Autonomic Arousal–An Early Indicator for the Development of Sleep Breathing Disturbances in Athletes

Background: Sleep is essential for everyone and is important for normal human functioning. Lack of sleep, called sleep deprivation, is a condition leading to poor sport training and achievements. Different factors contribute to sleep deprivation in athletes. Respiratory sleep disorders as Upper Airway Resistance Syndrome (UARS) and Obstructive Sleep Apnea (OSA) are factors that rebound most to sleep deprivation for certain groups of athletes such as wrestlers, judists and sumo wrestlers especially. Objective: The present study investigates the UARS and OSA occurrence in the above mentioned groups of athletes using Pulse Transit Time (PTT) as an early noninvasive indicator of respiratory effort and sympathetic nervous system activity. Methods: The study involved ten elite athletes from wrestling, judo and sumo wrestling. The participants underwent full standard polysomnographic examination using Alice 5 System Philips Respironics Inc. with the registration of PTT. Results: At all athletes, regardless of the presence of changes in hemoglobin saturation or Apnoea-Hypopnea Index (AHI) changes was observed significant drop in the value of PTT more than 8-15 ms for stage N1 and N2 (p<0,005), as well as more than 6-8 ms for stage N3 (p<0,005). We found bigger dependence of PTT by Arousal Index (ArI) than AHI and Dessaturation Index (DI) Therefore, PTT can be used as a good indicator for sleep fragmentation before the development of the clinical picture of OSA and UARS. Conclusion: As a good indicator for inspiratory effort and sympathetic changes in UARS and OSA, PTT gives an opportunity for early diagnosis of respiratory sleep disorders among athletes. Prevention, timely detection and appropriate treatment of sleep disorders before the development of their full clinical picture will improve the processes of recovery and performance in sport practice.