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Sleep Apnea Therapy Improves Golf Game

Sleep apnea sufferers may have some more motivation to wear their breathing machines at night … it could improve their golf game.

Golfers with obstructive sleep apnea (OSA) who received nasal positive airway pressure (NPAP) for their disorder lowered their golf handicaps by as much as three strokes.

“More so than many sports, golf has a strong intellectual component, with on-course strategizing, focus, and endurance being integral components to achieving good play,” Marc L. Benton, M.D., of Atlantic Sleep and Pulmonary Associates in Madison, N.J., was quoted as saying. “OSA can lead to daytime sleepiness, fatigue, and cognitive impairment — all side effects which can negatively impact a person’s ability to golf to the best of one’s ability.”

Dr. Benton and colleague Neil S. Friedman, R.N., from Morristown Memorial Hospital, evaluated the impact of NPAP on the golf handicap index (HI) of 12 golfers with diagnosed moderate to severe OSA. HI was recorded upon study entry, as was the Epworth sleepiness scale (ESS). After 20 rounds of golf while receiving NPAP treatment over a period of 3 to 5 months, the treatment group demonstrated a significant drop in average HI. Patients in the study group also improved their ESS scores. A control group of 12 subjects demonstrated no change in HI, ESS score, or SQ score during this study.

“As any golfer knows, when your ability to think clearly or make good decisions is compromised, the likelihood of playing your best is greatly diminished,” Dr. Benton said. “Through treatment with NPAP, we can improve many cognitive metrics, such as attention span, memory, decision-making abilities, and frustration management, which may, in turn, positively affect a person’s golf game.”

Dr. Benton estimates there are 1 to 3 million regular golfers who play 10 or more rounds per year, and who have OSA. Most are undiagnosed or untreated. Proper treatment is only effective if it is used regularly. In men, studies have reported compliance rates as low as 40 percent. Patients cite many reasons for noncompliance with NPAP, including discomfort, inconvenience, cost, noise, or embarrassment. In the current study, nearly all patients in the treatment group had a compliance rate of above 90 percent.

“Providers typically attempt to maximize compliance with NPAP by promoting its medical benefits or warning patients of the risks involved in not being treated, but this approach does not always work,” Dr. Benton said. “In the case of this study, the possibility of improving one’s ability to play golf appears to have been a significant motivation to improve treatment compliance.”

SOURCE: Presented at the scientific assembly of the American College of Chest Physicians, San Diego, CA, October 31 to November 5, 2009

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