Breathing Exercise Can Help With Fatigue, Daytime Sleepiness in Patients With OSA

A randomized, controlled, experimental study found that a breathing exercise decreased fatigue and daytime sleepiness at the end of the fourth and eighth weeks of an intervention in patients with obstructive sleep apnea (OSA).

Patients with obstructive sleep apnea (OSA) tend to experience symptoms including daytime sleepiness, loud snoring, and respiratory-related events. A study published in the Journal of Breath Research found that a breathing exercise could help decrease fatigue and daytime sleepiness in patients with a diagnosis of OSA.

The study was conducted with patients who applied to the chest disease outpatient clinic of Gaziantep University in Turkey. Participants were included in the study if they had volunteered themselves, were literate, had a phone and internet connection to make video calls, had no chronic obstructive pulmonary disease diagnosis, were diagnosed with OSA, had a mild or moderate apnea-hypopnea index, needed to use a positive airway pressure device, had no central sleep apnea, were 18 years or older, and had no mental confusion or psychiatric disorder.

All data were collected using a custom questionnaire, the Epworth Sleepiness Scale (ESS), and the Piper Fatigue Scale (PFS). Patients in the intervention group (n = 30) were taught the breathing exercise, which involved breathing through pursed lips and the diaphragm, and each patient in the intervention group virtually attended 2 sessions of breathing exercises per day for 10 to 15 minutes. The control group (n = 30) did not receive the breathing exercise intervention. Patients in both groups were administered the questionnaire, PFS, and ESS at baseline, 4 weeks later, and 8 weeks later.

The mean age of the intervention and control groups was 49.1 years and 46.93 years, respectively. Patients who had a diagnosis of OSA for 2 or more years made up 93.3% and 63.3% of the intervention and control groups, respectively.

The multidimensional analyses found that the mean score of the group time interaction of daytime sleepiness and fatigue was significant, which indicated that the pursed lip and diaphragmatic breathing exercise was effective in reducing daytime sleepiness and total fatigue level (both P = .001).

The mean PFS score in the intervention group decreased from 6.15 before the training session to 5.34 by the 8-week mark, whereas that in the control group increased from 5.59 to 5.77.

Similar patterns in ESS scores were observed, decreasing from 12.13 to 9.13 in the intervention group but increasing from 10.37 to 10.5 in the control group.

Anecdotally, the authors quoted patients in the intervention group as reporting being able to breathe more deeply and walk further during the day.

A limitation of this study was that daytime sleepiness and fatigue were measured only with scales.

The researchers concluded that the mean scores of fatigue and daytime sleepiness decreased at the end of the fourth and eighth weeks of the intervention in patients who used the respiratory exercise. They also determined that the mean scores of the patients in the control group increased at the end of the fourth and eighth weeks.


Serce S, Ovayolu O, Bayram N, Ovayolu N, Kul S. The effect of breathing exercise on daytime sleepiness and fatigue among patients with obstructive sleep apnea syndrome. J Breath Res. 2022;16:046006. doi:10.1088/1752-7163/ac894d