College American football players show higher rates of sleep apnoea than general population

More than a third of college American football players meet clinical criteria for obstructive sleep apnoea (OSA), significantly exceeding the estimated rates in the general US population, new research shows.

The study found that 35 per cent of players had mild to moderate OSA, compared to an estimated 9–25 per cent in the broader population, despite being young, athletic and physically fit.

OSA is a disorder in which the upper airway becomes blocked or collapses during sleep, repeatedly interrupting breathing.

If left untreated, it can lead to serious cardiovascular problems.

Researchers from the University of Colorado School of Medicine at Colorado State University studied 58 football players using the WatchPAT 300, a wearable device that collects sleep data and calculates an apnoea-hypopnoea index (AHI).

Players also completed questionnaires to help assess OSA prevalence.

Dr Josiane Broussard is a sleep researcher and associate professor of health and exercise science at Colorado State University, who led the study.

The researcher said: “This is not a condition we typically associate with younger individuals.

“That may be a reason college football players often fly under the radar and remain undiagnosed.”

Players with OSA tended to have higher body mass index (BMI), though neck circumference was generally the same as players without OSA symptoms.

The findings align with previous studies showing similar rates in college football athletes and higher OSA prevalence reported in professional National Football League players.

Broussard said: “We often think of this population as especially healthy because they exercise so much and have high muscle mass, but they’re still at an increased risk.

“It’s something to think about because if they’re 18 or 20 years old and are never screened for OSA, they may go on to live with the condition without treatment for another few decades and it could have been addressed early on.”

Dr Raj Trikha, co-author and recent graduate of the Fort Collins branch of the CU School of Medicine, highlighted the wider health implications.

Trikha said: “Untreated OSA leads to increased risk in virtually every chronic disease; including heart disease, cancer, and dementia.

“I chose to work in Dr Broussard’s lab during medical school because her research is vital and this presented a unique opportunity to learn more about sleep’s impact on health.”

Prevalence of OSA in patients with conditions including hypertension, heart failure, coronary artery disease, pulmonary hypertension, atrial fibrillation, and stroke can be as high as 40 to 80 per cent.

Many people with OSA may be unaware they have the condition, with episodes of interrupted breathing happening up to 60 times per hour in serious cases.

Broussard said: “Many people discover they have OSA because of their bed partner.

“It can be alarming to witness—someone appears to stop breathing during sleep, and it often sounds like they’re struggling to breathe but just can’t.”

These episodes lead to physiological changes including increased heart rate and stress hormones, “and the person may have little to no awareness that it’s happening,” she added.

The researcher said: “You could have someone who believes they’re getting eight to nine hours of sleep each night, yet they still feel exhausted during the day.”

Some players in the study scored high on the Epworth Sleepiness Scale but didn’t meet criteria for excessive daytime sleepiness, which researchers say may explain why most participants reported taking regular daytime naps.

The researchers emphasise screening collegiate football players for OSA is essential but can be difficult as it requires testing that isn’t common among young people and can require intensive testing in sleep clinics.

“…there is an urgent need for simple, effective, and scalable screening approaches for collegiate football players, especially given the absence of intercollegiate athletics screening protocols,” the researchers wrote.

According to the researchers, the wearable device and questionnaires used in the study could offer a more accessible screening approach.