Effects of aerobic exercise training combined with cognitive behavioral therapy on blood pressure, exercise tolerance, and sleep quality in patients with sleep disorders
10.3760/cma.j.cn341190-20240713-00899
- VernacularTitle:有氧运动训练联合认知行为疗法对睡眠障碍患者血压、运动耐量和睡眠质量的影响
- Author:
Jiaxi PAN
1
;
Yunrui ZHANG
1
;
Fanqi KONG
1
Author Information
1. 温州医科大学第三附属医院 瑞安市人民医院心血管内科，瑞安 325200
- Publication Type:Journal Article
- Keywords:
Sleep initiation and maintenance disorders;
Exercise therapy;
Cognitive therapy;
Prehypertension;
Exercise tolerance
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(2):214-221
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of aerobic exercise training combined with cognitive behavioral therapy on blood pressure, exercise tolerance, and sleep quality in patients with sleep disorders complicated by high-normal blood pressure.Methods:A total of 60 individuals with sleep disorders complicated by high-normal blood pressure, who underwent community health screening and received treatment at the Third Affiliated Hospital of Wenzhou Medical University (Ruian People's Hospital) from February 2022 to February 2024, were prospectively included in this study. The patients were randomly assigned to two groups using a random number table: a cognitive therapy group and a combined intervention group, with 30 patients in each group. The cognitive therapy group received cognitive behavioral therapy, while the combined intervention group received both aerobic exercise training and cognitive behavioral therapy. Changes in blood pressure, the proportion of patients with elevated blood pressure, exercise tolerance, and Pittsburgh Sleep Quality Index (PSQI) score were compared between the two groups. Additionally, the overall effective rate of treatment for sleep disorders was evaluated for both groups.Results:Before intervention, there was no statistically significant difference in blood pressure between cognitive therapy and combined intervention groups ( P > 0.05). After intervention, the 24-hour mean systolic blood pressure was (121.63 ± 3.47) mmHg (1 mmHg = 0.133 kPa) for the cognitive therapy group and (114.56 ± 3.07) mmHg for the combined intervention group. The 24-hour mean diastolic blood pressure was (81.03 ± 2.78) mmHg for the cognitive therapy group and (77.59 ± 2.09) mmHg for the combined intervention group. Both the 24-hour mean systolic and diastolic blood pressures in each group significantly decreased when compared with the values recorded before intervention ( t = 10.54, 17.52, 5.52, 10.68, all P < 0.05). After intervention, both the 24-hour mean systolic and diastolic blood pressures in the combined intervention group were significantly lower than those in the cognitive therapy group ( t = 8.36, 5.41, both P < 0.001). Before intervention, there was no statistically significant difference in the proportion of patients with elevated blood pressure between the two groups ( P > 0.05). After intervention, the proportion of patients with elevated blood pressure was 40.00% (12/30) in the cognitive therapy group and 66.67% (20/30) in the combined group. Both groups showed a significant increase in the proportion of patients with elevated blood pressure compared with pre-intervention values ( χ2 = 4.02, 11.38, both P < 0.05). After intervention, the proportion of patients with elevated blood pressure in the combined intervention group was significantly higher than that in the cognitive therapy group ( χ2 = 4.28, P < 0.05). Before intervention, there was no significant difference in exercise tolerance between the two groups ( P > 0.05). After intervention, the combined intervention group showed significant increases in anaerobic threshold [(1 475.25 ± 415.65) mL/min] and oxygen pulse [(14.78 ± 2.86) mL/beat] compared with pre-intervention values ( t = 3.58, 7.49, both P < 0.05). However, there was no significant difference in the carbon dioxide ventilation equivalent (VE/VCO 2@VCP) at the ventilatory compensation point compared with pre-intervention levels ( P > 0.05). After intervention, the anaerobic threshold and oxygen pulse in the combined intervention group were significantly higher than those in the cognitive therapy group [(1 137.41 ± 349.86) mL/min, (9.94 ± 2.05) mL/beat] ( t = -3.40, -7.53, both P < 0.05). There was no significant difference in exercise tolerance in the cognitive therapy group between pre- and post-intervention ( P > 0.05). Before intervention, there was no significant difference in PSQI score between cognitive therapy and combined intervention groups ( P > 0.05). After intervention, score for sleep quality [(1.65 ± 0.26) points , (1.24 ± 0.23) points], sleep onset time [(1.51 ± 0.19) points, (1.33 ± 0.18) points], sleep time [(1.47 ± 0.23) points, (1.31 ± 0.20) points], sleep efficiency [(1.31 ± 0.20) points, (1.05 ± 0.19) points], sleep disturbance [(0.93 ± 0.15) points, (0.77 ± 0.20) points], hypnotic medication use [(0.96 ± 0.22) points, (0.67 ± 0.17) points], and daytime function [(1.19 ± 0.25) points, (1.02 ± 0.22) points] decreased in both groups compared with pre-intervention scores ( t = 8.21, 15.58, 9.86, 14.76, 10.02, 15.36, 8.78, 17.59, 7.84, 12.36, 5.74, 11.98, 12.03, 17.14, all P < 0.05). After intervention, PSQI score in the combined intervention group was significantly lower than that in the cognitive therapy group ( t = 6.46, 3.76, 2.87, 5.16, 3.50, 5.71, 2.79, all P < 0.05). The total effective rate for treating sleep disorders in the combined intervention group was 86.67% (26/30), which was significantly higher than that in the cognitive therapy group [63.33% (19/30), χ2 = 4.35, P < 0.05). Conclusions:Aerobic exercise training combined with cognitive behavioral therapy can improve exercise tolerance, reduce blood pressure, and enhance sleep quality in patients with sleep disorders and high-normal blood pressure.
