New research led by investigators at Vanderbilt Health and the Football Players Health Study at Harvard University suggests that sleep apnea may be far more common — and more clinically significant — among former professional football players than previously recognized.
The study, published recently in the journal Neurology, examined nearly 2,000 former players. It found that while approximately 32% of participants were previously diagnosed with sleep apnea, the true prevalence may be closer to 69% when accounting for undiagnosed individuals whose screening measures showed they were at elevated risk.
Obstructive sleep apnea (OSA) is a condition in which throat muscles lose their tone and disrupt breathing by blocking the airway. The study's co-first author, Douglas Terry, PhD, assistant professor of Neurological Surgery and co-director of the Vanderbilt Sports Concussion Center, explained the risk factors associated with the physical traits commonly seen in professional football players.
"Football players are physically unique individuals," said Terry. "They're often quite tall and muscular, and when they retire, their bodies might predispose them to a variety of health risks. Being male, having a high body mass index (BMI) and having a thick neck, which many former football players do, often put people at greater risk for sleep apnea."
Terry added that of those who had been diagnosed with sleep apnea, many were not treating it adequately. Survey data suggested that over half of participants who had sleep apnea were not regularly using a continuous positive airway pressure (CPAP) machine, which is the most common treatment for sleep apnea.
The study also examined how sleep apnea may impact other symptoms, including cognitive and emotional effects.
"Individuals who had under-treated or undiagnosed sleep apnea had amplified symptoms of anxiety, depression, chronic pain and cognitive issues such as memory concerns," said the study's co-first author, Rachel Grashow, PhD, MS, director of Epidemiological Research Initiatives for the Football Players Health Study at Harvard University. "This study
underscores that sleep apnea is a modifiable risk factor, and that improved screening and adherence to treatment could meaningfully impact quality of life."
The study was supported by the National Football League Players Association (NFLPA). The study's authors wish to acknowledge that there was no editorial input from either the NFLPA or the National Football League (NFL) on the paper.
