Effects of Exercise and Weight Loss in Older Adults with Obstructive Sleep Apnea

DOBROSIELSKI, DEVON A.1,2; PATIL, SUSHEEL3; SCHWARTZ, ALAN R.3; BANDEEN-ROCHE, KAREN4; STEWART, KERRY J.2

Medicine & Science in Sports & Exercise: January 2015 - Volume 47 - Issue 1 - p 20–26
doi: 10.1249/MSS.0000000000000387
Clinical Sciences

Purpose: Obstructive sleep apnea (OSA) is prevalent among older individuals and is linked to increased cardiovascular disease morbidity. This study examined the change in OSA severity after exercise training and dietary-induced weight loss in older adults and the association of the changes in OSA severity, body composition, and aerobic capacity with arterial distensibility.

Methods: Obese adults (n = 25) with OSA, age 60 yr or older, were instructed to participate in supervised exercise (3 d·wk−1) and follow a calorie-restricted diet. Baseline assessments of OSA parameters, body weight and composition, aerobic capacity, and arterial distensibility were repeated at 12 wk.

Results: Nineteen participants completed the intervention. At 12 wk, there were reductions in body weight (−9%) and percentage of total body fat (−5%) and trunk fat (−8%) whereas aerobic capacity improved by 20% (all P < 0.01). The apnea–hypopnea index decreased by 10 events per hour (P < 0.01) and nocturnal SaO2 (mean SaO2) improved from 94.9% at baseline to 95.2% after intervention (P = 0.01). Arterial distensibility for the group was not different from that at baseline (P = 0.99), yet individual changes in distensibility were associated with the change in nocturnal desaturations (r = −0.49, P = 0.03) but not with the change in body weight, apnea–hypopnea index, or aerobic capacity.

Conclusions: The severity of OSA was reduced after an exercise and weight loss program among older adults, suggesting that this lifestyle approach may be an effective first-line nonsurgical and nonpharmacological treatment for older patients with OSA.

1Department of Kinesiology, Towson University, Towson, MD; 2Department of Medicine, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD; 3Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore MD; and 4Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

Address for correspondence: Devon A. Dobrosielski, Ph.D., Department of Kinesiology, Towson University, 8000 York Road, Towson, MD 21252; E-mail: ddobrosielski@towson.edu.

Submitted for publication February 2014.

Accepted for publication May 2014.

© 2015 American College of Sports Medicine