Impact of Snoring and Sleep Apnea on Cardiovascular Health in Young Athletes

Introduction

A recent study published in ERJ Open Research examined how snoring and sleep apnea affect cardiovascular health in young athletes. The sudden cardiac death of a young athlete is a profoundly tragic occurrence, particularly since these individuals are typically viewed as vigorous and healthy. While heart abnormalities can cause sudden cardiac deaths in young athletes, often the reasons remain undetermined after autopsy, leading researchers to suspect a link to cardiac arrhythmia.

Sleep-Disordered Breathing and Cardiac Arrhythmia

Sleep-disordered breathing, which encompasses conditions like snoring and sleep apnea, is known to cause cardiac arrhythmia, potentially resulting in sudden cardiac death. Although there is a recognized correlation between sleep-disordered breathing and sudden cardiac death in obese, inactive, and elderly populations, its effects on young athletes have been less explored.

Risk Factors for Sleep-Disordered Breathing

Factors contributing to sleep-disordered breathing include a larger neck circumference and a higher body mass index (BMI). Notably, young athletes participating in collision sports such as American football and rugby often exhibit these risk factors. However, the prevalence of sleep-disordered breathing and its impact on cardiovascular health in young collision athletes has not been adequately studied.

Study Overview: Sleep-Disordered Breathing in Young Rugby Athletes

Research Methodology

To investigate the relationship between sleep-disordered breathing and cardiovascular complications in young collision athletes, Japanese researchers conducted a study that was recently published in ERJ Open Research. The study focused on the sleep quality, breathing patterns, heart rates, and blood oxygen levels of 42 male rugby players, aged 18-19, from the Nippon Sport Science University rugby team in Japan.

Findings on Sleep-Disordered Breathing

Participants were classified as having sleep-disordered breathing if they exhibited at least five breathing interruptions lasting a minimum of 10 seconds during a total sleep time exceeding three hours. Surprisingly, 18 of the athletes, or 43%, were found to have sleep-disordered breathing. Professor Yoshitaka Iso, the study’s lead author, noted, “This [43%] is a higher rate than we expected, and is higher still than the levels of SDB reported among middle-aged men from the general population of the US and Europe.”

Physiological and Performance Differences

The researchers also examined physiological and performance differences between athletes with and without sleep-disordered breathing. Data revealed that those with sleep-disordered breathing had lower blood oxygen levels and higher average heart rates compared to their non-SDB counterparts. Performance assessments indicated that athletes with SDB experienced higher resting heart rates and more frequent irregular heartbeats. These findings suggest disturbed nerve activity, which may lead to cardiovascular complications. However, none of the athletes experienced serious health issues or fatal cardiac events within the year following the initial assessment. The researchers attribute this to the athletes’ young age but caution that cardiovascular complications may arise over time for those with sleep-disordered breathing.

Recommendations for Screening Young Collision Athletes

Importance of Screening

The researchers emphasized the need for screening for sleep-disordered breathing in young collision athletes. Professor Iso stated, “Based on the link between SDB and abnormal heart functions that we observed in this group, we speculate that SDB could be a possible factor in the unexplained deaths of some young collision sport athletes, as it appears to be very prevalent but currently is not regularly screened for.”

Study Limitations and Future Research

While the results of this study support the need for further investigation, it is important to acknowledge its limitations, including a small sample size and the single-night assessment of sleep-disordered breathing. Consequently, additional research is necessary to comprehensively understand the causes and implications of sleep-disordered breathing in young collision athletes.

References

Iso, Y., Kitai, H., Kyuno, E., Tsunoda, F., Nishinaka, N., Funato, M., et al. (2019). Prevalence and significance of sleep disordered breathing in adolescent athletes. Erjor, 5(1), 00029–2019.
European Lung Foundation. (2019, March 10). Study of young athletes suggests snoring and sleep apnea are linked to sudden cardiac death. EurekAlert! Retrieved March 12, 2019 from www.eurekalert.org/pub_releases/2019-03/elf-soy030719.php