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Football Players in Danger of Sleep Apnea

dragonfire101

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Football Players in Danger of Sleep Apnea

May 12, 2008 in Sleep Apnea, Sleep disorders, obstructive sleep apnea | Tags: Reggie White, Football, athletes, body mass index

Both current and former football players face the dangers of obstructive sleep apnea, the disorder that contributed to the tragic death of former Green Bay Packers superstar Reggie White.

Two of the major indicators for sleep apnea are neck size and body mass index. Perhaps as many as 75% of professional football players, and many college and even high school players, qualify for the neck size indicator, which is 18 inches. And despite being in sensational football condition, many qualify for the body mass index indicator, which is 30 and above.

These indicators plus questions relating to sleep are vitally important for team doctors to consider in player physical examinations. Sleep apnea can be treated very easily, and doing so would likely enhance the performance of athletes who think they are sleeping well, but are constantly exhausted. Certainly, it could reduce the risk of other serious diseases, such as heart disease, stroke, asthma, diabetes and more, and likely would prevent some premature deaths among athletes.

Realistically, any athlete who meets the neck and body mass indicators should consider whether they snore and gasp at night, are feeling exhausted during the day, and then consider talking with their doctor or a physician who specializes in sleep disorders. Some athletes who might wish to think about this are shot-putters, weight lifters, wrestlers and more.
Why take the chance?
 
Football Players in Danger of Sleep Apnea

May 12, 2008 in Sleep Apnea, Sleep disorders, obstructive sleep apnea | Tags: Reggie White, Football, athletes, body mass index

Both current and former football players face the dangers of obstructive sleep apnea, the disorder that contributed to the tragic death of former Green Bay Packers superstar Reggie White.

Two of the major indicators for sleep apnea are neck size and body mass index. Perhaps as many as 75% of professional football players, and many college and even high school players, qualify for the neck size indicator, which is 18 inches. And despite being in sensational football condition, many qualify for the body mass index indicator, which is 30 and above.

These indicators plus questions relating to sleep are vitally important for team doctors to consider in player physical examinations. Sleep apnea can be treated very easily, and doing so would likely enhance the performance of athletes who think they are sleeping well, but are constantly exhausted. Certainly, it could reduce the risk of other serious diseases, such as heart disease, stroke, asthma, diabetes and more, and likely would prevent some premature deaths among athletes.

Realistically, any athlete who meets the neck and body mass indicators should consider whether they snore and gasp at night, are feeling exhausted during the day, and then consider talking with their doctor or a physician who specializes in sleep disorders. Some athletes who might wish to think about this are shot-putters, weight lifters, wrestlers and more.
Why take the chance?

You have a very painful learning strategy. I've tried to explain to you that BMI per se and any girth measurement per se is not associated with OSA. This is my last attempt at any exchange with you, if you so value your ignorance and status as a broscientist then you can keep it along with your cherished bullshit theories.

The above article you cut-and-pasted is a fine example of bad science journalism and you are fine example of an uneducated and uncritical consumer of bad science journalism.

The simple and short rebuttal to your "theory" and the above piece of amateurish science journalism is that the BMI is an indirect index of adiposity. By relating height to weight (BMI=weight / height^2) BMI aims to identify those individuals with excess weight due to excess adiposity. Since BMI fails to take account of weight composition excess weight due to higher fat-free mass is counfounded with excess weight due to higher fat mass.

What follows is a more detailed rebuttal.

BMI is a proxy measure of body fat composition. Since primary care physicians do not have the equipment and/or time to determine body composition they use the BMI as a proxy for this measure. The BMI can not and does not measure body fat composition -- it is a proxy measure, all it is is the ratio of weight to height squared. When Quetelet formulated the BMI (then known as the Quetelet Index) in 1832 the purpose was to provide an index of fatness (because it became apparent that fatness was associated with cardiovascular disease at around the same time) which could be used by actuaries in forumulating insurance policies and epidemiologists in classifying people as obese or otherwise[1]. The BMI is based on Quetelet's observation that

If man increased equally in all his dimensions, his weight at different ages would be as the cube of his height. Now, this is not what we really observe.
The increase in weight is lower, except during the first year afer birth; then the proportion which we have just pointed out is pretty regularly observed. But after this period, and until near the age of pubert, the wight increases nearly as the square of the height.
[2]

Quetelet's observation is correct for most (Caucasian) populations and this is partly why the BMI became popular as a proxy measure for fatness. Quetelet came up with the idea of the average man and it is to this man that his index applies. The highly muscled man is modern phenonmenon. In Quetelet's time men with large amounts of LBM and BF < 10% would have been so rare that they were irrelevant. Since the 1950s the number of men in which height is dissociated from lean weight has multipled, much so since the 1980s with the wider availability of AAS and peptides. Why is the above article and your theory flawed? Simply because football players and bodybuilders have a total mass that is mainly fat-free i.e. they aren't fat.

Most people with a large neck girth are fat and it is the weight of this fat bearing on their pharynx which contributes to their airway collapse[13][14]. Football players have thick necks not because they are corpulent but because they perform neck exercises to strengthen their necks. Their neck girth is attributable to muscle not fat. Further, fat covers the front of the neck, muscle does not, so any neck muscle does not bear on the anterior of the pharynx. Some confirmatory empirical data:Matthews & Wagner (2008) measured BF directly using bioelectrical impedance and indirectly using the BMI in a sample of 85 National Collegiate Athletic Association (NCAA) Division I football players. They found that "BMI overestimated the prevalence of overweight and obesity in 50.6% of the cases" and concluded that "BMI alone is not a valid indicator of overweight and obesity in a strength-trained athletic population."

The relationship between all mortality and BMI is U-shaped i.e. elevated mortality rates are associated with both high and low BMI. This is paradoxical given that fat-loss is associated with lower mortality and morbidity[7][8]. This paradox is due to BMI being a non-specific measurement i.e. not distinguishing between fat mass (FM) and fat-free mass (FFM). It turns out that low BMI is associated with high mortality because low FFM is associated with high mortality[9][10]. Thus higher levels of FFM are associated with lower morbidity and mortality rates i.e. the more lean muscular mass you carry the less likely are you to become sick or die (from disease).

BMI undermeasures fatness in Asians. Why? Because again it is a non-specific measure of mass . BMI underestimates FM in Asians because of their comparatively lighter builds (i.e. smaller frames and lower amounts of FFM)[3][4][5][6]

Janssen et al (2004) found that waist circumference and not BMI are associated with obesity related health risks. Why? Because waist circumference is a better indirect measure of fatness than BMI.

Is a stable (normal) BMI throughout our senior years a good thing? No, not necessarily because the normal course of things for men is that FFM is lost as we age and replaced with FM. The BMI stays the same but risk of mortality (due to disease and accident) and morbidity increases[11][12]. Again this misclassification of old male folk is due to the non-specificity of BMI.

The limitations of the BMI are well-known to bio-medical researchers and epidemiologists. Primary care physicians, some science journalists and broscientists like you are yet to fully appreciate the limits of BMI.

People like you should stay away from PubMed because you don't have the necessary background knowledge to critically approach what you are reading (and you may lack the intelligence to ever gain it.)
 
Didn't I give you a study that shows new info showing evidence of possible myopathy and muscle change in the muscles of throat. I understand what your saying about BMI. Most sleep centers are now using neck measurement also as a contributing factor of over 17-18'.

Many sleep Centers still use still use the Stanford Method for predicting Obstructive Sleep Apnea, which cooperates BMI. They now use the quote below so get around that.

"If the person is obese and/or has a very thick neck (such as a weightlifter or bodybuilder), thickening of the muscles around the spine and the weight of the jaw on the throat can lead to collapse of the throat during sleep."
You have a very painful learning strategy. I've tried to explain to you that BMI per se and any girth measurement per se is not associated with OSA. This is my last attempt at any exchange with you, if you so value your ignorance and status as a broscientist then you can keep it along with your cherished bullshit theories.

So I'm not allowed to independently think and come up with my own theories or opinions if its not written as factual or proven in a already existing scientific study. I'm not out her saying take this drug or that drug and putting anyone safety a risk with what I'm saying like some do. I can see if that was your concern.
I'm looking at data an drawing from it although it may not be to your standards coming up with ideas that maybe need to be investigated or possibly studied. Maybe they have been, but you going around bashing people base don that shows you may be lacking or ignorant when it come to emotional intelligence.

What if I came up with something like this, would that satisfy you?

Changes in types Type I fibre and higher percentage of type IIa fibre in muscles of throat may predict higher risk of sleep apnea, which is more prevalent in weight lifters due to cell proliferation, and causes may be due to resistance training and use of anabolics and other growth factors.

In conclusion a majority of these individuals have low bodyfat levels, although BMI is usually greater than 30, and necks greater OF 17'. Further study is warranted if increase type I fibre and higher percentage of type IIa fibre changes are occurring in muscles of the throat, without the use of anabolics and other growth factors; or resistance training alone, and increasing large amounts of muscle contributing to a BMI greater than 30 and neck size over 17' may be risk factors to Obstructive Sleep Apnea.

People like you should stay away from PubMed because you don't have the necessary background knowledge to critically approach what you are reading (and you may lack the intelligence to ever gain it.)

I would like to know what is yours background knowledge and IQ as well.

Bro I have no problem with someone posting studies or clearing up misinterpretations on certain data, but u come off as a know all of everything an try to flame any member who disagrees or shows any attempt of posting other information that is anecdotal. Much of what people experiment on this board with and do is anecdotal and they give and share their experiences based on that.
 
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Didn't I give you a study that shows new info showing evidence of possible myopathy and muscle change in the muscles of throat. I understand what your saying about BMI. Most sleep centers are now using neck measurement also as a contributing factor of over 17-18'.

What you quoted above isn't even a piece of science journalism it's an entry in blog. You can't use some guy's ruminations as a basis for an argument.

Regarding neck girth, I will repeat what I have already stated: neck girth due to fat will cover the front of the neck and will weigh on it. Muscle does not cover the front of the neck. Sleep centers use neck girth as a risk factor because it is accurate for most people -- most people with thick necks have double-chins.

Many sleep Centers still use still use the Stanford Method for predicting Obstructive Sleep Apnea, which cooperates BMI. They now use the quote below so get around that.

"If the person is obese and/or has a very thick neck (such as a weightlifter or bodybuilder), thickening of the muscles around the spine and the weight of the jaw on the throat can lead to collapse of the throat during sleep."

The above quote (a) is incoherent (jaw weight is independent of neck girth and will only change in a small number of cases of HGH abuse); and (b) does not constitute evidence that large neck girth as a consequence of developed musculature contributes to the risk of developing OSA.

So I'm not allowed to independently think and come up with my own theories or opinions if its not written as factual or proven in a already existing scientific study.

The problem is you aren't thinking clearly or interpreting evidence correctly. You are presenting some guys empty opinion posted on his blog as weighty evidence.

I'm not out her saying take this drug or that drug and putting anyone safety a risk with what I'm saying like some do. I can see if that was your concern.

No but you are spreading misinformation and confusion.

I'm looking at data an drawing from it although it may not be to your standards coming up with ideas that maybe need to be investigated or possibly studied. Maybe they have been, but you going around bashing people base don that shows you may be lacking or ignorant when it come to emotional intelligence.

There is a difference between saying "I suspect -- without firm evidence -- that size in general and especially a thick neck -- regardless of composition -- may be implicated in OSA" and saying "High BMI and a thick neck cause OSA". You can conjecture as much as you please -- and I won't criticise you -- but don't try and pass off your conjecture as a substantiated result.

What if I came up with something like this, would that satisfy you?

Changes in types Type I fibre and higher percentage of type IIa fibre in muscles of throat may predict higher risk of sleep apnea, which is more prevalent in weight lifters due to cell proliferation, and causes may be due to resistance training and use of anabolics and other growth factors.

No it wouldn't satisfy me because it isn't a substantiated result. It reads like it came from the the discussion section of a research paper. It is conjectural that is why the word "may" appears repeatedly.

In conclusion a majority of these individuals have low bodyfat levels, although BMI is usually greater than 30, and necks greater OF 17'. Further study is warranted if increase type I fibre and higher percentage of type IIa fibre changes are occurring in muscles of the throat, without the use of anabolics and other growth factors; or resistance training alone, and increasing large amounts of muscle contributing to a BMI greater than 30 and neck size over 17' may be risk factors to Obstructive Sleep Apnea.

Again this isn't a substantiated result and that is why the phrase "Further study is warranted..." appears. As I have been repeating, there is no evidence that substantiates the idea that high levels of FFM and a large neck girth comprised of muscle elevates the risk of OSA. There is only conjecture.

I would like to know what is yours background knowledge and IQ as well.

You can find my background in another post. I will allow the content of posts to speak to the matter of my intelligence.

Bro I have no problem with someone posting studies or clearing up misinterpretations on certain data, but u come off as a know all of everything an try to flame any member who disagrees or shows any attempt of posting other information that is anecdotal. Much of what people experiment on this board with and do is anecdotal and they give and share their experiences based on that.

I have no problem being corrected. Patrick Arnold corrected me on the matter of the solubility of crystalline testosterone on this forum. I didn't cry about it, instead I am trying to find confirmatory references. I have been scouring books on drug pharmacokinetics to confirm Patrick's contention. If I find something I will gladly post a thread titled "I was wrong and Patrick Arnold was right" and I will reproduce the evidence.

Anecdotal evidence is fine where there is no alternative (eg. Trenbolone in humans) but many of the topics in fitness/bodybuilding aren't in this category (eg. DNP). I don't see any merit in reproducing and disseminating brolore when scientific evidence is available. What has brolore given us? Idiotic ideas (which are sometimes dangerous): some testosterone esters are more "powerful" than others, site injections of esterified testosterone will produce local muscle growth, androgen receptors get "burnt out", androgen receptors are "cleaned" by DNP, you will only get malignant hyperthermia from DNP if you dehydrate, high repetitions are for definition (remember that one), liquid orals are less toxic than tablets...blah, blah, blah.
 
What you quoted above isn't even a piece of science journalism it's an entry in blog.

There is a difference between saying "I suspect -- without firm evidence -- that size in general and especially a thick neck -- regardless of composition -- may be implicated in OSA" and saying "High BMI and a thick neck cause OSA". You can conjecture as much as you please -- and I won't criticise you -- but don't try and pass off your conjecture as a substantiated result.


No it wouldn't satisfy me because it isn't a substantiated result. It reads like it came from the the discussion section of a research paper. It is conjectural that is why the word "may" appears repeatedly.


Again this isn't a substantiated result and that is why the phrase "Further study is warranted..." appears. As I have been repeating, there is no evidence that substantiates the idea that high levels of FFM and a large neck girth comprised of muscle elevates the risk of OSA. There is only conjecture.

You can find my background in another post. I will allow the content of posts to speak to the matter of my intelligence.

HOLY CRAP U just missed the whole point of what I did. I freaken wrote you a Hypotheses based on what I suspected just like u stated in the paragraph before. That's why it reads as it came from a research paper. Its not a copy and paste. That was my proposal for additional study, which is why I wrote further study is warranted based on current or limited data (evidence) in hopes of finding substantiated results.

Narcissism can blind U.

Bro U come off as very condescending. Go find your post to figure out what background is. Just state it. :rolleyes:


Anyways I come on this board after a long day and my intentions are not to proof myself to anybody, but share my thoughts and talk with some friends on the board. Who really want's to play this back and forth crap.

I hope U have a lot of time on your hands if you goal is to try and shoot down anyone's opinion who don't present it as a dissertation with scientific studies to back it up. That's the majority of the board. A lot on here read articles on various things such as training ,diet drugs, from none science and science journalism and give their opinions, based on what they read and own anecdotal evidence (experiences) and previous collective data.

Maybe U should post a disclaimer to everyone to write "I suspect -- without firm evidence" anything they my post if they don't have dissertation ready with scientific studies for you.

I STILL THINK NECK SIZE IN NONE OBESE PERSONS MAY STILL BE INDICATOR IN RISK FOR OBSTRUCTIVE SLEEP APNEA. ;)
 
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