PS-BPC09-2: EFFECTIVENESS OF OROPHARYNGEAL EXERCISES AND PRANAYAMA ON BLOOD PRESSURE, AND QUALITY OF SLEEP AMONG HYPERTENSIVE WITH MODERATE OBSTRUCTIVE SLEEP APNEA.

Abstract

Introduction and Objectives: Burden of cardiovascular disease around the global is a major health concern and prevalence is high in adults with obstructive sleep apnea (OSA). Lowering blood pressure (BP) can greatly reduce cardiovascular disease risk and lifestyle modification including regular physical activity is routinely prescribed to achieve this goal. The relationship between sleep disordered breathing especially obstructive sleep apnea (OSA) and hypertension has been well investigated in both cross sectional and longitudinal studies. Many people with OSA suffer from severe fatigue and daytime sleepiness with poor exercise intolerance due to poor sleep quality and nocturnal hypoxemia. The objectives of this study was To evaluate the efficacy of a 6 week oropharyngeal exercises and Pranayama training program for reducing blood pressure and improving sleep quality in hypertensive patients with OSA . Design and method: This is a single site double blind randomized clinical trial. Total 40 patients with history of hypertension and moderate sleep apnea were selected that further divided into two groups oropharyngeal exercises and Pranayama group and control group. Patients were evaluated at study entry and at end by evaluating blood pressure pulse rate anthropometric measurements snoring frequency (range 0 to 4) and Pittsburgh sleep quality (0 to 21) questionnaires. After initial evaluation oropharyngeal exercises and Pranayama along with regular brisk walking for 30 to 40 mins 5 days in week is prescribed to experimental group. Pranayama consists of three phases: Puraka (inhalation) kumbhaka (retention) and rechaka (exhalation) that can be either fast or slow. Oropharyngeal exercises refers to 12 exercises of the 20 minutes duration involving tongue (4 exercises) soft palate (2 exercises) jaw (2 exercises) and lateral pharyngeal wall (4 exercises) to be performed twice a day for 6 weeks. The exercises were taught individually and were supplemented with a pamphlet for reinforcement. And only regular brisk walking for 30 to 40 mins 5 days in week is prescribed to control group. Results: Experimental group significantly (p < 0.05) decreased systolic & diastolic blood pressure snoring neck circumference and improved sleep quality. Heart rate changes were insignificant (p = 0.9). Conclusions: Oropharyngeal exercises and Pranayama are effective in reducing blood pressure and snoring in hypertensive patients with moderate OSA. Its also effective in improving in quality of sleep in these patients.