TO BREATHE OR NOT TO BREATHE…THAT IS THE QUESTION…

By: Reginald I. Givan

Research has uncovered an alarming new health concern in the ranks of NFL players that effects many Americans as well.

Based on a study involving 300 NFL players, conducted by Dr. Charles George, professor of medicine at the University of Western Ontario, it was discovered that players experience obstructive sleep apnea at a rate five times higher than other men their age, according to the published results of the study found in the January 23, 2003 issue of the New England Journal of Medicine.

The Greek word "apnea" literally means "without breath." Sleep Apnea can occur in both sexes and in all age groups, but is more common in men. It has been estimated that as many as 18 million Americans may suffer from sleep apnea. Four percent of middle-aged men and two percent of middle-aged women have sleep apnea along with excessive daytime drowsiness.

In general, the people most likely to have or to develop sleep apnea include those who are overweight, have unexplained high blood pressure, snore loudly and have necks that are 17 inches in diameter or more. Any physical abnormality found in the nose, throat, or other soft parts of the upper airway also contribute to the chances of developing sleep apnea. Weight is also a factor and Dr. Charles George, citing NFL statistics, stated "Among current NFL players, 338 weigh 300 pounds or more, compared with 200 in 1996, 10 in 1986 and none in 1976."

With our athletes, as well as the general public, getting larger each year, sleep apnea has become nearly as common as diabetes or asthma in terms of prevalence in our society; affecting approximately 20 million people in the US alone. It is surprising to learn that sleep apnea, once thought to be a relatively rare disorder limited to middle age and older men, is so widespread and even affects professional athletes in all sports categories under the age of 30 who appear to be in otherwise healthy condition.

For example, the more bodybuilding becomes popular, the more weight the obese is that the fat surrounding the airway pushes it closed. In weight lifters, the build up of muscle pushes in on the airway ("Neck diameter and OSA", Sleepnet.com, May, 2002).

For this same reason, it is likely that many professional race car drivers may also suffer from sleep apnea as they are subjected to G-forces in high speed maneuvers, which can exert loads totaling at least 65 pounds on their neck muscles causing them to have disproportionately thicker necks.

It has been proven that people with sleep apnea have difficulty concentrating, their reaction times are longer and their daytime performance suffers. The consequences of untreated sleep apnea can be life threatening. Symptoms may include depression, irritability, sexual dysfunction, learning and memory difficulties, and falling asleep while at work, on the phone, or behind the wheel. Sleep apnea patients are 3 times as likely to have automobile accidents. It has been estimated that up to 50 percent of sleep apnea patients have high blood pressure. Sleep apnea contributes to an increased risk for heart attack and stroke.

Continuous Positive Airway Pressure (CPAP) is a common effective treatment for sleep apnea. The patient wears a mask over the nose during sleep and pressure from an air blower forces air through the nasal passages. The air pressure can be adjusted so that it is just enough to prevent the throat from collapsing during sleep.

"We know there is a link between sleep and performance," says James K. Walsh, president of the National Sleep Foundation. "Proper sleep boosts metabolic efficiency, which helps burn body fat and increases the release of growth hormones, which help build muscle, accelerates recovery, and improves concentration and reaction times." He added, "This is an issue whether you are an NFL player, a weekend athlete, operate a truck, or work behind a desk."