High-intensity interval training combined with resistance training improved apnea-hypopnea index but did not modify oxygen desaturation index and oxygen saturation nadir in obese children with obstructive sleep apnea



To investigate the effect of high-intensity interval training (HIIT) combined with resistance training (RT) on sleep indices and vascular functions in obese children with obstructive sleep apnea (OSA).


A quasi-experimental study. Forty-four obese children with OSA were allocated into either an exercise intervention (n = 22) or a usual care control group (n = 22). The exercise group received 24 min of HIIT (> 60% heart rate reserved) and 20 min of RT (50–80% one-repetition maximum), three times per week for 8 weeks. Primary outcomes included the apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and oxygen saturation (SaO2) nadir. Secondary outcomes included the Sleep-Related Breathing Disorder-Pediatric Sleep Questionnaire (SRBD-PSQ) scores, vascular functions (flow-mediated dilation and mean blood flow velocity), and anthropometric variables. Outcomes were measured at baseline, at week 8, and at week 16.


No baseline differences were observed between groups. The compliance rate of exercise training was 99.47%. The AHI significantly decreased in the exercise group compared with the control group at week 16 (median AHI 1.30 to 0.60 and 1.00 to 1.60 episode/h, p = 0.01), but not at week 8. There were no differences between the groups in regard to the ODI and SaO2 nadir and any secondary outcomes at weeks 8 and 16 (all p > 0.05).


The eight-week HIIT combined with RT decreased AHI in obese children with OSA at week 16 follow-up. No changes in the ODI, SaO2 nadir, SRBD-PSQ, vascular function, and anthropometric outcomes were revealed at any time point. Further research is warranted.

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The authors would like to thank Miss Pimchanok Malasam, Miss Duanghathai Pasanta, and Mr. Porama Thepsiri for the data collection process and Mr. Nitinet Ketsuwan for assisting in exercise training sessions. Importantly, we are obliged to all of the children and their parents, who dedicated time to participate in this study.


This study was supported financially by the Faculty of Associated Medical Sciences (AMS Research Grant 6/2560) and the Graduate School of Chiang Mai University, Chiang Mai, Thailand.

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Corresponding author

Correspondence to Sainatee Pratanaphon.

Ethics declarations

This study was approved by the Research Ethics Committee, Faculty of Medicine, Chiang Mai University (#033/2017). All participants and their parents provided written informed consent (Thai Clinical Trials Registry: TCTR20170209001).

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Written informed consent was received from parents or legal guardians of the children, and written assent was obtained from children over 7 years old prior to commencement of this study.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Helsinki Declaration and its later amendment or comparable ethical standards. This study was approved by the Research Ethics Committee, Faculty of Medicine, Chiang Mai University.

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Longlalerng, K., Sonsuwan, N., Uthaikhup, S. et al. High-intensity interval training combined with resistance training improved apnea-hypopnea index but did not modify oxygen desaturation index and oxygen saturation nadir in obese children with obstructive sleep apnea. Sleep Breath 24, 571–580 (2020). https://doi.org/10.1007/s11325-019-01899-z

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  • High-intensity interval training
  • Resistance training
  • Polysomnographic indices
  • Vascular function
  • Obstructive sleep apnea