{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:08:16Z","timestamp":1792030096201,"version":"4.4.0"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Obstructive sleep apnea is the most common sleep disorder. This review aims to evaluate the effectiveness and safety of respiratory muscle training in the treatment of patients with obstructive sleep apnea. The study protocol was registered in Prospero Platform (CRD42018096980). We performed searches in the main databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) via Pubmed; Excerpta Medica dataBASE (Embase) via Elsevier; Cochrane Central Register of Controlled Trials (CENTRAL) via Cochrane Library; Latin American and Caribbean Literature on Health Sciences (LILACS) through the Portal of the Virtual Health Library and Physiotherapy Evidence Database (PEDro) for all randomised\u2013controlled trials published before July 2022. The randomised\u2013controlled trials were assessed for risk of bias and certainty of evidence. Thirteen randomised\u2013controlled trials were included. All studies had an overall high risk of bias. Inspiratory muscle training probably improves systolic blood pressure and sleepiness when compared with sham. However, inspiratory muscle training probably does not improve diastolic blood pressure and maximum expiratory pressure, and may not be superior to sham for apnea\u2013hypopnea index, forced expiratory volume in 1\u2009s, forced vital capacity, sleep quality and quality of life. In addition, it is uncertain whether there is any effect of inspiratory muscle training on maximum inspiratory pressure and physical capacity. Inspiratory muscle training may also improve maximum inspiratory pressure and maximum expiratory pressure compared with oropharyngeal exercises. However, it may not be superior for apnea\u2013hypopnea index, sleep quality, sleepiness, quality of life and functional capacity. When associated with physical exercise, inspiratory muscle training may not be superior to physical exercise alone for maximum inspiratory pressure, maximum expiratory pressure, systolic and diastolic blood pressure, and functional capacity. At the same time, when associated with cardiac rehabilitation exercises, inspiratory muscle training may reduce apnea\u2013hypopnea index, improve inspiratory muscle strength, sleepiness and sleep quality compared with cardiac rehabilitation alone. However, it may not be superior for improving quality of life. Regarding expiratory muscle training, it may improve expiratory muscle strength and sleep quality, but not sleepiness when compared with sham. The evidence on the effects of expiratory muscle training in apnea\u2013hypopnea index is very uncertain.<\/jats:p>","DOI":"10.1111\/jsr.13941","type":"journal-article","created":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T01:59:21Z","timestamp":1685584761000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Respiratory muscle training for obstructive sleep apnea: Systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4498-0410","authenticated-orcid":false,"given":"Andr\u00e9","family":"Silva de Sousa","sequence":"first","affiliation":[{"name":"Programa de P\u00f3s\u2010 Gradua\u00e7\u00e3o em Sa\u00fade Baseada em Evid\u00eancias Universidad Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0863-6500","authenticated-orcid":false,"given":"Aline","family":"Pereira da Rocha","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010 Gradua\u00e7\u00e3o em Sa\u00fade Baseada em Evid\u00eancias Universidad Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6286-5120","authenticated-orcid":false,"given":"Daniela Regina","family":"Brand\u00e3o Tavares","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010 Gradua\u00e7\u00e3o em Sa\u00fade Baseada em Evid\u00eancias Universidad Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9934-2937","authenticated-orcid":false,"given":"Jane \u00c9rika","family":"Fraz\u00e3o Okazaki","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010 Gradua\u00e7\u00e3o em Sa\u00fade Baseada em Evid\u00eancias Universidad Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9758-6148","authenticated-orcid":false,"given":"M\u00e1rcia Val\u00e9ria","family":"de Andrade Santana","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010 Gradua\u00e7\u00e3o em Sa\u00fade Baseada em Evid\u00eancias Universidad Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7180-6285","authenticated-orcid":false,"given":"Virg\u00ednia","family":"Fernandes Mo\u00e7a Trevisani","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010 Gradua\u00e7\u00e3o em Sa\u00fade Baseada em Evid\u00eancias Universidad Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Universidade de Santo Amaro  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1505-877X","authenticated-orcid":false,"given":"Ana Carolina","family":"Pereira Nunes Pinto","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010 Gradua\u00e7\u00e3o em Sa\u00fade Baseada em Evid\u00eancias Universidad Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Universidade Federal do Amap\u00e1  Macap\u00e1 Brazil"},{"name":"Iberoamerican Cochrane Centre \u2010 Biomedical Research Institute Sant Pau (IIB Sant Pau)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.congress-2019.PA4179"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119080336"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.01.012"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(19)30198-5"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0176-8"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2019.101250"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201804-0758OC"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4652"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2018.03.008"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2019.101229"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0110-2016"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2020.07.014"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-021-02364-6"},{"key":"e_1_2_10_15_1","first-page":"31","article-title":"Inspiratory muscle training and obstructive sleep apnea in older persons: A randomized clinical trial","volume":"12","author":"Fischer M. K.","year":"2019","journal-title":"Sleep Science"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2018.02.008"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-018-1025-7"},{"key":"e_1_2_10_18_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins J. P. T.","year":"2022"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.08.010405"},{"key":"e_1_2_10_20_1","volume-title":"The Cochrane Database of Systematic Reviews,","author":"Jen R.","year":"2018"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6506"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1513\/annalsats.202208-719oc"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2017.05.007"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.846532"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-019-01862-y"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2020.01.011"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2021.1852081"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10030471"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/5036585"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S269360"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1089\/chi.2016.0248"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.5152\/TurkThoracJ.2022.21115"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18179248"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00024.2020"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-0360"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-017-1591-5"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsmc.2022.07.006"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/clockssleep4020020"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-010-0377-9"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2017-211152"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.5826"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012770"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2018.06.001"}],"container-title":["Journal of Sleep Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.13941","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T05:01:10Z","timestamp":1715662870000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jsr.13941"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,31]]},"references-count":43,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/jsr.13941"],"URL":"https:\/\/doi.org\/10.1111\/jsr.13941","archive":["Portico"],"relation":{},"ISSN":["0962-1105","1365-2869"],"issn-type":[{"value":"0962-1105","type":"print"},{"value":"1365-2869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,31]]},"assertion":[{"value":"2023-02-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13941"}}