Men Find New Motivation for Using CPAP
SAN DIEGO, Nov. 2 /PRNewswire-USNewswire/ -- Golfers who undergo treatment forsleep apnea may improve their golf game as well as their overall health, showsnew research. A new study presented at CHEST 2009, the 75th annualinternational scientific assembly of the American College of Chest Physicians(ACCP), found that golfers with obstructive sleep apnea (OSA) who receivednasal positive airway pressure (NPAP) for their disorder improved theirdaytime sleepiness scores and lowered their golf handicap by as much as threestrokes. Researchers suggest that the possibility of improving your golf gamemay be a significant motivator to improve NPAP compliance rates among golfers."More so than many sports, golf has a strong intellectual component, withon-course strategizing, focus, and endurance being integral components toachieving good play,” said Marc L. Benton, MD, FCCP, Atlantic Sleep andPulmonary Associates, Madison, NJ. “OSAS can lead to daytime sleepiness,fatigue, and cognitive impairment, all side effects which can negativelyimpact a person’s ability to golf to the best of one’s ability.”
Dr. Benton and colleague Neil S. Friedman, RN, RPSGT, from Morristown MemorialHospital, Madison, NJ, evaluated the impact of NPAP on the golf handicap index(HI) of 12 golfers with diagnosed moderate to severe OSA. HI was recorded uponstudy entry, as was the Epworth sleepiness scale (ESS), a validatedquestionnaire used to assess daytime sleepiness, and a sleep questionnaire(SQ) developed by the authors. After 20 rounds of golf while receiving NPAPtreatment (approximately 3 to 5 months), the treatment group demonstrated asignificant drop in average HI, 12.4 (+/- 3.5) to 11.0 (+/- 4.7). Patients inthe study group also improved their ESS score, 11.8 (+/- 6.6) to 5.5 (+/-3.6), and the SQ score, 14.3 (+/- 7.5), to 3.1 (+/- 3.1). A control group of12 subjects demonstrated no change in HI, ESS score, or SQ score during thisstudy.
“As any golfer knows, when your ability to think clearly or make gooddecisions is compromised, the likelihood of playing your best is greatlydiminished,” said Dr. Benton. “Through treatment with NPAP, we can improvemany cognitive metrics, such as attention span, memory, decision-makingabilities, and frustration management, which may, in turn, positively affect aperson’s golf game.”
Results of the study also showed that the best golfers, defined as HI <12, hadthe biggest improvements in their game. Within this group, the average HIdropped from 9.2 (+/- 2.9) to 6.3 (+/- 3.0); the SQ score from 10.8 (+/- 1.9),to 2.8 (+/- 2.6).
“The biggest handicap improvements occurred in the lower handicap, often oldergolfers. This group typically would be expected to trend in the oppositedirection due to age-related deterioration in strength and endurance,” saidMr. Friedman. “The drop in handicap among the better golfers probablyreflected that the major limiting factor was not golf skill but cognitivecompromise that improved when the sleep apnea was treated.”
Dr. Benton estimates that there are 1 to 3 million regular golfers (regulardefined as 10 or more rounds per year) who have OSA, and most are undiagnosedor untreated. However, even when proper treatment is offered, it is onlyeffective if it is used regularly. In men, studies have reported compliancerates as low as 40 percent. Patients cite many reasons for noncompliance withNPAP, including discomfort, inconvenience, cost, noise, or embarrassment. Inthe current study, nearly all patients in the treatment group had a compliancerate of above 90 percent.
“Providers typically attempt to maximize compliance with NPAP by promoting itsmedical benefits or warning patients of the risks involved in not beingtreated, but this approach does not always work,” said Dr. Benton. “In thecase of this study, the possibility of improving one’s ability to play golfappears to have been a significant motivation to improve treatmentcompliance.”
“Compliance with CPAP therapy is an ongoing issue in the treatment of patientswith sleep apnea,” said Kalpalatha Guntupalli, MD, FCCP, President of theAmerican College of Chest Physicians. “Finding new and more effective ways toincrease CPAP compliance based on individual motivations is definitelyencouraged.”
CHEST 2009 is the 75th annual international scientific assembly of theAmerican College of Chest Physicians, held October 31-November 5 in San Diego,CA. The ACCP represents 17,400 members who provide patient care in the areasof pulmonary, critical care, and sleep medicine in the United States andthroughout the world. The ACCP’s mission is to promote the prevention andtreatment of diseases of the chest through leadership, education, research,and communication. For more information about the ACCP, please visit the ACCPWeb site at www.chestnet.org.
SOURCE American College of Chest Physicians
Jennifer Stawarz of the American College of Chest Physicians, +1-847-498-8306,jstawarz@chestnet.org
