Effects of Inspiratory Muscles Strengthening Among Coronary Patients on the Sleep Apnea Obstructive Syndrome

Effects of Inspiratory Muscles Strengthening Among Coronary Patients on the Sleep Apnea Obstructive Syndrome (SAOS)

Obstructive sleep apnea (OSA) syndrome affects up to 5% of the general population. The prevalence is multiplied by 13 in coronary artery disease (CAD) patients. Many studies have shown that OSA syndrome was the main risk factor for cardiovascular morbidity and mortality (RR = 9.1 [95%, 2.6 to 31.2]).

If the value of treatment with Continuous Positive Airway Pressure (CPAP) in symptomatic CAD patients (daytime sleepiness and/or 2 clinical symptoms with Apnea Hypopnea Index (AHI) ≥ 20) appears to be established, treatment with CPAP in asymptomatic CAD patients (with AHI> 30) may be too demanding. Alternative treatments are rare and results are highly variable. Therefore, it would be interesting to suggest other treatment modalities with moderate coronary and/or minimally symptomatic OSA syndrome.

This study aims to assess the relevance of inspiratory muscles strengthening on reducing AHI in CAD patients with moderate OSA (AHI between 15 and 30).

Inclusion Criteria:

• Patients with moderate OSA (15 <AHI <30)
• Period between acute coronary syndrome and inclusion <60 days
• Patients included in cardiac rehabilitation

Exclusion Criteria:

• Obstructive lung disease with Tiffeneau index less than 70%.
• Restrictive lung disease with a reduction of total lung capacity (TLC)
• Treatment for OSA or clinical context (comorbidity) justifying CPAP
• Congestive heart failure, thoracic surgery by sternotomy
• Spontaneous pneumothorax
• Severe Asthma
• Ruptured eardrum, or another disease of the middle ear, or acute sinusitis