Comprehensive home-based telerehabilitation in a morbidly obese male patient with severe obstructive sleep apnea. A case report.

continuous positive airway pressure obesity obstructive sleep apnea polysomnography rehabilitation telerehabilitation

Journal

Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
ISSN: 1804-7521
Titre abrégé: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub
Pays: Czech Republic
ID NLM: 101140142

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 21 03 2023
accepted: 19 05 2023
pubmed: 14 6 2023
medline: 14 6 2023
entrez: 14 6 2023
Statut: ppublish

Résumé

Rehabilitation may be an effective additional treatment method in patients with obstructive sleep apnea (OSA). Physical exercise, weight reduction, pulmonary rehabilitation, and myofunctional therapy (MT) represent beneficial components of rehabilitation recommended as a possible adjunct to standard OSA treatment. A 54-year-old man with morbid obesity, long-lasting snoring, breathing pauses, frequent waking, as well as persistent drowsiness and fatigue during the day underwent polysomnography (PSG) to investigate suspected OSA. Severe OSA was confirmed by PSG and a 12-week comprehensive, home-based telerehabilitation program (tele-RHB program) along with continuous positive airway pressure (CPAP) therapy was implemented. The tele-RHB program included regular teleconsultations, aerobic-endurance training, MT, inspiratory and expiratory muscle training, as well as recommendations on proper nutrition, a healthy lifestyle, and behavioral changes. Following the treatment, the patient's quality of life (QoL), exercise capacity, lung function, and OSA severity significantly improved. The patient achieved an overall 19.9 kg reduction in weight, of which 16.2 kg was body fat, and his apnea-hypopnea index decreased by 42.6 episodes/hour. Our case report suggests that the comprehensive home-based tele-RHB program adjunct to CPAP therapy may be a novel approach for improving OSA severity, a patient's QoL, exercise capacity, lung function and body composition. It is important to note that such a program should be optional, however it may be needed to achieve the highest possible overall improvement in a patient's life. Further clinical investigations are needed to determine the therapeutic efficacy and clinical potential of this tele-RHB program.

Sections du résumé

BACKGROUND BACKGROUND
Rehabilitation may be an effective additional treatment method in patients with obstructive sleep apnea (OSA). Physical exercise, weight reduction, pulmonary rehabilitation, and myofunctional therapy (MT) represent beneficial components of rehabilitation recommended as a possible adjunct to standard OSA treatment.
METHODS AND RESULTS RESULTS
A 54-year-old man with morbid obesity, long-lasting snoring, breathing pauses, frequent waking, as well as persistent drowsiness and fatigue during the day underwent polysomnography (PSG) to investigate suspected OSA. Severe OSA was confirmed by PSG and a 12-week comprehensive, home-based telerehabilitation program (tele-RHB program) along with continuous positive airway pressure (CPAP) therapy was implemented. The tele-RHB program included regular teleconsultations, aerobic-endurance training, MT, inspiratory and expiratory muscle training, as well as recommendations on proper nutrition, a healthy lifestyle, and behavioral changes. Following the treatment, the patient's quality of life (QoL), exercise capacity, lung function, and OSA severity significantly improved. The patient achieved an overall 19.9 kg reduction in weight, of which 16.2 kg was body fat, and his apnea-hypopnea index decreased by 42.6 episodes/hour.
CONCLUSION CONCLUSIONS
Our case report suggests that the comprehensive home-based tele-RHB program adjunct to CPAP therapy may be a novel approach for improving OSA severity, a patient's QoL, exercise capacity, lung function and body composition. It is important to note that such a program should be optional, however it may be needed to achieve the highest possible overall improvement in a patient's life. Further clinical investigations are needed to determine the therapeutic efficacy and clinical potential of this tele-RHB program.

Identifiants

pubmed: 37313735
doi: 10.5507/bp.2023.022
doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

390-394

Déclaration de conflit d'intérêts

The authors report no conflicts of interest in this work.

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Auteurs

Jakub Hnatiak (J)

Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic.
1st Department of Internal Medicine - Cardioangiology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Lujza Zikmund Galkova (LZ)

1st Department of Internal Medicine - Cardioangiology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Cardiovascular Sleep Center, 1st Department of Internal Medicine - Cardioangiology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Petr Winnige (P)

Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic.
Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Ladislav Batalik (L)

Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic.
Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Filip Dosbaba (F)

Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic.

Ondrej Ludka (O)

Department of Internal Medicine, Geriatrics and Practical Medicine, University Hospital Brno, Brno, Czech Republic.

Jan Krejci (J)

1st Department of Internal Medicine - Cardioangiology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Classifications MeSH