Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023, 167(4):390-394 | DOI: 10.5507/bp.2023.022

Comprehensive home-based telerehabilitation in a morbidly obese male patient with severe obstructive sleep apnea. A case report

Jakub Hnatiak1, 2, Lujza Zikmund Galkova2, 3, Petr Winnige1, 4, Ladislav Batalik1, 4, Filip Dosbaba1, Ondrej Ludka5, Jan Krejci2
1 Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
2 1st Department of Internal Medicine - Cardioangiology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
3 Cardiovascular Sleep Center, 1st Department of Internal Medicine - Cardioangiology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
4 Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
5 Department of Internal Medicine, Geriatrics and Practical Medicine, University Hospital Brno, Brno, Czech Republic

Background: Rehabilitation may be an effective additional treatment method in patients with obstructive sleep apnea (OSA). Physical exercise, weight reduction, pulmonary rehabilitation, and myofunctional therapy (MT) represent beneficial components of rehabilitation recommended as a possible adjunct to standard OSA treatment.

Methods and Results: A 54-year-old man with morbid obesity, long-lasting snoring, breathing pauses, frequent waking, as well as persistent drowsiness and fatigue during the day underwent polysomnography (PSG) to investigate suspected OSA. Severe OSA was confirmed by PSG and a 12-week comprehensive, home-based telerehabilitation program (tele-RHB program) along with continuous positive airway pressure (CPAP) therapy was implemented. The tele-RHB program included regular teleconsultations, aerobic-endurance training, MT, inspiratory and expiratory muscle training, as well as recommendations on proper nutrition, a healthy lifestyle, and behavioral changes. Following the treatment, the patient's quality of life (QoL), exercise capacity, lung function, and OSA severity significantly improved. The patient achieved an overall 19.9 kg reduction in weight, of which 16.2 kg was body fat, and his apnea-hypopnea index decreased by 42.6 episodes/hour.

Conclusion: Our case report suggests that the comprehensive home-based tele-RHB program adjunct to CPAP therapy may be a novel approach for improving OSA severity, a patient's QoL, exercise capacity, lung function and body composition. It is important to note that such a program should be optional, however it may be needed to achieve the highest possible overall improvement in a patient's life. Further clinical investigations are needed to determine the therapeutic efficacy and clinical potential of this tele-RHB program.

Keywords: obstructive sleep apnea, obesity, rehabilitation, telerehabilitation, polysomnography, continuous positive airway pressure

Received: March 21, 2023; Revised: April 27, 2023; Accepted: May 19, 2023; Prepublished online: June 1, 2023; Published: December 4, 2023  Show citation

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Hnatiak, J., Galkova, L.Z., Winnige, P., Batalik, L., Dosbaba, F., Ludka, O., & Krejci, J. (2023). Comprehensive home-based telerehabilitation in a morbidly obese male patient with severe obstructive sleep apnea. A case report. Biomedical papers, 167(4), 390-394. doi: 10.5507/bp.2023.022
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