Sleep Apnea Prevalent Among NFL Retirees

 

Two-time National Football League Defensive Player of the Year Reggie White, who played for the Philadelphia Eagles, Green Bay Packers, and Carolina Panthers, famously suffered from sleep apnea. Though White’s death in 2004 was attributed to cardiac and pulmonary sarcoidosis, the medical examiner’s office report stated that the sleeping disorder may have contributed to his death.

Now, a recent study shows that sleep apnea is highly prevalent among retired NFL players, particularly linemen. The study involving 167 players showed that sixty percent of linemen, average age of fifty-four, had sleep disordered breathing, as defined by having at least ten sleep-related breathing disorder episodes, such as pauses in breathing, per hour. Linemen had an average of 18.1 episodes per hour.

The monitoring of breathing at night was conducted while the retired players slept at home. In addition, researchers discovered that age and obesity were significantly associated with sleep disorder breathing. Linemen had an average body mass index of 34.2; a BMI of thirty or more is considered obese.

According to Dr. Virend Somers, a Mayo Clinic cardiologist who helped guide the study, the prevalence of sleep apnea and obesity among these retired NFL players was higher than expected, and serves as a warning that athletes need to monitor their weight and health carefully when they retire—a time when physical activity levels may begin to abruptly decline.

Retired football players are not the only ones affected by sleep apnea. According to the Institutes of Health, the disorder affects more than twelve million Americans, making it as common as adult diabetes. Certain factors increase the risk of sleep apnea, such as being male, overweight, and over the age of forty; but sleep apnea can strike anyone at any age, including children. The vast majority of sufferers go undiagnosed and untreated. Untreated, sleep apnea can lead to high blood pressure and other cardiovascular diseases, memory problems, weight gain and diabetes, impotence, and headaches.

In addition to anesthetic agents used during surgery, sufferers of sleep apnea need to be mindful of how they use certain narcotic analgesics (pain relievers) after surgery. Like anesthesia, many drugs and agents used post-surgery to relieve pain and to depress consciousness remain in the body at low amounts for hours or even days afterwards.

Researchers at the University of Alberta and Cortex Pharmaceuticals, a neuroscience company based in Irvine, California, believe that a novel class of molecules known as AMPAKINE compounds may provide protection from drug-induced respiratory depression, while simultaneously allowing the sedative or analgesic to continue working as it was intended.

AMPAKINE compounds act on the most common excitatory receptor in the brain, the AMPA-type glutamate receptor. Dr. John J. Greer of the University of Alberta demonstrated that certain AMPAKINE compounds stimulate primitive areas of the brain called the pre-Botzinger Complex that controls breathing, without causing side effects.

In animal models, AMPAKINE compounds were shown to enhance the respiratory drive and breathing rhythm in laboratory rats whose respiration rates were purposely suppressed by administration of central nervous system depressants. 

The company recently announced that the UK’s Medicines and Healthcare product Regulatory Agency (MHRA) gave it permission to proceed with the clinical development of CX1739 in subjects with moderate to severe sleep apnea. The study will be conducted in a UK sleep unit using a double-blind, placebo-controlled design in twenty subjects.

“CX1739 has been very well tolerated in Phase I healthy volunteer studies, and we are excited to be able to proceed with an efficacy study in sleep apnea,” said Dr. Mark Varney, President and Chief Executive Officer of Cortex.

Data obtained from animal studies have demonstrated that AMPAKINE compounds can specifically stimulate breathing by activating regions in the brain stem.  Last year, Cortex announced positive results of two clinical studies that demonstrated the AMPAKINE CX717 could prevent the depression of breathing induced by an opioid analgesic. Further analyses of these clinical studies also showed that CX717 reduced both the number and duration of apnea events caused by the opioid. Studies in animals suggest that CX1739 is approximately three times better than CX717 at reversing breathing depressed by opioids. CX1739 also stimulates another brain region that regulates muscle tone in the upper airways.

“Our hypothesis is that by stimulating breathing and increasing muscle tone in the upper airways, CX1739 will be effective in maintaining breathing throughout the night in sleep apnea patients,” commented Dr. Varney.

AMPAKINES could one day allow for improved safety and a more effective use of opiate analgesics and barbiturate sedatives, two important classes of central nervous system drugs. There is currently no drug treatment option available for sleep apnea and the market is considered a multi-billion dollar opportunity in North America alone.