Sleep on the Watch: How Sleep Apnea Affects Exercise and Athletic Performance

Admin@ | September 18, 2018 | 0 | Health

Achieving that bulk muscles is one of the bodybuilders main goals. They religiously go the gym, carry heavy weights, do push ups, bench press, deadlift and even doing midnight late exercises. Most people do their workouts somewhere 5:00 am and 10:00 pm. However, due to work shifts schedules, some may be forced to go to the gym in the middle of the night which sacrifices quality sleep.

Most fitness enthusiast and athletes would agree that getting enough sleep is vital for optimal performance. This claim remains a theory until recently this has been back up by research and studies.

According to the study conducted by Eve Van Cauter, Ph.D., from the University of Chicago sleep deprivation slows glucose metabolism by as much as 30-40% and decreases the level of cortisol (a stress hormone). Cortisol is linked to memory impairment, age-related insulin resistance and impaired recovery in athletes. Sleep deprivation also affects cognitive and endocrine function.

Given the fact that sleep deprivation could have a big impact on athletes and fitness enthusiast people, it is essential to know the critical factor that causes it. Several studies have been conducted to determine what is one of those factors. Some may have heard of this term but does not really understand it. Some may already have it but is not aware. Keep reading to know more of this disorder that might be affecting your routines, sleep apnea.

Sleep apnea: Signs and Symptoms

Sleep apnea is a serious sleep disorder that occurs when breathing is interrupted during sleep. People with this disorder stop breathing repeatedly. Sometimes a hundred times! It means the brain and other parts of the body may not be getting enough oxygen.

Below are some of the signs and symptoms of sleep apnea:

  • Loud snoring
  • Episodes in which you stop breathing during sleep — which would be reported by another person
  • Gasping for air during sleep
  • Awakening with a dry mouth
  • Morning headache
  • Difficulty staying asleep (insomnia)
  • Excessive daytime sleepiness (hypersomnia)
  • Difficulty paying attention while awake
  • Irritability

There are three main types of sleep apnea:

  • Obstructive Sleep Apnea – the most common type of sleep apnea. It is sometimes referred to as OSA. It happens when the throat muscles in the back of your throat collapse too much to allow for normal breathing. The throat muscles support the tissues in the back of the throat. When the muscles collapse too much, the soft tissues can fall back into the throat which partially or completely blocks the normal flow of air in your airway. When this happens, the person may start to snore. However, not all people who snore are suffering from sleep apnea.
  • Central Sleep Apnea – It occurs when the brain is not sending the proper messages to the muscles that control breathing. Robson Capasso, MD, chief of sleep surgery and associate professor of otolaryngology and head and neck surgery at Stanford University School of Medicine in California explains that central sleep apnea is caused by neurological reason.
  • Complex Sleep Apnea – In patients with this type of sleep apnea, breathing problems still persist even after the airway is addressed and treated. This could mean something besides the collapsing throat muscles are also contributing to the apnea.

Consider visiting your doctor when you experience these signs and symptoms. Prevention is still better than cure as they say.

Sleep Apnea: Even Athletes and Bodybuilders are at Risk

Between 18 and 20 million Americans are suffering from sleep apnea. Obesity often contributes to this disorder. However, Dr. Kevin Berry, a sleep apnea dentist claims that you don’t need to be overweight to be diagnosed with sleep apnea. Even athletes and fitness enthusiasts are at risk of sleep apnea. This disorder is not just a fat person’s disease, he added.

Normally, you wouldn’t link sleep with elite athletes. But did you know that when athletes are at their fittest, sleep apnea is at its most dangerous? Unfortunately, sleep apnea isn’t a new discovery, but it’s something that deserves more attention.

A recent article published on the Men’s Health told a cautionary tale of a man named Tom Zehmisch. Tom Zehmisch died at the age of 46. Judging his appearance and look, no one would think that he is at risk of obstructive sleep apnea. Four months earlier, he participated in a national swim met and died while participating in a triathlon.

The stereotypical obstructive sleep apnea patient is more likely of an obese one more like Don Dillard. Don Dillard had reached a staggering 401 pounds in 2007 and had been hospitalized four times for serious health problems including congestive heart failure. He was diagnosed with sleep apnea.

Despite their difference in appearance, what do they have in common? It is in the airways.

Athletes may be in good physical condition, but having a “thick neck” is one of the risk factors of sleep apnea according to National Health, Lung and Blood Institute. The thick neck may develop through excessive weightlifting as well as carrying the extra pounds needed to push people as in the football game. This sports routine may contribute to the thickening of the wall of the windpipe which makes it harder to stay open when the body is relaxed, added the National Institutes of Health.

In an email address to Sleep Dental by Dr. Helene A. Ensellem, MD, director of the Center for Sleep and Wake Disorders in Chevy Chase and co-author a 2005 study titled “Sleep Apnea and Sports Performance,” she said that an increased in neck circumference and short neck are affecting in some athletes’ performance. For this reason, Dr. Ensellem recommends conducting dentist screen athletes for sleep apnea.

Bodybuilders are also at risk for health concerns related to sleep apnea including blood pressure stroke and other life-threatening issues including death. This is because some of their routines include carrying weights just like the wrestlers, football players and other muscular athletes. Sleep apnea is pointed out as one of the contributing cause to the death of football legend Reggie White who died at the age of 43. His death was attributed to sarcoidosis, a tissue inflammation disorder, and sleep apnea.

Sleep Apnea Linked to Impaired Exercise Capacity

In a study led by the University of California San Diego (UCSD),they found out that people with sleep apnea may not be capable of burning sufficient levels of oxygen during strenuous aerobic exercise. This study was published in the Journal of the clinical sleep medicine.

This study was participated by a group of 15 subjects with moderate or severe sleep apnea and 19 with mild or no sleep apnea. The participants were asked to pedal an exercise bike until they reach the point of exhaustion. They found out that participants with moderate to severe apnea had on average 14% lower VO2 max than the controls. The data gathered suggest that there is a link between the severity of apnea(measured by the number of times breathing stops for 10 seconds or more per hour of sleep) and reduced levels of VO2. Wikipedia defines VO2 as the maximum rate of energy consumption during incremental exercise. Common tool use is CPET(cardiopulmonary exercise testing) which engages subjects in an aerobic activity such as riding a bicycle to assess heart and lung function.

The team found that this measure of apnea severity – known as Apnea Hypopnea Index – could predict 16% of the variability seen in the group’s peak VO2, a result that Prof. Beitler, assistant clinical professor in pulmonary and critical care medicine at UCSD sees as “a big discrepancy.”

According to him, sleep apnea itself causes structural changes in muscle that contributes to their difficulty exercising.

Does Sleep Apnea Limit Exercise?

Sleep apnea does limit exercise due to several health problems associated with cardiovascular factors like exaggerated blood pressure or delayed heart rate recovery. In a recent study, researchers examined the link between obstructive sleep apnea and exercise testing outcomes in a sample of 1204 patients. They found out that patients with severe OSA had significantly lower heart rate recovery, functional aerobic capacity and a higher post-exercise blood pressure than those without OSA.

Sleepiness is concluded to be one of the contributing factors for reduced physical activity in patients with OSA as it reduces the time and needs to do such activities. In a survey of 40 patients with obstructive OSA which aims to clarify their exercise capacities and the possible relationship with the other findings, a battery of aerobic and anaerobic tests was performed in these patients and 40 control subjects. It revealed that the apnea-hypopnea index was an independent predictor of aerobic capacity which might be due to restricted daily physical activity by the OSA itself.

Also in an important survey of 1106 consecutive patients (741 men and 365 women) referred to a sleep clinic for OSA, they found out that sleepiness reduced the hypertensive response to exercise. AHI(apnea-hypopnea index), depression and lack of exercise were the significant predictors of sleepiness. In this study, it is proved that sleepiness which impairs one’s ability to exercise well is significantly affected by sleep apnea. Sleep apnea also causes inflammation with elevated levels of C-reactive protein and tumor necrosis factor alpha and interleukin-6 which are associated with sleepiness and fatigue.

Sleep Apnea Hampers Performance

People who suffer from sleep apnea may not be getting the restorative rest it needs for optimal physical and mental performance. Whether you are training for triathlon or marathon, doing bodybuilding exercises or just shaving time off of the Saturday morning run, science says sleep is a key.

High levels athletes and bodybuilders need to undergo rigorous training and exercises respectively. Other than training and exercise, they also need to work on their mental aspects of performance enhancement. However, it has been proven that sleep improves performance and enhance endurance, hence giving them an edge with their counterparts.

The Stanford University’s Center for Sleep Sciences and Medicine is using extended athletes sleep time to evaluate performance enhancement in recent years. They found out that extending sleep time has a performance-enhancing effect across several sports and that optimal sleep was a contributing factor in reaching peak performance.


Whatever your purpose for going to the gym, it is necessary that you will know some of the factors that may hinder you in achieving your goal. Do you want to be the champion of the next bodybuilding competition? Do you want to increase your strength and endurance to ace the next sports game? Whatever the reasons, it is of great importance to know what hampers your performance.

Sleep apnea is not a new thing. It is something that we do not really understand. It is something that should not be taken for granted as anyone can have it, even the healthy and the fit ones. What is more surprising is that athletes, bodybuilders especially those who are into sports or activities that involve weightlifting, carrying extra loads and deadlifting are more prone to sleep apnea.

For some who knows how serious sleep apnea is, they are beginning to raise awareness to the public. Take NBA All-Star player Shaquille O’Neal for example. He currently suffers from sleep apnea and is receiving treatments. Aware how serious this sleep disorder is, he partakes in advocating sleep apnea awareness. The 3rd module of online Sleep and Health Education Program released by the Division of Sleep Medicine at Harvard Medical School features a four-minute video interview with him.

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