Effects Of 8-week Respiratory Training Combined With Aerobic Exercise On Obstructive Sleep Apnea In Pregnant Women

Prenatal exposure to Obstructive Sleep Apnea(OSA) is an independent risk factor for adverse pregnant women outcomes. Exercise-training are recommended to treat mild to moderate OSA. However, the effect of combined training on OSA in pregnancy remains unclear. PURPOSE: To assess the effect of respiratory training combined with aerobic exercise on pregnant women with OSA. METHODS: Twelve singleton pregnant women (age 28 ± 4 years old) without any high-risk condition, and OSA of mild to moderate severity (respiratory disturbance index ≥5/<30 events/hour) , who presented in the first trimester (gestational age, GA 0-16 weeks) were randomly divided into either the training group (TG; n = 6) or control group (CG; n = 6). The TG consisted of a 8-week training (3 times per week) composed by supervised aerobic exercise,30-min walking bout (40-60% HRmax) and three set of 5-min respiratory training separated by 3-min resting whereas the CG conducted usual antenatal care. OSA severity was assessed by full night polysomnography(PSG). The Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Short Form-36(SF-36), the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS) were used to evaluate subjective sleep parameters, quality of life, and the severity of negative emotions respectively. Scores and parameters were compared at baseline and following 8-week training by t-test. RESULTS: The 8-week training significantly decreased the Apnea-Hypopnea Index (AHI, 17.0 ± 3.0 vs. 9.8 ± 2.0, p < 0.0001), the PSQI scores (13.3 ± 2.0 vs. 6.7 ± 3.0, p < 0.0001), the ESS scores (16.2 ± 1.4 vs. 10.9 ± 4.7, p = 0.008) and slightly reduced diastolic blood pressure (DBP, 93.0 mmHg ±6.0 mmHg vs. 88.0 mmHg ±4.0 mmHg, p = 0.032); It was observed improvement in mental status with reduction in the overall SAS(65.2 ± 5.6 vs.47.8 ± 3, p < 0.0001) and in the SDS scores(56.7 ± 3.7 vs.47.0 ± 1.7, p = 0.0003), as well as an increase of quality of life (SF-36, 436 ± 152 vs. 547 ± 128, p = 0.0006) in TG group. No significant change were found for measured variables between Pre and Post in CG group(p > 0.05). CONCLUSIONS: Prenatal respiratory training combined with aerobic exercise could reduce the severity of sleep apnea and improve quality of life of pregnant women with mild and moderate OSA.