Efficiency of aerobic exercises on snoring and obstructive sleep apnea (OSA): A comprehensive review

Abstract

Background: Obstructive Sleep Apnea (OSA) is a prevalent sleep-related breathing disorder marked by repeated episodes of upper airway obstruction during sleep. While Continuous Positive Airway Pressure (CPAP) remains the gold standard for treatment, its limitations related to adherence and comfort necessitate exploration of non-invasive adjunct therapies. Aerobic exercise has emerged as a promising intervention capable of reducing OSA severity and associated symptoms such as snoring and daytime sleepiness.Objective: To evaluate the efficacy of aerobic exercise in reducing snoring severity and improving clinical outcomes in patients with obstructive sleep apnea, based on synthesized evidence from available literature.Methods: A comprehensive search was conducted through Google Scholar and PubMed. After removing duplicates and applying inclusion criteria, 30 studies were included for qualitative synthesis. Primary outcomes analyzed included the Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), and Pittsburgh Sleep Quality Index (PSQI). The methodology was aligned with PRISMA guidelines.Results: Aerobic exercise interventions consistently demonstrated a significant reduction in AHI (from 28.6±4.2 to 17.0±3.9 events/hour, p<0.001) and ESS scores (from 13.6±2.3 to 7.2±1.8, p<0.01). Improvements were observed even in the absence of substantial weight loss, suggesting benefits beyond fat reduction. Sleep quality (PSQI) and oxygen saturation levels also improved in a majority of the included studies. Adherence to aerobic training programs averaged 83.5%, with no serious adverse events reported.Conclusion: Aerobic exercise is an effective, low-cost, and non-invasive intervention that significantly reduces OSA severity and associated symptoms such as snoring and daytime sleepiness. It can serve as a valuable adjunct or alternative to conventional OSA treatments, especially in patients who are CPAP-intolerant. Future research should focus on defining optimal exercise protocols and long-term benefits across diverse patient populations.