College of Medicine – Tucson clinical trial investigating a simple breathing exercise for obstructive sleep apnea

Researchers at the University of Arizona College of Medicine – Tucson, part of UArizona Health Sciences, are starting a Phase II clinical trial to evaluate the long-term effectiveness of a unique breathing training protocol known as “inspiratory muscle training” for lowering blood pressure and improving cardiovascular health in adults with obstructive sleep apnea.

E. Fiona Bailey, PhD, a professor in the Department of Physiology at UArizona College of Medicine – Tucson, has received a five-year grant of $ 3.4 million from the National Institute on Aging, a division of the National Institutes of Health, to study previous research her group that showed that breathing exercise with 30 breaths a day can lower blood pressure.

“High blood pressure is a major risk factor for cardiovascular disease, which is the number one killer in America. Five minutes of inspiratory muscle training per day, consisting of just 30 inspiratory efforts against resistance, offers an inexpensive, non-pharmacological way to improve both sleep quality and blood pressure, ”said Dr. Bailey, who specializes in respiratory physiology.

Obstructive sleep apnea is a serious condition in which the muscles of the throat relax and collapse inward while you sleep, preventing air from reaching the lungs for a short period of time. This leads to a lack of oxygen and repeated awakening from sleep. Together, the lack of oxygen at night and the inability to sleep uninterruptedly contribute to an increased risk of high blood pressure and cardiovascular disease. Previous research has shown that around 50% of adults in the US and nearly 1 billion people worldwide have obstructive sleep apnea.

The new clinical study offers Dr. Bailey and her research team, which includes staff from the University of Colorado at Boulder, gave the opportunity to do six-month inspiratory muscle training in a larger group of 50- to 80-year-old adults with obstructive sleep apnea and above-average blood pressure. The team will monitor the participants three months after the end of the training to see how long the antihypertensive effects last.

Study participants will undergo an initial screening of cardiovascular, respiratory and sleep health. Eligible participants are randomly assigned to one of two training groups, one emphasizing high resistance training and the other emphasizing low resistance training. Participants in both groups do their training at home and take 30 breaths a day, 5 days a week for 24 weeks.

Respiratory muscle training was originally developed for athletes and people with breathing problems such as chronic obstructive pulmonary disease, asthma and bronchitis. Dr. Bailey adapted the protocol for daily use by adults with obstructive sleep apnea. In its current form, the inspiratory muscles can be trained at home, at work or when traveling with a hand-held training device similar to an inhaler.

Results of previous studies by Dr. Bailey’s group showed that inspiratory muscle training builds respiratory muscle strength and has a surprising secondary benefit – it lowers blood pressure. The decrease in blood pressure is greater than that obtained with traditional aerobic exercise and in many cases can exceed the decreases achieved with blood pressure medication. The results of this early work are published in the journals Sleep and the Journal of Applied Physiology.

Continuous positive airway pressure (CPAP) is the standard therapy for obstructive sleep apnea and is effective in reducing oxygen starvation during sleep, but many users find they cannot tolerate it all night.

Regular aerobic exercise can help and is important for cardiovascular health, but current recommendations are 150 minutes per week of moderate intensity. This amount of exercise can be difficult to achieve – less than 30% of American adults reach this minimum – and can be particularly challenging for adults with obstructive sleep apnea, many of whom experience chronic fatigue and excessive daytime sleepiness.

“New cost-effective and time-efficient strategies are needed to manage the health problems caused by obstructive sleep apnea,” said Dr. Bailey, also a member of the BIO5 Institute. “It is critical that we develop new approaches to help people keep their blood pressure under control and improve cardiovascular health.”

Dr. Bailey was recently appointed by Drs. Douglas Seals and Daniel Craighead of the Boulder Department of Integrative Physiology at the University of Colorado. In this study, they showed that six weeks of inspiratory muscle strength training in older adults with above-average blood pressure lowered blood pressure and improved arterial health, which contributed to an overall reduction in the risk of cardiovascular disease.

For more information on participating in the clinical trial, contact Lupita Ramos-Barrera at 520-626-0836 or [email protected] or visit https://redcap.link/breathe.

The research discussed in this publication is supported by the National Institute of Aging, a unit of the National Institutes of Health (R01AG065346-01A1). This project was approved by the University of Arizona Institutional Review Board.