Obstructive sleep apnea syndrome (OSAS) is associated with impairment of cognitive functions, and improvement is often noted with treatment. Golf is a sport that incorporates cognitive skills. We evaluated the impact of treating golfers with moderate-severe OSAS (defined as an apnea-hypopnea index > 15/hr) on their handicap index (HI), a well-defined outcome in golf.
Golfers underwent a nocturnal polysomnogram (NPSG) to determine whether they had moderate-severe OSAS. Patients with a positive NPSG were treated with nasal positive airway pressure (NPAP). HI was recorded upon study entry, as was the Epworth Sleepiness Scale (ESS), a validated questionnaire used to assess daytime sleepiness, and a sleep questionnaire (SQ) developed by the authors. After 20 rounds of golf on NPAP treatment, the HI was recalculated, and the questionnaires were repeated. 12 patients completed the active treatment arm of this study, and 12 non-OSAS matched controls also completed the study to assess impact of the study construct on HI, ESS, and SQ. Statistical comparisons between pre and post-NPAP treatment were made using the paired t-test or the nonparametric Wilcoxon Signed-Ranks test.
The 12 control subjects demonstrated no change in HI, ESS, or SQ during this study. The active treatment group demonstrated a significant drop in average HI, 12.4 (+/− 3.5) to 11.0 (+/− 4.7), P = .01; the ESS, 11.8 (+/− 6.6) to 5.5 (+/− 3.6), P = .01; and the SQ, 14.3 (+/− 7.5), to 3.1 (+/− 3.1), P = .003. Among better golfers, defined as HI < 12, the average HI dropped from 9.2 (+/− 2.9) to 6.3 (+/− 3.0), P < .001; the SQ from 10.8 (+/− 1.9), to 2.8 (+/− 2.6), P = .004. Average utilization of NPAP was 92.2% of the nights (+/− 8.2) as measured by data card reporting.
Treatment of OSAS can enhance performance of golfers with this condition. Treatment adherence was unusually high in this study.
Golf may be a strong motivator for selected patients to seek treatment and maximize adherence.
Marc Benton, No Financial Disclosure Information; No Product/Research Disclosure Information