Sleep Disordered Breathing Prevalence High in Adolescent Athletes

rugby players in match
Adolescent athletes have an increased prevalence of sleep disordered breathing.

Adolescent athletes have an increased prevalence of sleep disordered breathing (SDB), according to a study published in ERJ Open Research. This disorder is associated with potential health consequences later in life, underscoring the importance of screening.

This study included 42 male participants (mean age, 18.6±0.5 years and mean years of experience, 8.2±4.0) who played rugby for Nippon Sport Science University in Yokohama, Japan. Participants were given cardiorespiratory evaluations between 2015 and 2016. Body composition was measured using bioelectrical impedance analysis. Abnormal cardiovascular features were examined using 24-hour Holter monitoring, ophthalmologic examinations, cardiopulmonary exercise testing, and echocardiography.

Of the study participants, 43% (n=18) were diagnosed with SDB, which was defined as ≥5 apnea-hypopnea events per hour during >3 hours of sleep. This rate was higher than that previously reported in the general population of middle-aged men in the United States and Europe. SDB was mild in most participants (n=16), with between 5 and fewer than 15 apnea-hypopnea events per hour, 2 participants had moderate SDB (between 15 and 30 events/h) and there were no cases of severe SDB (≥30 events/h).

An apnea-hypopnea index was negatively associated with minimum oxygen saturation (r= –0.696; P <.0001) and positively associated with both average heart rate (r=0.426; P <.01) and oxygen desaturation index (r=0.889; P <.0001). Compared with participants without SDB, athletes with the disorder had a higher oxygen desaturation index with a lower minimum oxygen saturation as well as a higher average heart rate.

Limitations to this study included only 1 assessment of SBD on a single night, a small cohort size, and limited power because of baseline stratification.

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The researchers concluded that “SDB was more prevalent in the adolescent rugby football athletes than expected, and several potential warning signs related to autonomic nerve activity appeared in the SDB athletes. SDB screening may prevent associated downstream risks, such as cardiovascular consequences in the future. Moreover, screening may minimize the present risk for sports-related injuries.”


Iso Y, Kitai H, Kyuno E, et al. Prevalence and significance of sleep disordered breathing in adolescent athletes [published online March 10, 2019]. ERJ Open Res. doi:10.1183/23120541.00029-2019