Rehabilitation and therapeutic exercise in obstructive sleep apnea: a perspective beyond the apnea-hypopnea index.
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Guerrero-Vega Luis F, Jáuregui-Gutiérrez Víctor R, Elías-León Jonathan, Trejo-Osorio David A, Pérez-Nieto Orlando R, Reyes-Montufar Jonathan, García-Pantoja María Del Carmen, Mendiola-Enriquez Fernando, Vargas-Reynoso Cesar E, Reyes-Monge Rafael A, Macarena-Liendro Silvana, Razo-Alvarado Mariana I, Paniagua-Sosa María de la Luz, Olvera-Montoya Emanuel, Tolentino-de la Mora Abraham M, Herrera-Estrada Edwin E, Morgado-Villaseñor Luis A, Muñoz-Velázquez Alonso J, Linton-Cornejo Dante A
Аннотация
OBJECTIVE: To synthesize the available scientific evidence on the role of rehabilitation in individuals with OSA, highlighting its clinical impact beyond the AHI and its contribution to patient-centered outcomes.
METHODS: A narrative review with structured bibliographic search was conducted in PubMed, Embase/Scopus, and Google Scholar. Randomized controlled trials, systematic reviews, and meta-analyses evaluating rehabilitative interventions in adult populations with OSA were included. The search covered exercise training, oropharyngeal myofunctional therapy, inspiratory muscle training, and interdisciplinary lifestyle programs using a comprehensive, multi-term search syntax.
RESULTS: The evidence indicates that rehabilitative interventions lead to consistent improvements in daytime sleepiness, sleep quality, functional capacity, cognitive performance, and quality of life, even when changes in the AHI are modest or variable. Interdisciplinary programs demonstrated the most robust effects, including reductions in AHI exceeding 50% in selected subgroups (INTERAPNEA trial). A recent umbrella review confirmed that structured physical activity achieved the greatest improvements in quality of life among all non-pharmacological interventions evaluated.
CONCLUSION: Rehabilitation represents an essential component of the comprehensive management of OSA, providing clinically meaningful benefits beyond the AHI and reinforcing a therapeutic approach centered on patient functionality and quality of life.