# Physiological Parameters of Sleep and the Risk of Obstructive Sleep Apnea in Competitive Athletes with Poor Sleep Quality

## TL;DR

This study examines how poor sleep quality in athletes relates to obstructive sleep apnea risk and changes in sleep stages and heart rate variability.

## Contribution

The study identifies physiological sleep patterns and heart rate variability differences in athletes at risk of OSA.

## Key findings

- Athletes at OSA risk showed higher percentages of Stage 1 and Stage 2 sleep and greater heart rate variability.
- AHI positively correlated with Stage 1/2 sleep and sympathetic activity, but negatively with Stage 3/4 sleep and parasympathetic activity.
- OSA risk in athletes is linked to disrupted sympathovagal balance during sleep.

## Abstract

This study aimed to explore the sleep conditions and obstructive sleep apnea (OSA) risk in athletes with poor sleep quality. Athletes with poor sleep quality before competition were recruited. Cardiopulmonary coupling analysis, the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Insomnia Severity Index were used to assess and compare athletes at risk of OSA (apnea-hypopnea index (AHI) ≥ 5 events per hour) with those not at risk (AHI < 5 events per hour). Comparisons were made between the non-OSA group (n = 23) and the OSA risk group (n = 19, AHI = 10.79 ± 4.47 events per hour). The OSA risk group exhibited a significantly higher percentage of Stage 1 (S1) and Stage 2 (S2) sleep and greater heart rate variability (HRV) (p < 0.05). Positive correlations were found between AHI and the percentage of S1 and S2 sleep, low-frequency (LF), and the LF/HF ratio (p < 0.05). Conversely, significant negative correlations were observed between AHI and the percentage of Stage 3 (S3) and Stage 4 (S4) sleep, as well as HRV (p < 0.05). Athletes with poor sleep quality and high OSA risk demonstrated reduced parasympathetic activity, increased sympathetic activity, and affected sympathovagal balance during nocturnal HRV.