Sleep apnea in athletes: how common it is, who's at risk and why fit people should still get checked

Sleep apnea in athletes is more common than most people expect, and being in great shape doesn't protect you from it. Studies of football players, rugby players and other athletes have found sleep-disordered breathing ranging from a small minority to more than half of some groups. Size matters more than fitness: big bodies and thick necks narrow the airway at night, whatever your training load.

Can athletes get sleep apnea?

Athletes can get sleep apnea, and some sports carry a higher risk than the general population. A 2025 systematic review in Sleep Medicine pulled together 20 studies of sleep-related breathing disorders in athletes and para-athletes. Using an apnea-hypopnea index (AHI) of 5 or more events per hour as the cutoff, the rates varied widely by sport:

• 24% to 86.5% of rugby players, across four studies
• 8% to 62.5% of active football players, across four studies
• 22% to 41% of retired football players, across four studies
• 30% of elite swimmers and 61% of ice hockey players, in one study each
• 68% of judo athletes and 58.5% of golfers, in one study each
• 8% of basketball players and 7% of Brazilian Olympic athletes, in one study each
• 22% of para-athletes with spinal cord injury, in one study

Those ranges are wide because the studies were small and used different tests. But the message is consistent: sleep apnea turns up in athletes often enough that it shouldn't be dismissed because someone is young and strong. If you want to understand the AHI cutoffs, see what is AHI.

How common is sleep apnea in football linemen?

Football linemen are the most studied group of athletes, and they often appear to be at higher risk than teammates, though not in every study. We rate the evidence as limited because the studies are small, use different testing methods, and often recruit players more likely to snore.

The first major study, published in Sleep Medicine in 2003, screened 302 players from eight professional football teams. Most were under 30, with an average neck size of 45.2 cm and an average BMI of 31.5. Fifty-two players had a full overnight sleep study in a lab, with players flagged as high risk deliberately over-sampled. An AHI of 10 or more turned up in 34% of the high-risk players but only 7% of the low-risk ones. Offensive and defensive linemen made up 12 of the positive cases. The authors estimated that about 14% of players overall had sleep-disordered breathing.

A larger 2010 study in Sleep tested 137 active NFL players from six teams with a home monitor. It found that 19% had at least mild sleep-disordered breathing, and only 4.4% had moderate to severe disease. In this study, linemen and non-linemen didn't differ. Every player reported snoring, and about a quarter reported observed breathing pauses. The authors pointed out that even the smaller non-linemen had an average BMI of 30.

College players have been studied too. A 2016 study in Respiratory Care screened a college team and tested 51 players overnight. About 8% had an AHI of 5 or more, and the positive cases were two offensive linemen, a linebacker and a tight end.

What happens after athletes retire?

Rates look higher in retired players. A 2010 study in the Journal of the American College of Cardiology screened 257 retired NFL players and found sleep-disordered breathing, defined as an AHI of 10 or more, in 52.3%. Former linemen were more affected than other positions (61.3% vs 46.6%), and they were also more likely to have obesity.

The researchers found that once they accounted for age and BMI, playing position no longer predicted sleep apnea. In other words, it was body size, not the position itself, that drove the difference. They suggested this should serve as a warning about weight gain in later life, regardless of past fitness. Our guide to sleep apnea and weight gain explains how the two feed into each other.

Why are some athletes at higher risk?

Athletes are at higher risk of sleep apnea mainly because of size and the shape of the airway. The National Heart, Lung, and Blood Institute (NHLBI) says extra fat deposits in the neck can block the upper airway, and that a large neck, tonsils or tongue can narrow it. Neck size comes up again and again in the athlete studies. The professional players in the 2003 study had an average neck size of 45.2 cm.

The 2025 review listed the risk factors identified across studies:

• Older age and male sex
• High body mass index and heavy body weight
• Large neck circumference
• A history of concussion
• Playing lineman in football or forward in rugby

BMI can be misleading in muscular athletes, since it doesn't separate muscle from fat. The 2010 Sleep study looked at body fat percentage specifically and found it wasn't more strongly linked to sleep apnea than BMI was.

How does sleep apnea affect performance and health?

Sleep apnea can affect both how an athlete feels day to day and their long-term health, though few studies have measured performance directly.

Daytime sleepiness and focus

NHLBI says sleep apnea can cause daytime sleepiness and tiredness that lead to problems with learning, focusing and reacting, all of which matter in sport. In the 2003 football study, more than 20% of players had an Epworth sleepiness score above 10, a sign of excessive daytime sleepiness, and scores were highest in habitual snorers. A 2021 expert consensus on sleep in athletes, published in the British Journal of Sports Medicine, notes that athletic performance is reduced by a night or more without sleep.

Evidence that treatment helps

The direct evidence is small but positive. In a 2013 study in the Journal of Clinical Sleep Medicine, 12 golfers with significant sleep apnea (a respiratory disturbance index above 15) started positive airway pressure therapy. After 20 rounds, their average handicap fell by 11.3%, and by 31.5% among the more skilled golfers. A matched group of golfers without sleep apnea showed no change. The authors noted that the golfers used their machines unusually consistently, and suggested that better performance could motivate some people to stick with treatment.

The 2025 review found two studies where CPAP improved sleep quality, reduced sleepiness and enhanced performance, in golfers and judo athletes. It also found two studies where a mandibular advancement device reduced apnea severity and snoring in rugby players. Our guide to oral appliances for sleep apnea explains how those devices work.

Heart and blood pressure

The longer-term concern is heart health. The 2025 review listed impaired heart function, depression and cognitive problems among the reported consequences of sleep-disordered breathing in athletes. In the retired NFL study, sleep-disordered breathing was linked to high blood pressure, though not after adjusting for age and BMI. Among active players, the 2010 Sleep study found that sleep apnea didn't explain the players' high blood pressure rates. For the bigger picture, see sleep apnea and high blood pressure.

How should athletes be screened for sleep apnea?

Athletes are usually screened with a short questionnaire first, then an overnight sleep test if the risk looks high. The 2016 college football study used the STOP-BANG questionnaire to sort players into high and low risk. The high-risk group had larger necks and higher BMIs. Our guide to the STOP-BANG questionnaire walks through the questions.

Screening tools miss people, though. In that same study, players flagged as low risk had sleep apnea at about the same rate as high-risk players. The authors still said the results underline the importance of screening and treatment in this group because of the link to heart disease. The 2021 sports medicine consensus also includes sleep screening in its toolbox for practitioners working with athletes.

If screening suggests a problem, the next step is a sleep study. Many people can now do this at home. Our guide to the home sleep apnea test explains what's involved.

When should an athlete see a doctor?

An athlete should see a doctor about sleep apnea if they have its warning signs, no matter how fit they are. NHLBI lists breathing that stops and starts, frequent loud snoring and gasping for air as nighttime symptoms, and daytime sleepiness, dry mouth, headaches and waking often to urinate as symptoms you might notice yourself. NHLBI notes you may not know about the nighttime symptoms until someone tells you, so listen if a teammate or partner mentions them. Our list of sleep apnea warning signs has more detail.

It's also worth asking if you've retired from a contact sport and gained weight, if you've had concussions, or if you have high blood pressure. A blocked nose that doesn't clear, or snoring that starts during pregnancy, is worth raising with a clinician too. This article is general information, not medical advice.

Read next

• Sleep apnea warning signs
• The STOP-BANG questionnaire
• Sleep apnea treatment options

* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.