Abstract Recent studies suggest that physical exercise can be an alternative intervention to reduce the severity of obstructive sleep apnea (OSA). However, whether physical activity (PA) recommendations are suitable for patients with OSA remains unclear. To evaluate the effectiveness of general physical activity recommendations in improving OSA in adults. A comprehensive search was conducted in the PubMed/MedLine, Scopus, Cochrane Library, and EMBASE databases, including studies published up to August 2025. This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in PROSPERO (#CRD42023430359). Metanalyses were performed using the Review Manager software. A total of 3818 studies were found, of which 40 were included in the qualitative analysis and 25 in the quantitative analysis. There is a greater range of studies combining aerobic and resistance exercises, particularly using moderate intensity. In the quantitative analysis, it was observed that physical exercise significantly reduced the apnea-hypopnea index (AHI), by 10.95 events/hour (95%CI = -12,62 to -9.29; p < 0.001). Moreover, programs which achieved the PA recommendations reduced the AHI (mean difference = −11.23; 95%CI = -15.21 to -7.24; p < 0.001), whereas the ones that did not, also reduced (mean difference = -12.90; 95%CI = -16.01 to -9.80; p < 0.001). Physical exercise significantly reduces AHI in adults with OSA regardless of meeting the PA recommendations.
Aguiar et al. (Sun,) studied this question.