that none of the reviewed studies explored the effects of exercise on individ - uals with diabetes who also have obstructive sleep apnea—a syndrome linked to insulin resistance and glucose intolerance, for which exercise is considered an effective therapy [44].”
Kline, C. E. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-815373-4.00020-4 · Cited by 2 · see citing works
Participation in physical activity is associated with reduced nocturnal hypoxaemia in males
Stevens, D. J., Appleton, S., Melaku, Y. A., Martin, S., Adams, R., & Wittert, G. (2021) · ERJ Open Research · doi:10.1183/23120541.00852-2020 · Cited by 2 · see citing works
Katsagoni, C. N., Kokkinos, P. F., & Sidossis, L. S. (2023) · Wiley eBooks · doi:10.1002/9781119833475.ch19 · Cited by 2 · see citing works
Latrille, C., Hayot, M., Bosselut, G., Bughin, F., & Boiché, J. C. S. (2024) · Journal of Behavioral Medicine · doi:10.1007/s10865-024-00474-6 · Cited by 1 · see citing works
“Regarding BMI, results in the literature seem to support a negative relationship with PA (Mendelson et al., 2018a, 2018b) but these results are based on populations of obese people without an OSA diagnosis (DeLany et al., 2013).”
InfluentialMessaoud, R. B., Baillieul, S., Tamisier, R., Terrail, R., Bailly, S., Joyeux‐Faure, M., & Pépin, J. (2024) · BMC Digital Health · doi:10.1186/s44247-024-00077-w · Cited by 1 · see citing works
Self-citationKrzykawski, K., Maciejczyk, T., Mól, P., Sadowski, J., Zabawa, B., Dołęga, J., Papież, Ł. S., Hudzińska, P., Sieńko, A., & Łabuś, M. (2024) · Quality in Sport · doi:10.12775/qs.2024.36.56515 · Cited by 1 · see citing works
Physical activity phenotypes in obstructive sleep apnea: real-world data
Mendelson, M., Baillieul, S., Tondo, P., Louis, R., Wang, K.-P., Tamisier, R., Pépin, J., & Bailly, S. (2026) · Annals of the American Thoracic Society · doi:10.1093/annalsats/aaoag004 · Cited by 1 · see citing works
Self-citationFank, F., Artismo, R. S., da Rocha, A. G. R., Santana, M. G., Esteves, A. M., Lins-Filho, O., Matte, D. L., & Mazo, G. Z. (2026) · Sleep Medicine · doi:10.1016/j.sleep.2026.108967 · Cited by 1 · see citing works
Tkáčová, R., Paraničová, I., Timkova, E., Vonkova, D., & Joppa, P. (2018) · Journal of Health Psychology · doi:10.1177/1359105318788695 · Cited by 1 · see citing works
“…CPAP alone has prompted researchers and clinicians to seek strategies to promote weight loss in overweight and obese patients with OSA (Abuzaid et al., 2017; Barbé et al., 2012; Bratton et al., 2014; Drager et al., 2015; McEvoy et al., 2016; Mendelson et al., 2018; Shechter, 2016; Yu et al., 2017).”
BackgroundEuropean Respiratory Society International Congress 2020: highlights from best-abstract awardees
Britton, N., Elbehairy, A. F., Mensink‐Bout, S. M., Blondeel, A., Liu, Y., Cruz, J., & Brandt, J. D. (2020) · Breathe · doi:10.1183/20734735.0270-2020 · Cited by 1 · see citing works
“In patients with OSA, a combined treatment strategy is needed, including physical activity and exercise training, aiming to also address the cardiovascular and metabolic risk [24].”
BackgroundBerger, M., Bayon, V., Hirotsu, C., Haba‐Rubio, J., Barthélemy, J., Roche, F., & Heinzer, R. C. (2020) · Médecine du Sommeil · doi:10.1016/j.msom.2019.11.006 · Cited by 1 · see citing works
Kızılırmak, D., Karadoğan, D., Yıldırım, H., Akyıl, F. T., Eyüboğlu, T. Ş., Emiralioğlu, N., Sertçelik, Ü. Ö., Günaydın, F. E., Ataoğlu, Ö., Oguz, M. S., et al. (2022) · Turkish Thoracic Journal · doi:10.5152/turkthoracj.2022.21081 · Cited by 1 · see citing works
Hou, Y., Cui, E., Ikramuddin, S., & Zhang, R. (2024) · medRxiv · doi:10.1101/2024.11.11.24317124 · Cited by 1 · see citing works
Zhang, R., Hou, Y., Cui, E., Lim, K. O., Chow, L. S., Howell, M. J., & Ikramuddin, S. (2025) · Research Square · doi:10.21203/rs.3.rs-6263507/v1 · Cited by 1 · see citing works
The benefits of cardiac rehabilitation for patients with sleep apnea.
Komasi, S. (2018) · Europe PMC (PubMed Central) · doi:10.22122/arya.v14i4.1798
- Authors
- Mendelson, M., Bailly, S., Marillier, M., Flore, P., Borel, J. C., Vivodtzev, I., Doutreleau, S., Verges, S., Tamisier, R., & Pépin, J.-L.
- Affiliations
- Inserm (FR)
- Corresponding author
- Mendelson, Monique
- ORCID
- Venue
- Frontiers in Neurology
- Publisher
- Frontiers Media SA
- Published
- 2018-02-22
- Volume
- 9
- Pages
- 73-73
- ISSN
- 1664-2295 (ISSN-L)
- PMC
- PMC5827163
- OpenAlex
- W2791102933
- Cited by
- 134
- References
- 87
- Citations by year
- 2026: 11 · 2025: 17 · 2024: 18 · 2023: 14 · 2022: 15 · 2021: 20 · 2020: 22 · 2019: 7 · 2018: 9
- FWCI
- 1.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Frontiers in Neurology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Fondation Air Liquide
- ResMed
- Agence Nationale de la Recherche (IDEX-02, ANR‐15‐IDEX‐02, ANR-15-IDEX-0002, 15-IDEX-02)
- Agir pour les Maladies Chroniques
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- obstructive sleep apnea, physical activity, exercise training, step count, apnea-hypopnea index, daytime sleepiness, cardiorespiratory fitness, body mass index, OSA severity
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
