In this report by SADE OGUNTOLA, experts highlight the importance of physical activity as a preventive measure against weight gain and in alleviating sleep apnea and its complications, including hypertension.
IT is not exactly a secret that getting regular exercise helps ensure better sleep. It is a simple formula. It is not only because of the health benefits of exercising regularly, but the obvious benefit in promoting healthy sleep.
National Sleep Foundation in a recent poll to find out just how significant the connection between sleep apnea and exercise really revealed that, among people who claim to exercise, 67 per cent report that they sleep well, claiming that they “rarely or never” experienced sleep-loss symptoms like insomnia, difficulty falling asleep, or waking up too early.
Sleep apnea is a common sleep-related breathing disorder. Snoring itself—though annoying—is not the same as sleep apnea. People with sleep apnea do not take in enough oxygen. This makes them gasp and often wake up. In many cases, people are unaware that they have stopped breathing, and believe that their sleep cycle is normal. Sleep apnea sounds like snoring.
During sleep, the space behind the tongue narrows, and the tissue around it becomes floppy and relaxed. When air gets forced through while breathing, the tissue flutters, making noise like a flag whipping in the wind.
People with sleep apnea might also suffer from unexplained fatigue and mood swings, because their breathing interruptions continually wake them and prevent them from settling into a deep, nourishing sleep.
But only 39 per cent of people who do not exercise regularly claim they still sleep well. Half of those non-exercisers say they frequently wake up during the night, and 24 per cent say they have trouble falling asleep.
Much more, just a mild increase in physical activity, such as walking, was associated with a 10 per cent reduction in the risk of developing obstructive sleep apnea (OSA) in a study published in the Journal of Clinical Sleep Medicine.
Interestingly, walking at a moderate pace for 20 minutes or increasing vigorous daily activity by just eight minutes would be enough to achieve a lower sleep apnea risk.
This is the largest published study to date which focused on the relationship between OSA and levels of physical activity in the general population. The researchers looked at lifestyle, medical, socio-demographic and sleep health data obtained from more than 155,000 adults participating in the Ontario Health Study.
The observational population-based study evaluated baseline questionnaire data from 155,448 adult residents of Ontario, Canada. Their average age was 46 years. Nearly seven per cent of participants reported being told by a doctor that they had sleep apnea. Those with OSA were more sedentary, sitting for a median of 4.4 more hours per week than those without OSA.
Dr Ayotunde Fasunla, an Ear, Nose Throat specialist at the University College Hospital (UCH), Ibadan, stated that sleep apnea means simply that breathing ceases intermittently when sleep occurs for many reasons, including obstruction in the airway due to a growth, poor tone of the muscles of the airway, adenoids (a growth at the back of the mouth), tonsils (a growth at the entrance of the airway) and infectious diseases such as catarrh.
He, however, said cases of obstructive sleep apnea which cause such things as enlarged adenoids and tonsils, which are growths in the throat, poor tone of the muscles of the throat and infectious diseases such as catarrh may not be prevented or ameliorated by exercises but only through surgery and medication. Also, breathing devices may be helpful, particularly in milder cases.
According to him, “The tonsils and adenoids are part of the immunological system in the body. They are at the gateway to our respiratory and digestive tracts. They help to remove organisms, dirt, allergens and things that may be injurious to the respiratory and digestive tracts. In doing this, they become bigger and bigger in size every day, gradually blocking the airway.”
Dr Fasunla, however, said exercise might help in preventing or reducing severity of OSA in individuals with pot belly, especially those that also have big neck circumference since they are likely to have fat accumulate also in the airway.
According to him, in these individuals, exercising will help burn the accumulated fat in the airway and tone the muscles in the region, thus alleviating the severity of OSA.
He warned that exercising would not alleviate an OSA due to sleeping pills or intake of alcohol. “Sleep medications are supposed to help relax the muscles of the body to ensure sleep, including the muscles in the airway. Similarly, intake of large quantity of alcoholic drinks too relaxes the throat muscles that control breathing, leading to snoring and an interrupted sleep cycle.”
Dr Temitope Farombi, a consultant neurologist at the Chief Tony Anenih Geriatric Centre, UCH, Ibadan, said cases of OSN caused by diseases such as COPD in that they have air hunger already and exercising can actually help.
He declared that in instances such as obesity–related OSN, exercise might be prescribed, an appropriate exercise and timing are important to ensure that it is not counterproductive.
“The exercise must not be vigorous because it can be counterproductive. It also shouldn’t be towards bedtime. Over-stressing the body can stimulate stress hormones and other chemicals that are stressors too to the body. So, it must be timed and be the appropriate type of exercise. In such individuals, quality sleep is just one of the benefits of exercising; a good sleep will also reduce the individual’s risk of having such diseases as dementia, stroke, memory loss and even hypertension. OSN can also worsen these diseases.”
Professor Aderonke Akinpelu, an honorary consultant at the department of physiotherapy, UCH, Ibadan corroborated that exercise is good for everyone irrespective of age and social class, even if it is not aimed at promoting a good sleep.
“In fact, it is important that the habit of regular exercise is developed from childhood. Sleep is very important to our general health and also in preventing illnesses,” she added.
Akinpelu stated that individuals have a higher likelihood to snore, regular exercising can bring down their body weight and tone the muscles in the throat and thus can make breathing easier. However, she stated that science is yet to fully understand the mechanism by which exercise actually benefits the problem of OSN, “but certainly, aerobic exercises lasting for at least 30 minutes, preferably every day or at least three times a week. Gradual build-up on minutes of exercise is important to prevent muscle soreness. It will certainly benefit the whole body, including the breathing system and also improve blood circulations to different parts of the body.”
Conversely, the result of the study that highlights the importance of physical activity as a preventive measure against developing sleep apnea indicated that adults with increased levels of physical activity, including vigorous-intensity exercise and walking, had a lower risk of obstructive sleep apnea (OSN). Not only vigorous physical activity, but also just walking alone, was associated with a decreased risk of sleep apnea.
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