Obstrüktif Uyku Apne Sendromu Olan Hastalarda Yoganın Aerobik Kapasite, Solunum Kas Kuvveti ve Kognitif Performans Üzerine Etkisi

Abstract

Impaired aerobic capacity, respiratory muscle strength, and cognitive function negatively affects the health-related quality of life in patients with obstructive sleep apnea syndrome (OSAS). This study aimed to examine the effects of yoga on aerobic capacity, respiratory muscle strength, and cognitive performance in patients with OSAS. Forty-four OSAS patients (40 males, 4 females) were randomized to yoga (n=22, AHI 31.7±21.2 events/hour) and control (n=22, AHI 24.9±17.8 events/hour) groups. The yoga group underwent live synchronous group-based TY sessions, 60 min/day, three days/week, for 12 weeks. The control group performed unsupervised thoracic expansion exercises at home 4 times daily for 12 weeks. Anthropometric measurements, circumference measurements, inspiratory and expiratory respiratory muscle strength (MIP and MEP), cardiopulmonary exercise test (CPET) and six-minute walking test (6MWT) were performed at baseline, 6th and 12th weeks. During CPET, maximum oxygen consumption (VO2max), peak oxygen consumption at anaerobic threshold (atVO₂), minute ventilation (VE), ratio of minute ventilation to carbon dioxide production (VE/VCO2), maximum heart rate (HRmax), oxygen consumption per heartbeat (O2 pulse), heart rate recovery per minute maximum respiratory exchange rate (RQmax), respiratory exchange rate at anaerobic threshold (atRQ), maximum metabolic equivalent (METmax), and metabolic equivalent at anaerobic threshold (atMET) were measured. Corsi Block Test and Stroop TBAG Test were applied to evaluate cognitive performance. Pittsburgh Sleep Quality Index (PSQI) was used for sleep quality, and Epworth Sleepiness Scale (ESS) was used to measure daytime sleepiness, and SF-36 was used for health-related quality of life. Yoga decreased the percentage of fat body fat and increased epigastric and subcostal chest circumference values (p<0.05). Yoga significantly improved MIP and CPET parameters (VE, HRmax, %HRmax, first-minute heart rate recovery and RQmax), Corsi Block Test (Forward) and Stroop TBAG Test scores (sections 3,4 and 5) compared to controls (p<0.05). Although there was no statistical difference when compared with the control group, maximal oxygen consumption values increased over time in the yoga group (p>0.05). There was no significant change in 6MWT in the yoga group compared to the control group (p>0.05). Sleep efficiency, sleep quality PSQI and ESS scores improved significantly in the yoga group compared to the control group (p<0.05). SF-36 (emotional role limitatıon, mental health, general body pain parameters at the 12th week were higher in the yoga group than in the control group (p<0.05). There was no difference between the groups in the 6th and 12th week measurements of MEP, Corsi Block Test (Backward), Stroop (sections 1,2), PSQI sleep disorder, sleep latency, daytime sleep dysfunction, sleep medication use, and physical function, social function, physical role limitatıon, energy/fatigue, general health perception sub-parameters of SF-36 (p>0.05). In conclusion, yoga increases respiratory muscle strength, heart rate parameters of CPET, neurocognitive performance, and sleep quality in OSAS patients. Our study supports that the addition of yoga to exercise programs in OSAS patients can improve the health-related parameters of the patients.