Obstructive sleep apnea in professional rugby league athletes : An exploratory study

Objectives
To explore the prevalence of obstructive sleep apnea (OSA) within a professional rugby league team and determine associations of OSA with ethnicity, positional group, and physical characteristics.

Design
Observational prospective cohort study.

Methods
Twenty-two professional rugby league athletes underwent one night of home-based polysomnography with apnea-hypopnea index (AHI), rapid eye movement (REM)AHI, non-REMAHI and supineAHI determined to indicate OSA. Linear models were used to assess if playing position (back or forward) or ethnicity (European-Australian or Polynesian) influenced AHI, REMAHI, non-REMAHI and supineAHI. Models were also built to determine differences according to body composition.

Results
Seven athletes were classified with mild OSA (6 forwards and 1 back, 3 European-Australians, and 4 Polynesians) and three with moderate OSA (2 forwards and 1 back, 3 Polynesians). When considering ethnicity, differences were observed between Polynesians and European-Australians for REMAHI (ES = 0.90, p = 0.02). Increased body mass index (BMI) was associated with a moderate increase in AHI (r = 0.38, p = 0.04) and non-REMAHI (r = 0.36, p = 0.05), while higher skinfold thickness moderately related to a higher AHI (r = 0.40, p = 0.05) non-REMAHI (r = 0.47, p = 0.02), and supineAHI (r = 0.41, p = 0.04).

Conclusions
This exploratory study found 10 cases of OSA. Polynesian athletes and athletes classified as forwards constituted the majority of reported cases, suggesting their susceptibility to OSA. Furthermore, the data suggests that athletes with greater BMI and skinfold thickness may be predisposed to OSA.