Treating sleep apnea may lower handicap
Published 12:00 am Monday, March 10, 2014
A new set of irons, a $400 driver or a new putter might improve your golf game. Or you could try treating your sleep apnea.
Obstructive sleep apnea — characterized by repeated long pauses in breathing during sleep — is a serious disorder that increases the risk of hypertension, cardiac disease and stroke. Treating apnea can result in important health benefits. As it turns out, a small study has found that treatment might also lower a golfer’s handicap.
Researchers studied 12 golfers, average age 55, with moderate to severe sleep apnea, comparing them with 12 healthy control subjects. All the subjects filled out questionnaires about their health and golf performance. They were required to maintain a handicap with the Golf Handicap and Information Network, a service run by the U.S. Golf Association.
The golfers with sleep apnea were treated for an average of six months with continual positive airway pressure therapy, or CPAP, a treatment that uses a machine worn by the patient during sleep to keep airways open.
The control group started with an average handicap of 12.2, and by the end — 20 rounds of golf later — their average was 12.6. The group treated for sleep apnea moved from an average of 12.4 at the start to an 11.0 at the end, a small but significant improvement. And among the most skilled golfers — those with a handicap of 12 or lower at the start — the change was worth hoisting a celebratory Arnold Palmer. The best players among the control group had an 8.4 at the start, which eroded to a 9.2 at the end. Those treated for sleep apnea moved from an average 9.2 to a 6.3 by the time treatment was done.
Golf seems to require precisely the skills that treatment for sleep apnea improves.
“We know that the cognitive parameters — vigilance, attention span, memory — people with sleep apnea do poorly on these tests and improve with treatment,” said the lead author, Dr. Marc L. Benton, the medical director of the SleepWell Centers of New Jersey. “For years, I’ve been telling people who play golf that golf is work: memory, decision-making, anger management, calculation, hand-eye coordination. It’s very cognitive.”
According to the American Academy of Sleep Medicine, apnea is more common in men over 40 and women over 50, and most common of all in people over 60. An estimated 18 million Americans are affected. But persuading patients to adhere to the treatment for sleep apnea — getting them used to wearing the sometimes uncomfortable equipment every night — can be a problem. Previous studies have shown that adherence ranges from 40 to 70 percent. But adherence among the study participants was high: Digital recording devices showed that the golfers used their CPAP machines more than 91 percent of the nights. The researchers suggested that the participants’ belief that treatment might improve their golf performance could have encouraged adherence.
Nagging patients is not especially helpful, Benton said. “But if you can tell people with some degree of assurance that you’ll be better at work, your memory will be better, you’ll be better socially, you’ll play better golf — these are things you have to focus on.”
The authors acknowledged that the study, published in the December issue of the Journal of Clinical Sleep Medicine, had a small sample and the golfers were not assigned randomly to treatment or no treatment. Still, the authors said, the 24 subjects were a representative sample of avid golfers: middle-aged men who play 25 or more rounds of golf a year.
Will treating sleep apnea improve your game? Maybe. Finding out the exact effect of treatment on athletic performance will require larger and better-designed studies. But treating sleep apnea is an important health measure in any case. Although some golfers may not believe it, there are more important things than lowering your handicap.