Sleep and breathing in professional football players.
OBJECTIVE
To evaluate sleep in professional football players and describe clinical features of players at risk for sleep for sleep-disordered breathing (SDB).


METHODS
The Multivariable Apnea Prediction (MAP) index was used to stratify players into high (MAP> or =0.5) and low (MAP<0.5) risk for SDB. Players from both risk groups were randomly selected for overnight polysomnography, with over-sampling from the High-risk group. Of 302 players from eight professional football teams; 52 underwent attended polysomnography. Anthropometrics including neck circumference, airway size (Mallampati score, maxillary overjet) and sleepiness measured by Epworth scores (ESS) were recorded. The primary outcome measures were ESS and an apnea-hypopnea index (AHI) > or =10.


RESULTS
Ninety-two percent of players were <30 years old (mean (SD) age: 25.5+/-2.7 years) with large necks (45.2+/-3.6 cm) and elevated BMI (31.5+/-4.6). More than 20% of players had an ESS>10 with ESS highest in habitual snorers. An AHI of > or =10 was found in 13 (34%, 95% confidence interval (CI) 21-50%) high-risk players but only one (7%, 95% CI 1-31%) of 14 low-risk players. Offensive (9) or defensive (3) linemen accounted for the majority of the positive cases. Based on our sample, we estimate the prevalence of SDB to be 14% (2-25%).


CONCLUSIONS
Excessive daytime sleepiness (EDS) is present in a large fraction of professional football players. Some but not all of this may be due to an increased prevalence of SDB. Further study is required to understand all of the factors responsible for EDS and to determine which of the biggest players will have SDB, which may impact not only performance and productivity but also future health.
University of Western Ontario, London Health Sciences Centre, Victoria Campus, 375 South Street,London, ON N6A 4G5, Canada. cgeorge@uwo.ca
Charles F P
CF
George
Vyto
V
Kab
Patricia
P
Kab
John J
JJ
Villa
Allan M
AM
Levy
D000328:Adult; D015992:Body Mass Index; D002170:Canada / Q000453:epidemiology; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology; D005538:Football; D006801:Humans; D008297:Male; D015995:Prevalence; D012119:Respiration; D012307:Risk Factors; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D012913:Snoring / Q000150:complications