White suffered from sleeping disorder

DAVID W. UNKLE -- Special to SLAM! Sports

, Last Updated: 11:35 AM ET

PHILADELPHIA -- The death of NFL great Reggie White has drawn attention to the potentially dangerous disorder known as obstructive sleep apnea (OSA) and its prevalence among football players.

A preliminary autopsy report listed White's death as the result of "fatal cardiac arrhythmia," but a condition known as pulmonary sarcoidosis and sleep apnea may also have been contributing factors.

White suffered from both OSA and pulmonary sarcoidosis, an inflammatory disorder that causes stiffening of the lungs.

According to Scott B. Rosenberg, M.D., FCCP, Medical Director of the Center for Sleep Medicine and Attending Physician at Underwood Memorial Hospital in Woodbury, NJ it is "uncommon" to die from sleep apnea alone.

"Underlying disorders, such as sarcoidosis, increase the risk of that happening," said Rosenberg.

According to Rosenberg OSA impacts approximately 2-4 per cent of the general adult population, making it nearly as commonplace as asthma or diabetes and one of the most under-diagnosed (and therefore under-treated) disorders.

Previously seen in older, overweight and poorly conditioned adults, White's death and a 2002 study has focused attention on OSA's prevalence among professional football players.

"Professional football players have some of the risk factors associated with sleep apnea, but their age and physical condition previously would not have suggested a prevalence of the disorder until they were much older," said Charles F.P. George, M.D., Professor of Medicine at the University of Western Ontario.

A study involving professional football players from eight randomly selected NFL teams, that appeared in the January 2003 edition of The New England Journal of Medicine (NEJM), found that 14 per cent of the players suffered from sleep apnea - a rate nearly five times higher than in the general adult population.

Eighty-five per cent of those players afflicted with sleep apnea were either defensive or offensive lineman. White played defensive end throughout his 15-year NFL career.

It is common in adults to have brief periods during sleep where either their breathing stops (apnea) or the volume inhaled on breathing is less than adequate. When either of these two symptoms becomes excessive, OSA is said to occur.

As a result of interrupted sleep, impaired performance and persistent fatigue is seen among individuals with OSA and is associated with hypertension, cardiac arrhythmias and vessel disease, and stroke.

Risk factors for OSA include obesity, increased neck circumference, structural disorders of the head and face and excessive secretion of growth hormone. Among the players in the NEJM study who were assigned to the high-risk category, the prevalence of sleep apnea was 34 per cent.

Conservative treatment of OSA involves weight loss, side-lying position for sleep, avoidance of alcohol and other sedatives. Continuous positive airway pressure (CPAP) therapy, which involves the patient wearing a nasal mask to facilitate oxygenation during sleep, is also commonly used.

"OSA is a problem for many Americans who may not realize that they have the condition," said former NFL tight end Vyto Kab, co-managing Director of SleepTech Consulting Group and co-author of the NEJM study. "We know that there's a link between sleep and performance. That's an issue whether you're an NFL player, a weekend athlete, operate a truck, or work behind a desk."

For more information on Obstructive Sleep Apnea and Sarcoidosis:

The National Sleep Foundation: www.sleepfoundation.com

SleepTech Consulting Group: www.sleeptech.com

The American Sleep Apnea Association: www.sleepapnea.org

The American Lung Association: www.lungusa.org

David W. Unkle is a freelance football, hockey and medical writer along with hosting a weekly interview-formatted radio program in the Philadelphia (PA) market. He is a Fellow of the American College of Critical Care Medicine and an Instructor at the University of Medicine and Dentistry of New Jersey - Stratford Campus.

David can be contacted at www.topcatsports.org

Wire reports and previous reports were used in the preparation of this article.


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