The benefits of exercise on your body and mind are huge. Not only does it reduce the risk of major illness, it also leaves you with a warm, endorphin-fuelled after-glow – the perfect cure if you’re feeling sad. And best of all, it can even reduce the severity of sleep apnoea.
But there is a flip side: Take exercise to the extreme and you can actually cause sleep apnoea, especially if you build up your chest and neck muscles. You might be surprised to learn that Sleep apnoea is rife among elite basketball and American football players yet most remain undiagnosed and untreated. This not only affects their sporting performance but also stores up health problems that emerge come retirement.
Before you chuck away those gym shoes — frequent, moderate exercise is good for you
I’m sure you’ve had it drummed into you that you should be exercising for at least 2 ½ hours a week. But if you’re anything like me, digging into a nice slice of cake and keeping the sofa warm always wins out. Well, some of us have muffin tops and beer bellies to maintain and anyway, chewing burns calories, right?
Actually it turns out that exercise is no joke — if you do enough of it you can cut your risk of heart disease, stroke, type 2 diabetes and cancer by up to 50% and the risk of early death by up to 30%. And if those percentages haven’t grabbed your attention, exercise reduces the severity of sleep apnoea…
Exercise will almost always reduce the severity of your sleep apnoea
On average, exercise reduces your apnoea hypopnoea index by 6 events per hour. That is, you’ll have 6 less apnoeas or hypopnoeas every hour of sleep, just because you moved your body a bit more than usual! In fact, exercise may be better at treating mild to moderate sleep apnoea than a Mandibular Advancement device.
Not only does your sleep apnoea become less severe but you will:
- Fall asleep quicker
- Sleep for longer
- Get more deep, restorative sleep
- Wake up feeling more refreshed in the morning.
And it doesn’t have to be an agonising hour in the gym or a 10 mile run up a hill; you can enjoy a brisk walk in the park surrounded by Mother Nature or take your children to the local swimming pool for a vigorous splash about. It all counts. And as with most things in life, moderation is the key to a good exercise routine. As many athletes have found to their detriment, exercising to excess can actually cause sleep apnoea.
When exercise goes wrong — too much can actually cause sleep apnoea!
You might think that world-class athletes, at the peak of their fitness, would never have to worry about sleep apnoea but you’d be wrong. I found this fantastic video by Harvard Medical School that shows world famous Shaquille O’Neal, the now retired basketball star getting a sleep study and a CPAP machine:
As you can see Shaq is exceptionally fit and takes care of himself, yet has sleep apnoea. It made me wonder how many more athletes are in the same boat and a quick Google search revealed a surprisingly long list. Why the paradox? It all comes down to physique. Athletes with sleep apnoea generally have:
- Extremely muscular chests — bulky chest muscles reduce lung volumes, increasing the chance of having apnoeas.
- Thick-set necks — excess muscle around the neck squeezes the airways, making them more likely to collapse during sleep.
- BMI’s in the obese range — Even though the percentage of fat in the body is low, well-defined muscles are heavy so the BMI appears to be high. A high BMI is a risk factor for sleep apnoea irrespective of whether the culprit is fat or muscle.
Certain sports are riskier than others
As athletes are pushed harder and harder to be the biggest and strongest in their game it is of no wonder that approximately 40% snore and about 8% report that someone has seen them having apnoeas. Although all athletes are at risk of sleep apnoea, there are certain sports that jeopardise sleep the most, namely those that require a muscular build:
- American Football — particularly the linemen
- Rugby — especially those that take part in the scrum
- Weight lifting
The sad truth is that when athletes complain of fatigue the first thing that springs to their doctor’s mind is overtiredness from a gruelling exercise regime — not a sleep disorder.
Sleep apnoea is underdiagnosed in athletes
Sleep apnoea is a highly underdiagnosed and undertreated sleep disorder in the general population. It has been estimated that 4% of men and 2% of women have sleep apnoea with excessive daytime sleepiness. In reality, the percentages are almost certainly higher but most people blame their sleepiness on something else; late nights, early starts, alcohol or work stress, to name but a few. Not to mention that most people hate making a fuss.
Now imagine being a world-class athlete at peak fitness in the prime of your career! It would just seem ridiculous that you have a sleep disorder and can’t breathe properly at night. And if you complain of fatigue you will probably be given a cardiopulmonary exercise test to check you are still fit rather than an overnight sleep study. So your sleep disorder goes undiagnosed. Not only does this affect your performance, it places you at risk of several serious complications.
It’s not just sleep that get ruined, sleep apnoea stresses the heart too
The stress placed on an athlete’s body during training is immense. Couple this with the stress caused by apnoeas and you have a nasty recipe for heart disease later in life. Many athletes with sleep apnoea develop high blood pressure and even coronary artery disease where the arteries supplying blood to the heart become clogged and narrow. This can lead to a heart attack. Not what most professional athletes expect come retirement!
If you take your sports seriously and feel fatigued get your sleep checked out
Now if you are an up-and-coming basketball or football player I’m not trying to put you off! It’s wonderful to be able to immerse yourself in the sport you love. Just be aware that if you start feeling sleepy and fatigued it may not be down to just your exercise regime — you might need an overnight sleep study.
Have you been involved in professional sports and developed a sleep disorder? Have you got sleep apnoea despite being a gym enthusiast? Please let us know your story in the comments section below.