The Impact of Exercise on Irisin-BDNF Regulation in Obstructive Sleep Apnea

The goal of this clinical trial is to learn whether aerobic exercise can improve sleep and nervous system regulation in adults with mild to moderate obstructive sleep apnea (OSA). The study will also examine whether exercise changes blood markers related to inflammation and brain health. The main questions this study aims to answer are: 1. Does four weeks of aerobic exercise change blood levels of irisin, brain derived neurotrophic factor (BDNF), and markers related to inflammation? 2. Does aerobic exercise improve sleep apnea, heart rate variability, cognitive function, daytime sleepiness, sleep quality, and daily functioning? Researchers will compare an aerobic exercise group with a sleep education group to determine whether adding regular aerobic exercise provides additional benefits for people with mild to moderate OSA. Participants will be randomly assigned to one of two groups. Participants in the aerobic exercise group will: 1. Receive sleep education. 2. Complete four weeks of supervised treadmill exercise, three to five times per week. Each session will last about 45 to 60 minutes. Exercise intensity will be adjusted to each participant's heart rate and physical condition. Participants in the comparison group will: 1. Receive sleep education about OSA, common symptoms, treatment options, and healthy sleep habits. 2. Practice the recommended healthy sleep habits at home during the four-week study period. Participants in both groups will complete assessments before and after the four-week study period. These assessments will include an overnight sleep study, blood tests, heart rate measurements, cognitive tests, and questionnaires about daytime sleepiness, sleep quality, and daily functioning.

Inclusion Criteria: * Adults aged 20 years or older * Diagnosed with mild to moderate pure obstructive sleep apnea by polysomnography (PSG) * Body mass index (BMI) between 18 and 40 kg/m² Exclusion Criteria: * Central or mixed sleep apnea * History of central or peripheral neurological disorders, such as dementia * Musculoskeletal disorders that prevent participation in the prescribed exercise program * Cardiovascular conditions associated with a high risk for exercise * Severe psychiatric disorders * Major head and neck diseases or cancer * Structural abnormalities of the upper airway * Pregnancy * Alcohol abuse or circadian rhythm disruption, such as shift work * Regular exercise within the 6 months before study enrollment, defined as approximately 150 minutes per week of moderate-intensity exercise or 75 minutes per week of vigorous-intensity exercise