SAN DIEGO — Golfers with obstructive sleep apnea can anticipate knocking strokes off their game by adhering to treatment with continuous positive airway pressure.
What's more, the better the player at baseline, the bigger the improvement in golf handicap resulting from CPAP, as demonstrated in a small prospective controlled study presented at the annual meeting of the American College of Chest Physicians.
Compliance with CPAP is notoriously challenging. Many patients with OSA, put off by CPAP's noise, inconvenience, and expense, remained unswayed by physician warnings of the medical risks they face in not being treated. For the avid golfer, however, the prospect of playing a better game appears to be a powerful and previously untapped motivator to seek and adhere to treatment for OSA.
“The adherence in this study was absolutely off the charts,” said Dr. Marc L. Benton, who has a sleep disorders and pulmonary medicine practice in Madison, N.J.
He came up with the idea of studying the impact of OSA therapy on golf performance after two physician friends, both golfers, that he treated for OSA told him their handicaps had improved and they felt better able to manage their game.
“More so than almost any other sport, golf has a strong intellectual component, with on-course strategizing, focus, and endurance being integral components to achieving good play,” he noted. “Through treatment with nasal positive airway pressure [NPAP], we can improve many cognitive metrics, including attention span, memory, decision-making abilities, and frustration management, which may in turn positively affect a person's golf game.”
Dr. Benton's study involved 12 golfers with moderate to severe OSA and 12 control subjects matched by age and golf handicap. None of the golfers with OSA had previously been interested in treatment for their disorder—but the prospect of potentially lowering their handicap lured them into study participation.
After 3-5 months of NPAP, during which the patients played 20 rounds of golf, their handicap dropped from an average of 12.4 to 11.0. All of them felt that they were able to perform better on the course.
Their mean score on the Epworth Sleepiness Scale decreased from 11.8 to 5.5, and their score on a sleep questionnaire improved from 14.3 to 3.1, placing them in the normal range.
Meanwhile, the control subjects showed no change from baseline in golf handicap, the Epworth Scale, or sleep questionnaire score.
The study participants didn't take golf lessons or get new clubs during the study period.
The outcomes were particularly striking in the five golfers with OSA who were already quite skilled at the game, as defined by a baseline handicap below 12. Their average handicap dropped from 9.2 to 6.3, nearly a 3-stroke improvement, about which they were exultant.
Sleep specialists typically consider the use of CPAP for 4 hours or more per night on 75% of nights to be acceptable compliance. The golfers took their treatment far more seriously, using their CPAP machines for 5.5 to 7 hours per night on 92% of nights, as measured by the equipment's data cards.
Dr. Benton estimated 1-3 million American golfers have OSA, in most cases undiagnosed or untreated.
Disclosures: Dr. Benton reported having no financial conflicts of interest in connection with his study.
The outcomes were particularly striking in the five golfers with OSA who were already quite skilled at the game.
Source DR. BENTON