Golfers with the nighttime breathing disorder obstructive sleep apnea can improve their scores by treating their problem, according to study findings presented this week at the CHEST 2009 meeting in San Diego, California.

After a few months of using a night-time device that provides nasal positive airway pressure (NPAP) - a treatment that has been shown effective for curbing sleep apnea - a dozen golfers saw their average handicap fall significantly from 12.4 to 11.0. The effect was even more pronounced in better golfers (handicap <12), whose average handicap dropped from 9.2 to 6.3.

“The original intent of the study was to investigate whether there would be improvement in the performance of golfers with sleep apnea once treated. That was seen and was no surprise to me. The surprise was that the most significant improvement was noted in the lower handicap golfers, many of whom were older,” study co-author Dr. Marc L. Benton told Reuters Health.

Obstructive sleep apnea is a disorder in which the tissues at the back of the throat temporarily collapse during sleep, causing repeated stops and starts in breathing during the night. This leads to poor-quality sleep and, often, daytime drowsiness, fatigue, and cognitive impairment, “all side effects which can negatively impact a person’s ability to golf to the best of one’s ability,” Benton noted in a prepared statement.

“As any golfer knows,” Benton added, “when your ability to think clearly or make good decisions is compromised, the likelihood of playing your best is greatly diminished. Through treatment with NPAP, we can improve many cognitive metrics, such as attention span, memory, decision-making abilities, and frustration management, which may, in turn, positively affect a person’s golf game.”

Benton, from Atlantic Sleep and Pulmonary Associates in Madison, New Jersey, and Neil Friedman from nearby Morristown Memorial Hospital studied 12 golfers with moderate to severe sleep apnea who were treated with NPAP and 12 control golfers. Handicap and levels of sleepiness were assessed at the start of the study and again after 20 rounds of golf during NPAP treatment.

In addition to reduced handicaps, the NPAP-treated golfers had significant improvements in their levels of sleepiness. The control golfers, by contrast, showed no significant improvements in any parameters, including handicap.

Rates of compliance with NPAP therapy were high in this study - greater than 90 percent. Prior studies have reported compliance rates as low as 40 percent. People cite many reasons for noncompliance with NPAP, including discomfort, inconvenience, cost, noise, or embarrassment.

“Providers typically attempt to maximize compliance with NPAP by promoting its medical benefits or warning patients of the risks involved in not being treated, but this approach does not always work,” said Benton.

“In the case of this study, the possibility of improving one’s ability to play golf appears to have been a significant motivation to improve treatment compliance,” he added. Benton estimates that there are 1 to 3 million regular golfers who suffer from sleep apnea, and most are undiagnosed or untreated.

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By Anthony J. Brown, MD

NEW YORK (Reuters Health)