Obstructive sleep apnoea happens when breathing is either stopped or reduced during sleep because of a narrowing or blockage of the upper airway (passage to the lungs). It causes loud snoring and occasional apnoea (stopping breathing). It can lead to daytime sleepiness and may cause, hypertension, stroke and road accidents. Lifestyle modification, especially weight loss, sleep hygiene and exercise, are often recommended. These could help by relieving pressure on the upper airway, and increasing muscle tone in the airway. However, the review found no trials to assess the effects of these strategies, and more research is needed.
There is a need for randomised controlled trials of these commonly used treatments in obstructive sleep apnoeas. These should identify which sub groups of patients with sleep apnoeas benefit most from each type of treatment and they should have clear and standardised outcome measures.
Obstructive sleep apnoeas are due to transient closure of the upper airway during sleep and merge into hypopnoeas in which the airway narrows, but some airflow continues. They are due to the forces compressing the airway overcoming those which stabilise its patency. The commonest association is obesity in which fatty tissue is deposited around the airway. Exercise has been recommended as a method of losing weight, but other techniques which achieve this are also thought to improve symptoms due to sleep apnoeas. Sleep hygiene may alter the sleep structure and the control of the upper airway during sleep and thus promote its patency.
The objectives of this review are to determine whether weight loss, sleep hygiene and exercise are effective in the treatment of obstructive sleep apnoeas.
The Cochrane Airways Group Specialised Register, CENTRAL, MEDLINE, EMBASE, CINAHL and reference lists of review articles have been searched. The date of the last search was April 2009.
Randomised, single or double blind placebo controlled, either parallel group or crossover design studies of any of these interventions were to have been included.
No completed trials have been identified.
No randomised trial data were available for analysis. An update search has identified a study presented in abstract form only. The findings from one additional ongoing study are awaited.