May 7, 2019
May 7, 2019
In previous review study, it was hypothesized that a comprehensive rehabilitation can combine both local pharyngeal muscle exercise and systemic cardiopulmonary rehabilitation for the OSA patients with oropharyngeal muscle dysfunction or ventilator drive instability. To develop a comprehensive rehabilitation model is of innovative care strategy in this study.
BACKGROUND: Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder, which was characterized by repetitive events of complete and partial obstructions of the upper airway. The pathogenesis of OSA is interacted by multiple factors, primarily including upper airway (UA) anatomic impairment, ventilatory drive instability, and oropharyngeal muscle dysfunction. However, studies have proven prior oropharyngeal exercise was designed for those OSA patients with oropharyngeal muscle dysfunction. Unlike prior oropharyngeal exercise, comprehensive rehabilitation should emphasize the cardiorespiratory regulation capability in addition to oropharyngeal function. OBJECTIVES: Therefore, the purpose of this study is to explore both the clinical and biological effects of our comprehensive rehabilitation, we used PSG data as clinical effect and biomarker of inflammation expression as biological effect. METHODS: Thirty subjects with moderate or severe OSA (AHI≥15) were randomized into intervention group (N=15) and control group (N=15). In intervention group, a 12-week-intervention of out-patient rehabilitation program included oropharyngeal muscle training, threshold respiratory muscle training, and therapeutic exercise. ANTICIPATED OUTCOMES: The preliminary results would demonstrate promisingly clinical effects and biological effects of our comprehensive rehabilitation model. Therefore, the further studies should emphasize the methods to differentiate diagnosis for the indicated patients with oropharyngeal muscle dysfunction or ventilatory drive instability.
|Experimental: intervention group
We conducted a twice a week, 12-week-intervention of 'comprehensive rehabilitation'
Behavioral: comprehensive rehabilitation
oropharyngeal rehabilitation, cardiopulmonary rehabilitation, and therapeutic exercise
- Patients aged 35-65 with or without surgery had difficulty accepting or adhering CPAP
- BMI<32 - Smoking or alcoholism - Severe allergic rhinitis - Stroke history - CVD - Severe restricted or obstructive pulmonary disease - Hypothyroidism - DM or HTN without stable control - Psychiatric disease - Co-existing non-respiratory sleep disorders
National Cheng Kung University Hospital
National Cheng-Kung University Hospital
Principal Investigator: Chinghsia Hung, PhD National Cheng-Kung University Hospital