| Abstract | Cilj: U odabranom uzorku profesionalnih boksača, kickboksača i igrača ragbija odrediti zastupljenost opstrukcijske apneje tijekom spavanja, procijeniti rizik nastanka OSA-e te procijeniti sveukupnu kvalitetu spavanja i razinu prekomjerne dnevne pospanosti obzirom na sport i pretrpljenu ozljedu glave.
Ispitanici i metode: U istraživanje je bilo uključeno ukupno 32 muškarca, 12 boksača, 5 kickboksača i 15 igrača ragbija. Ispitanici su podijeljeni u dvije skupine ovisno o pretrpljenoj ozljedi glave pri čemu se ozljeda glave odnosila na dijagnozu potresa mozga i/ili loma nosa. Istraživanje je po ustroju presječno i kliničko. Ispitanici su obrađivani u razdoblju od listopada 2017. godine do studenog 2018. godine u Centru za medicinu spavanja Kliničkog bolničkog centra Split i Medicinskog fakulteta u Splitu. Svi ispitanici su ispunili jedan dio standardiziranih upitnika validiranih na hrvatski jezik (STOP i Pittsburgh upitnik, Epworthova ljestvica dnevne pospanosti). Potom je svim ispitanicima postavljen prenosivi uređaj Alice1 za cjelonoćno poligrafsko ispitivanje te su ispitanici noć proveli kod kuće.
Rezultati: Skupina boksača i kickboksača je u odnosu na skupinu ragbijaša bila mlađa (28 vs. 43, P<0.001) te su imali manju masu (84 kg vs. 102 kg, P<0.001), manji indeks tjelesne mase (24.9 kg/m2 vs. 28.9 kg/m2, P<0.001) i manji opseg vrata (40.5 cm vs. 43 cm, P=0.003). U skupini boksača i kickboksača 17.6% ispitanika ima potvrđenu dijagnozu OSA-e (AHI≥5), dok je u skupini ragbijaša dijagnoza OSA-e potvrđena u 60% ispitanika (AHI≥5), (P=0.015). Od ukupno 32 ispitanika, 12 ispitanika (37.5%) je imalo AHI≥5, od toga je 8 ispitanika (25%) bilo iz skupine s pretrpljenom traumom glave, dok je 4 ispitanika (12.5%) bilo iz skupine bez traume. Prosječna vrijednost AHI u skupini s pretrpljenom traumom glave iznosila je 4.2 (3-7.23), dok je u skupini bez traume bila 2.7 (1.65-6.3). Prosječna vrijednost ODI bila je 3.7/h (1.48-9.33) u skupini s traumom, dok je u skupini bez traume 1.87/h (0.475-3.5). Prosječan indeks kvalitete spavanja u ispitanika s OSA-om u skupini s traumom je iznosio 3.5 (2-5.25), dok je u ispitanika s OSA-om u skupini bez traume iznosio 6 (5.75-6.25). Prosječna vrijednost ukupnog zbroja Epworthove ljestvice dnevne pospanosti u ispitanika s OSA-om iz skupine s traumom iznosila je 3.5 (2.75-4.25), dok je u ispitanika s OSA-om iz skupine bez traume iznosila 7 (6-7.25).
Zaključak: U skupini ragbijaša veći je broj sportaša (60%) kojima je dijagnosticirana OSA (AHI≥5) nego u skupini boksača i kickboksača (17.6%). Ispitanici iz skupine s pretrpljenom ozljedom glave imali su višu prosječnu vrijednost AHI, veći broj ispitanika s dijagnosticiranom OSA (AHI≥5) te veću ODI vrijednost u odnosu na ispitanike bez ozljede glave. S pomoću Pittsburgh upitnika dokazana je razlika u vremenu latencije spavanja koja je bila kraća u ispitanika kojima je dijagnosticirana OSA iz skupine s pretrpljenom traumom glave. |
| Abstract (english) | Objectives: The aim of this study was to determine prevalence of obstructive sleep apnoea in the selected sample of professional boxers, kickboxers and rugby players. Also, to determine the risk for OSA and evaluate general sleep quality and level of daytime sleepiness.
Patients and methods: A total of 32 men, 12 boxers, 5 kickboxers and 15 rugby players were involved in the study. The respondents were divided into two groups depending on the head injury suffered, with head injury related to diagnosis of brain concussion and/or nasal fracture. Conducted study was cross-sectional and clinical with all respondents being treated in period from October 2017 to November 2018 in the Split Sleep Medicine Center. All respondents completed one part of the standardized questionnaires validated in Croatian (STOP and Pittsburgh Questionnaire, Epworth Sleepiness Scale). Then, all respondents were fitted with the Alice1 portable device for full-length polygraphic testing and they spent the night at home.
Results: The respondents from the boxer and kickboxer group were younger (28 vs. 43, P<0.001), weighed less (84 kg vs. 102 kg, P<0.001), had a lower body mass index (24.9 kg/m2 vs. 28.9 kg/m2, P<0.001) and a smaller neck circumference (40.5 cm vs. 43 cm, P=0.003). In the boxing and kickboxing group, 17.6% of respondents had confirmed OSA diagnosis (AHI≥5), while in the group of rugby players diagnosis was confirmed in 60% of respondents (AHI≥5), (P=0.015). Of the 32 respondents, 12 respondents (37.5%) had AHI≥5, of whom 8 respondents (25%) were in the group with head trauma, while 4 respondents (12.5%) were from a non-traumatic group. The mean value of AHI in the group with head trauma was 4.2 (3-7.23), while in the non-traumatic group was 2.7 (1.65-6.3). The mean value of ODI was 3.7/h (1.48-9.33) in the traumatic group, while in the non-traumatic group 1.87/h (0.475-3.5). The mean sleep quality index in the respondents with OSA in the trauma group was 3.5 (2-5.25), while in the respondents with OSA in the non-traumatic group was 6 (5.75-6.25). The mean value of the total number on Epworth sleepiness scale in the respondents with traumatic OSA was 3.5 (2.75-4.25), and in the non-traumatic OSA respondents 7 (6-7.25).
Conclusion: The number of athletes who were diagnosed with OSA (AHI≥5) was greater in group of professional rugby players (60%) than in the boxer and kickboxer group (17.6%). Respondents with a history of head trauma had higher mean AHI, higher number of respondents with diagnosed OSA (AHI≥5), and higher ODI in relation to respondents without head injury. Using the Pittsburgh Questionnaire, there was a difference in sleep latency, which was shorter in respondents with a diagnosed OSA in the group with head trauma. |
