Inspiratory Muscle Strength Training for Sleep-related Breathing Disorders

Respiratory Strength Training Mitigates Hypertension and Sleep Fragmentation in Obstructive Sleep Apnea

The purpose of the current study is to investigate the effects of a novel breathing training, called inspiratory muscle strength training (IMST), on sleep patterns, breathing and blood pressure for patients diagnosed with mild, moderate and severe sleep apnea.

Aims of the study:

1. To determine the influence of IMST on resting blood pressure and baroreceptor sensitivity.
2. To determine the effect of IMST on sympathetic nervous system by measuring plasma cathecholamines and nerve recording (MSNA).

Population:

30 subjects aged 30-75 years, who have previously been diagnosed with obstructive sleep apnea, as defined by the National Institutes of Health (National Heart Lung, and Blood Institute) will be included in this study.

Study Protocol:

• Pre-training assessment and overnight sleep study
• 5-10 minutes each day breathing training (IMST) at home using a hand-held device for 6 weeks
• Once weekly laboratory visit
• Post-training assessment and overnight sleep study

Pre- and post-training assessment include blood pressure measurement, body weight, neck circumference, cardiorespiratory monitoring, nerve recording, blood draw and sleep surveys.

Inclusion Criteria:

• Age 30-75 years
• Diagnosed with Obstructive Sleep Apnea with Apnea Hypopnea Index (AHI) > 15
• Neck circumference > 16 cm

Exclusion Criteria:

• Body mass index (BMI) > 40kg/m2
• Implanted pacemaker
• On anticoagulant medication
• On hypnotic medication
• On immunosuppressive medication
• Acute or recent (3 months prior to study) infection
• History of hypothyroidism
• History of stroke or neuromuscular disease
• Moderate to severe heart failure
• Severe ischemic heart disease
• Severe obstructive and restrictive lung disease
• Cor pulmonale
• Cognitive disorders
• Obstructive nasal disease or history of spontaneous pneumothorax or rib fracture
• History of neurological, respiratory, head /neck, or thoracic surgery