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Effects of acute exercise performed at different times of day on respiratory, blood pressure, and cardiac autonomic modulation outcomes in patients with obstructive sleep apnea: a randomized crossover trial

Journal of Human Hypertension volume 39, pages 841–848 (2025)Cite this article

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Abstract

This study aimed to analyze the effect of acute aerobic exercise at different times of the day on respiratory sleep parameters, blood pressure (BP), and cardiac autonomic modulation in patients with obstructive sleep apnea (OSA). In this randomized cross-over trial, 22 patients with OSA were recruited and completed four experimental sessions in random order: aerobic exercise and control in the morning (8:00–11:00 AM) and in the afternoon (3:30–6:30 PM). Each exercise session consisted of 40 min of aerobic exercise on a treadmill at 54–59% heart rate reserve; each control session consisted of seated rest for 40 min. Measurements were taken in the supine position before and after each session for clinic and central BP and cardiac autonomic modulation (by heart rate variability). After each session, all patients underwent at-home polysomnography using a portable polygraph. Clinic and central systolic BP decreased following both morning (Clinic: −16.1 mmHg; 95%CI = −22.5–−9.7 mmHg; p < 0.001; Central: −13.3 mmHg −21.6–−5.0 mmHg, p = 0.002) and afternoon (Clinic: −11.4 mmHg; 95%CI = −16.8–−5.9 mmHg; p = 0.03; Central: −13.9 mmHg; 95%CI = −20.1–−7.7 mmHg; p < 0.001) exercise sessions; however, no significant difference was observed between sessions. No significant changes were observed regarding diastolic BP, respiratory, or heart rate variability parameters (p > 0.05 for all). In conclusion, a single session of aerobic exercise has no effect on respiratory sleep parameters but led to a similar reduction in systolic blood pressure following both morning and afternoon sessions.

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Fig. 1: Experimental design of the study.
Fig. 2: Flowchart of the study.
Fig. 3: Net-effect of clinic and central blood pressure in obstructive sleep apnea patients.

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Data availability

Additional data are available from the corresponding author on reasonable request.

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Funding

This work was supported by Fundação de Amparo à Ciência de Pernambuco – FACEPE and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES.

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Authors and Affiliations

  1. Sleep and Heart Laboratory, Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Universidade de Pernambuco, Recife, Brazil

    José Lucas Porto Aguiar, Ozeas de Lima Lins-Filho, José Ricardo Vieira de Almeida, Elton Carlos Felinto dos Santos & Rodrigo Pinto Pedrosa

  2. Graduante program in Physical Education, Universidade Federal de Pernambuco, Recife, Brazil

    José Lucas Porto Aguiar, Ozeas de Lima Lins-Filho, José Ricardo Vieira de Almeida & Breno Quintella Farah

  3. Graduate program in Health Sciences, Universidade de Pernambuco, Recife, Brazil

    Elton Carlos Felinto dos Santos & Rodrigo Pinto Pedrosa

  4. Department of Health and Human Development, University of Pittsburgh, Pittsburgh, USA

    Christopher E. Kline

  5. Graduate Program in Movement Sciences, Universidade Federal Rural de Pernambuco, Recife, Brazil

    Breno Quintella Farah

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  1. José Lucas Porto Aguiar
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  2. Ozeas de Lima Lins-Filho
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Contributions

José Lucas Porto Aguiar: data collection, data analysis and manuscript draft Ozeas L. Lins-Filho: study design, data collection, and manuscript draft José RV Almeida: data collection and manuscript draft Elton C Felinto: data collection and manuscript draft Christopher E. Kleine: Review and manuscript draft Rodrigo P Pedrosa: Review and manuscript draft Breno Q. Farah: study design, data analysis, and manuscript draft

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Correspondence to Breno Quintella Farah.

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The study was approved by the institutional review board of the University of Pernambuco in compliance with the Brazilian National Research Ethics System Guidelines.

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Supplementary information

41371_2025_1080_MOESM1_ESM.docx

Supplementary Table S1. Pre-experimental sessions values of blood pressure and heart rate variability in patients with OSA.

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Aguiar, J.L.P., Lins-Filho, O.d.L., Almeida, J.R.V.d. et al. Effects of acute exercise performed at different times of day on respiratory, blood pressure, and cardiac autonomic modulation outcomes in patients with obstructive sleep apnea: a randomized crossover trial. J Hum Hypertens 39, 841–848 (2025). https://doi.org/10.1038/s41371-025-01080-y

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