背景與目的：許多文獻證實頦舌肌及橫膈膜吸氣肌的疲乏是造成阻塞性睡眠呼吸中止症發生的主要原因。到目前為止，在舌肌訓練和橫膈膜吸氣肌幫浦肌肉訓練的研究當中，對生活品質、身體活動量及憂鬱做出探討的只佔了少數。因此， 本研究對阻塞性睡眠呼吸中止症對於生活品質、身體活動量及憂鬱的影響進行了探討，並提出了治療後的改善。
研究方法：對六十一位中至重度阻塞性睡眠呼吸中止症候群患者及二十二位正常受試者進行生活品質、身體活動量及憂鬱的比較。另外，中至重度阻塞性睡眠呼吸中止症候群患者將會分成三組（舌肌訓練組、橫膈膜吸氣肌幫浦肌肉訓練組及持續性正壓呼吸器治療組），以各介入方式接受3個月的訓練；之後比較3組受試者接受治療後之效益。
結果：相較於正常受試者，呼吸中止症候群患者舌頭肌肉前突的力量較弱。 此外，其生理健康、心理及生活品質之平均值都來得比較低 (p<0.05) 。 另外，其總活動及中等費力活動量是正常受試者的三分之一。六分鐘走路測試的距離也比正常受試者短。本研究也發現生理健康、心理範疇跟六分鐘走路距離有正相關的關係。但憂鬱卻和生活品質產生負相關。在3個月的訓練後，舌肌訓練組及橫膈膜吸氣肌幫浦肌肉訓練組的受試者在呼吸暫停指數及睡眠品質都有改善。再者，3個訓練組隨著時間的變化，在生理健康、心理、社會關係及生活品質之平均值都有明顯的進步。然而，身體活動量卻沒有改善。然而，六分鐘走路測試的距離隨著時間的變化都有明顯的進步。
結論：相較於正常受試者，呼吸中止症候群患者有較低生活品質及身體活動量。呼吸中止症候群患者經3個月的舌肌訓練和橫膈膜吸氣肌幫浦肌肉訓練後，其效果可與持續性正壓呼吸器治療組的受試者相互兼容。

Background and Purpose: Genioglossus muscle and inspiratory muscle have been showed contributing towards obstructive sleep apnea-hypopnea (OSAH). Nonetheless, currently, little is known about the effects of tongue muscle training (TMT) and threshold inspiratory muscle training (TIMT) on quality of life (QOL), physical activity and depression state. Therefore, aside from evaluating the impacts of OSAH on QOL, physical activity and depression, we would like to evaluate the effects of tongue muscle and inspiratory muscle training on QOL, physical activity and depression.
Methods: 61 moderate to severe OSAH participants were compared with 22 control participants on QOL, physical activity and depression state. In addition, OSAH participants were assigned to TMT, TIMT and CPAP group. Re-evaluations were performed after one month and three months post interventions.
Results: OSAH group was significantly lower in tongue protrusion strength (p<0.05). Besides, the physical, psychological and the average QOL domain scores were significantly lower in OSAH (p<0.05). Moreover, the total physical activity and total moderate activity performed were three-fold lower in OSAH group compared to the age- and BMI- matched control group. In addition, six-minute walk distance achieved by OSAH group was shorter in distance (p<0.05). Physical and psychological domains were positively correlated to the six-minute walk distance while depression score was negatively correlated to all of the domains in WHOQOL (p<0.001). Significant changes were found in AHI and sleep parameters after three months of TMT and TIMT training. After three months of TMT, TIMT and CPAP, significant improvements found over time in physical, psychological, social relationship, and the average QOL, as well as in the depression status and sleepiness level (p<0.05). The physical activity showed no significant changes over time among the groups. However, six-minute walk distance increased over time in TIMT and CPAP groups.
Conclusion(s): Compared to the age- and BMI- matched control group, participants from the OSAH groups had lower QOL, physical activity, 6MWD and tongue protrusion strength that were impaired as a result of OSAH. However, three months of training with either tongue muscle training or threshold inspiratory training is compatible to the gold standard CPAP treatment in patients with moderate to severe OSAH.

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