Effect of Exercise Training on Obstructive Sleep Apnea Syndrome Severity (EXESAS)

Sleep apnoea affects more than 20% of people over 65 years and is largely underdiagnosed. It does multiply tenfold the occurrence of vascular events, particularly stroke. While Continuous Positive Airway Pressure (CPAP) is currently the Gold standard treatment to prevent cerebrovascular and cardiovascular events, with a major clinical benefit, long term adherence to CPAP is a significant problem and search for alternative treatment is essential. The investigators hypothesize that long-term exercise training would allow to reduce significantly sleep apnoea syndrome severity. Thus, in this study, the investigators will compare evolution of Apnoea Hypopnea Index (AHI) in an exercise trained group performed through in a national based non-profit organization (Fédération Française d'éducation Physique et de Gymnastique Volontaire (FFEPGV)) using a medical established program (NeuroGyV) during nine months against a control group receiving only standard dietetic and physical activity counseling.

In this group, patients will perform 3 sessions of one hour per week of the "NeuroGyV" training program. It is a physical activity program with one session of Nordic walking, one session of "aquagym" and one session of gymnastic. Program lasts 9 months.

Percentage of patients with AHI < 15/hour through polysomnography assessment after nine months of follow-up in the training and the control groups

Percentage of patients with AHI<15/hour through polysomnography assessment after three months of follow-up in the training and the control groups.

Percentage of patients with AHI<15/hour through polysomnography assessment after six months of follow-up in the training and the control groups.

Correlation between change in AHI and change in high frequency (HF) of spectral analysis of heart rate variability (parasympathetic index) at 9 months of follow-up in the 2 groups

Correlation between the change in VO2max during stress test, walking distance during 6 minutes and AHI in the two groups

Correlation between the change in daily physical activity energy expenditure (estimated by the POPAQ questionnaire) and AHI in the two groups

Correlation between the daily physical activity energy expenditure (estimated directly by an actimetry sensor for 7 days) and AHI in the two groups

Comparison of the variation of Epworth Sleepiness Scale (ESS) after 9 months follow-up for the two groups

Inclusion Criteria: Patients affiliated or entitled to a social security system Patients with AHI from 15 to 30 per hour Signature of consent Exclusion Criteria: Patients being already treated for sleep apnea or clinical status (cardiovascular comorbidities) justifying an immediate initiation of CPAP Daytime sleepiness (ESS score > 10) Known respiratory or heart disease (or discovering during stress test) contraindicated exercise training Patients with Parkinson's disease

Berger M, Barthelemy JC, Hupin D, Raffin J, Dupre C, Labeix P, Costes F, Gaspoz JM, Roche F. Benefits of supervised community physical activity in obstructive sleep apnoea. Eur Respir J. 2018 Nov 22;52(5):1801592. doi: 10.1183/13993003.01592-2018. Print 2018 Nov. No abstract available.