Impact of respiratory muscle training on sleep disordered breathing in people with tetraplegia: a sub-analysis of a randomised controlled trial.
Claire L Boswell-Ruys, R H Chaminda Lewis, Rachel A McBain et al.
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In 30 seconds
This sub-analysis of a randomised controlled trial examined whether six weeks of supervised respiratory muscle training (RMT) changed sleep-disordered breathing (SDB) or daytime sleepiness in adults with tetraplegia. Of 62 participants, 48 completed home polysomnography at baseline and follow-up. Active RMT increased maximal inspiratory pressure more than sham training (between-group difference 11.8cmH₂O; 95% CI, 5.2–18.4; p = 0.001), but there were no between-group differences in SDB measures or Epworth Sleepiness Scale scores. The authors concluded that RMT did not reduce SDB or daytime sleepiness in this population.
Key findings
- Maximal inspiratory pressure improved more with active RMT than sham, with a between-group difference of 11.8cmH₂O (95% CI, 5.2–18.4; p = 0.001).
- Apnoea-hypopnoea index did not differ between groups (p = 0.553); active-group means were 46 ± 21 and 45 ± 22 events/h, and sham-group means were 44 ± 25 and 40 ± 25 events/h.
- Epworth Sleepiness Scale scores showed no between-group difference (p = 0.952).
Why it matters
The findings distinguish improvement in respiratory muscle strength from improvement in sleep-related outcomes. In people with tetraplegia and severe SDB, greater inspiratory strength after this RMT programme did not translate into lower measured SDB or daytime sleepiness, so these outcomes should not be assumed to improve together.
What to keep in mind
Only 48 of 62 participants completed both home polysomnograms, and the intervention and follow-up lasted six weeks.