The fittest amongst us suffer from a variety of sleep disorders and leading sports professionals are not excluded

Many of us play active sport or focus on our fitness so perhaps we think that as a result our health is in better shape, but at the same time, getting good restful sleep can still be a major problem even for those who are professional sportsmen or women and make a career out of their skills.

sleep and sporing performance

Sleep disorders are so painfully common among the general population, but there’s one demographic that suffers significantly more than the rest of us: athletes. A new study from Finland has some good news for this group, though, because researchers now say that for the first time ever, they’ve shown just how treatable sleep disorders among athletes really are.

The survey revealed that one in four of the athletes involved in the study suffered from significant sleep problems, including having trouble falling asleep, snoring, and unbelievably, having serious issues with their breathing, such as sleep apnoea. Most of the athletes surveyed admitted to sleeping too few hours and one in six of them even used sleeping pills.

Although many of the athlete’s sleep troubles were classified as “significant” the study showed that general sleep-related guidance and personalized treatment plans greatly improved their sleep. Simple ‘Stop snoring mouthpieces’ and more customised versions can restrict or even eliminate the problem and greatly improve their performance and fitness as a result. Lack of sleep can reduce performance quality, though, and as many as one in four athletes involved in the study reported that sleep-related guidance helped to improve their athletic performance.

Aside from affecting how good someone is at sport, lack of sleep can also have serious health consequences and also lead to weight gain.

Sleep disorders among many groups of professional sportsmen and sportswomen are a widely reported problem, and researchers have suggested a variety of issues that might cause them. Intense training, rigorous schedules, and frequent traveling, sometimes across world time zones, are only some of the factors that may disrupt sleep patterns.

Professional athletes travel a great deal, often flying overnight before waking up to an early-morning practice or next-day game, and share risks for sleep problems with other high-frequency travellers and people who work non-traditional schedules. People in these jobs are at higher risk for sleep disorders such as insomnia and obstructive sleep apnoea. They also can be at elevated risk for health problems associated with poor sleep, including obesity, Type 2 diabetes, and cardiovascular disease.

The professional sports world appears to be continuing to turn a great deal of attention to what has previously been a much-overlooked issue: sleep.

In the USA, it’s the National Hockey League that is leading the way and that is addressing sleep problems on several fronts. Last year, teams like the New York Jets decided to hire sleep specialists to work with players on improving their sleep habits, and the sleep-friendly adjustments made to the team’s practice schedule improved their overall performance considerably.

At the same time numerous players of American football have recently headlined with major sleep apnoea problems but after watching a football game, it’s hard to believe that any of these big, tough men might be seriously ill. Injured, maybe. But sick? It seems very unlikely.

However, according to a recent study by New England Journal of Medicine, this might well be the case. Sleep apnoea affects about 4% of the general population, but when football players participated in sleep studies, the percentage rose to 14% of all players. Offensive and defensive linemen had an even higher prevalence of apnoea with 34% of them affected, probably due to their higher weight.

All sports are affected – even Sumo wrestlers in Japan – and many of them have serious problems with sleep apnoea caused by extra weight, which in that particular arena is an obvious advantage. Or is it? New investigations conducted by the Douai Hospital in Tokyo have determined that if the wrestler suffers from obstructive sleep apnoea, he lacks the concentration needed for the sport. This may be causing injuries and is also causing those wrestlers to lose more matches than is normal or to even miss tournaments.

The problem is easily solved for all these sportsmen and women – just as it is for the rest of us. If you suffer from sleep disorders or obstructive sleep apnoea you must deal with it. It’s easy and inexpensive to do so and can have a major effect on your life whether you’re a sports professional or not.

John Redfern

 


Sleep apnoea is a more dangerous condition for women than men

We now all know that sleep apnoea, which stops your breathing frequently during the night, is linked with serious health conditions, but it may be even more dangerous for women’s hearts than for men’s, according to a major new study in the journal Circulation.

snoring and apnea more dangerous for women

Obstructive sleep apnoea, or OSA, is characterized by frequent stopping of breathing during sleep and often followed by choking and gasping to recover. It is linked to cardiovascular disease, diabetes, depression, osteoporosis, increased mortality, and possibly earlier onset of cognitive decline and dementia.

Some of the leading experts in this field have spoken out further on this matter as they want to stress that both men and women can have this condition, and snoring is not necessarily a symptom, although it often is.

Dr. John Swartzberg of UC Berkeley said: “Don’t think sleep apnoea is just a man’s problem because men tend to snore loudly and more often. Snoring is a warning sign, but you can have sleep apnoea without snoring or very little snoring.” Swartzberg says this was a large and well-done study.

“These were women who tended to be older, their average age was 63,” he explained. “What they found was that women with sleep apnoea had high rates of complications, such as high blood pressure, heart failure, heart enlargement, and even premature death.” Recently it has been further linked with Breast Cancer and aggressive melanoma when left untreated.

The study followed more than 1,500 initially healthy people (average age 63) for 14 years and found that in women, but not in men, the condition was independently associated with a marker for heart damage in the blood called troponin T, as well as with heart failure, heart enlargement (ventricular hypertrophy), and premature death.

Snoring and Sleep apnoea is often regarded as a man’s problem, but women also have high rates, especially those who are obese. The new findings highlight the importance of screening women and getting early treatment for them as well as men.

Snoring by itself is usually a less critical matter, though it can be a source of strife between bed partners or roommates, but when associated with OSA it is a different matter altogether.

Estimates vary widely, but it’s likely that sleep apnoea affects about 10 per cent of all adults. Rates have been rising steadily over the past 20 years, largely because of the obesity epidemic. The biggest worry is that the great majority of people with sleep apnoea do not know they have it and continue without treatment whilst their health steadily worsens as a result.

OSA is certainly more common in men, especially black and Asian men, but this recent research has found it is surprisingly prevalent among women, too, especially after menopause. Being overweight greatly increases the risk, as a result of excess soft tissue in the throat. Though not everyone who snores has sleep apnoea, loud snorers are most likely to have it.

Increasing age, family history and certain anatomical abnormalities also increase the risk. In addition, heavy drinking, smoking and sedatives can promote the development and danger of OSA.

If you think that you have sleep apnoea, doing the following may help.

  • If you’re overweight, lose weight.
  • Limit or avoid alcohol, especially in the evening.
  • Avoid sedating medications.
  • Avoid heavy meals in the evening.
  • If you smoke, stop.
  • Try sleeping on your side, not on your back. This helps keep your tongue from falling back and obstructing the airway.
  • Elevate the head of your bed about six inches using a foam wedge.

In the meantime you can prevent the development of OSA by obtaining a custom-made mandibular advancement device made by a specialist NHS Approved company, such as SleepPro. The Custom fitted mouthpiece is easy to wear and much less expensive than any Dentist made product, and it keeps the airway open while you sleep by pulling the tongue and jaw (mandible) forward.

John Redfern


High fat diets cause weight gain and snoring – resulting in obstructive sleep apnoea and heart problems

Recent research conducted as totally separate studies in both Australia and the USA throws new light on the relationship between sleep and weight gain. Experts suggest sufficient undisturbed slumber every night is required to life a healthy life and snoring is a key factor that needs to be eliminated.

High fat diets cause weight gain and snoring – resulting in obstructive sleep apnoea and heart problems

The first report, from the University of Adelaide, tracked 1,800 Australian men aged between 35 to 80 and looked at their eating habits during a one year period. It concluded that men who consumed the highest amounts of fat were more likely to experience ‘excessive daytime sleepiness’ and that a high-fat content to a diet was strongly linked to sleep apnoea.

The data was taken from a larger study into Australian lifestyles called the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study.

Data extracted from this, with a focus on diet and sleep apnoea has found a strong correlation between higher fat content and sleep disorders.

The scope of the study included 1,800 Australian men who were aged between 35-80 years. The men were surveyed over a 12-month period and they recorded information about what they eat, when they felt sleepy and the quality and quantity of sleep they achieved each night. A high fat diet was linked to sleep apnoea and even more interestingly, the sleepiness was not linked to a person’s obesity – meaning smaller males were just as affected as larger-sized ones.

Almost half – 47% – with a high fat diet said they slept poorly at night and 42% admitted feeling lethargic and tired during the day. Meanwhile 54% suffered ‘mild-to-moderate’ sleep apnoea and 25% categorised as having ‘moderate-to-severe’ sleep apnoea. None of the men had previously been diagnosed with the condition.

The data was adjusted for the age groups and for lifestyle factors and note was also taken of any chronic diseases that the men were suffering from. With these factors accounted for, the results remained unchanged.

Comments from the participants suggested many of the men were locked into a vicious circle. Because they felt tired during the day they tended towards a high fat diet; and because they eat a high fat diet they were more likely to feel sleepy during the day. It’s long been suspected that a diet rich in carbohydrates and fat can adversely affect sleeping patterns and has significant implications for alertness and concentration, which would be of particular concern to workers.

Separate reports from the Universities of Delaware and Columbia in the USA independently supported this, and said that in a simpler study, one of them using nearly half a million individuals, that there’s a clear link between insufficient or disturbed sleep and obesity.

But getting fat is not the only problem caused by poor sleeping habits. Other research said that not getting enough sleep affects the cholesterol level. Thus there’s a link between heart diseases and lack of sleep. It has become evident that poor or lack of sleep may lead to a slowing of the metabolism and is linked to getting fat and worse – even causing obesity – and is also linked to cardiovascular diseases.

According to The European Society of Cardiology “Sleep disorders are very closely related to the presence of cardiovascular diseases. However, until now there has not been a major population based study examining the impact of sleep disorders on the development of a heart attack or stroke.”

Leading UK nutritionist and neuroscientist Victoria Wills has welcomed the news, saying it could even help save countless lives.

She said: “We’ve all experienced that feeling of eating a large, unhealthy meal and then being completely zapped of energy. Now this study shows that a long-term diet of fatty foods can have a fatiguing effect on your day-to-day life, even bringing about sleep apnoea – a common cause of night terrors – which is worrying in the extreme”.

“If you are eating too much fat then you may not be physically able to exercise properly because you haven’t been able to rest properly and your energy levels are depleted. It’s then a vicious circle. Meanwhile those who work in jobs where it’s vital that they stay alert and awake should also take note, or risk accidentally day-dreaming into a serious accident.”

You should improve your sleep initially by stopping snoring while you work on the lengthy task of reducing the fat from your diet to lower your weight.

John Redfern


Lack of sleep and regular snoring linked to poorer breast cancer survival

A new study from the USA reports that short sleep duration combined with frequent snoring reported prior to cancer diagnosis may influence subsequent breast cancer survival.

Lack of sleep and breast cancer

 

Results show that women who typically slept less than the recommended 7 hours of sleep per night and were frequent snorers in the years before their cancer diagnosis experienced a poorer cancer prognosis.

The findings were especially robust for women who were diagnosed with breast cancer. Breast cancer patients who reported sleeping 6 hours or less per night and snoring 5 or more nights per week before their diagnosis were 2 times more likely to die from breast cancer (hazard ratio = 2.14) than patients who reported sleeping 7 to 8 hours per night and rarely snored.

The study results are published in the April 15 issue of the Journal of Clinical Sleep Medicine.

In a week where scientists have revealed extensive data on the world’s sleeping patterns, leading researchers have told the BBC that society has become “supremely arrogant” in ignoring the importance of sleep. They say people and governments really need to take the problem seriously.

The body clock drives huge changes in the human body. Cancer, heart disease, type-2 diabetes, infections and obesity have all been linked to reduced sleep. It alters alertness, mood, physical strength and even the risk of a heart attack in a daily rhythm.

Sleep experts worldwide, including many who are based in the UK, endorse these statements. They include Dr Akhilesh Reddy, from the University of Cambridge, who said that the body clock influences every biological process in the human body and the health consequences of living against the clock were “pretty clear cut”, particularly in the case of breast cancer.

But the pressures of work and social lives mean many people cut their sleep during the week and catch up at the weekend. Researchers are investigating whether there is a health impact.

The study, by a team at the University of Bristol in the UK and Weill Cornell Medical College in Qatar, assessed “sleep debt” – a measure of the difference in the nightly hours asleep on weekdays and at the weekend.

“We found that as little as 30 minutes a day sleep debt can have significant effects on obesity and insulin resistance,” said Prof Shahrad Taheri from Weill Cornell. He added: “Sleep loss is widespread in modern society, but only in the last decade have we realised its metabolic consequences.

“Our findings suggest that avoiding sleep debt could have positive benefits for waistlines and metabolism and that incorporating sleep into lifestyle interventions for weight loss and diabetes might improve their success.”

The study was funded by the UK’s Department of Health, where 10% of healthcare budgets are already spent on treating diabetes. Perhaps they’ll act on it accordingly.

Information on global sleep habits has been equally informative and it was clearly evident that there was a conflict between our desire to stay up late and our bodies urging us to get up in the morning.

Prof Daniel Forger, one of the researchers, said “Society is pushing us to stay up late, our body clocks are trying to get us up earlier, and in the middle the amount of sleep that we have is being sacrificed; that’s what we think is going on in global sleep crisis.

The study found people in Japan and Singapore had an average of seven hours and 24 minutes sleep while the people in the Netherlands had eight hours and 12 minutes. People in the UK averaged just under eight hours – a little less than the French. The study also showed women had about 30 minutes more per night in bed than men, particularly between the ages of 30 and 60.

The message to everyone is very evident.
Sleep enough – Stop Snoring – and don’t ignore the opinions of the experts.

John Redfern


The dangers of driving with sleep apnoea – and the legal situation

The dangers of driving with sleep apnoea – and the legal situation

The most common symptom of obstructive sleep apnoea, and the most dangerous by far, is daytime drowsiness. This is accompanied when you sleep by heavy snoring, and choking sounds or gasping for breath on numerous occasions throughout the night. It’s a deadly problem to have.

OSA and driving

Drowsy driving may result and this is defined as operating a motor vehicle while being cognitively impaired by lack of sleep. Leading Motoring Associations in the UK and USA state that drivers with untreated sleep apnoea pay less attention to the road, react more slowly when braking suddenly, and make bad driving decisions that may lead to an accident.

Obstructive Sleep Apnoea is very common among middle-aged men, especially if they are overweight. Studies show that drivers with untreated OSA are five times more likely to be involved in road accidents with 25% of motorway or expressway accidents can be attributed to drowsiness. Most countries have had numerous examples in the headlines recently where this has caused tragedy both on the roads and on the rail systems.

In December 2014 a bin lorry careered out of control in a busy shopping street in Glasgow leading to the tragic death of six people. The accident inquiry into the incident has led to increased concern among doctors about their responsibility to disclose information about their patients to the DVLA.

A Doctor’s responsibility is to explain to the patient that they have a medical condition that may affect their ability to drive and that they have a legal obligation to inform the DVLA or DVA, and to stop driving if they are not having treatment for the problem. It is the driver’s legal responsibility to inform the authorities and it is a criminal offence for the driver to fail to do so.  The decision on whether the patient’s licence will be withdrawn rests with the DVLA or DVA and not the doctor.

Doctors in the UK have said they are anxious about disclosing information to the DVLA or DVA but have now been issued with a step-by-step approach by the General Medical Council approach that will allow them to deal with these difficult discussions more confidently. It runs as follows:

  1. Tell the patient to inform the Licensing Authority (DVLA)
  2. Assess the patient’s medical condition against required standards
  3. Try to persuade the patient to stop driving
  4. Only disclose the minimum information
  5. Keep detailed records

In Australia, NSW will soon have instant health checks for the 400,000 motorists who need to prove they are capable of driving. The checks are for elderly drivers who need to prove they can drive safely, heavy ­vehicle drivers, and motorists with epilepsy, sleep disorders and diabetes.

Doctors assess elderly drivers aged 75 or over each year to determine if their eyesight, motor function and attention is at a level where it is safe to drive. For holders of a class MC licence drivers have to be assessed at age 21 and then every 10 years, and after then at age 40 and then every five years

The state government will automate fitness-to-drive medical assessments, so GPs can send them to Roads and Maritime Services instantly. Roads Minister Duncan Gay said it meant doctors could instantly send applications to the RMS licence ­review unit, and elderly drivers would not be forced to queue at service centres or post offices to send application forms.

Although drinking while driving is a very serious problem, the deadliest habit is proving to be even more widespread: drowsy driving. In 2014, over 33 per cent of all U.S. drivers fell asleep behind the wheel of a car.

There are 42 drowsy drivers for every drunk driver on the road today.

In the USA however the greatest focus has been on commercial drivers, who are required to pass a health screening in order to drive. Regulators overhauled the system in 2014 and have disqualified roughly 70,000 truckers since then, out of some 8.5 million.

Treatment for OSA, bringing high restorative sleep, has been proved in research to overcome the problem. Oral appliances are approved and available for a very small cost and without any form of prescription so the solution is seen to be in the hands of those who wish to continue driving.

It brings a whole new meaning to the old phrase ‘Keep Death off the road’.

John Redfern