1250 Sleep Disorders and Symptoms Among Former Professional American-Style Football Players: The Football Players Health Study

Abstract Introduction Former professional American-style football (ASF) players experience a high burden of chronic health conditions. While prior studies suggest a strong relationship between ASF participation and sleep-related disorders, the prevalence and clinical characteristics of these conditions in retired players have not been fully described. In this context, we assessed the prevalence of sleep disorders and symptoms among former professional ASF players and explored differences by position (linemen vs. non-linemen). Methods The Football Players Health Study (FPHS) at Harvard University is an epidemiological cohort of approximately 5,000 former ASF players. Among this cohort, 111 participants enrolled in an in-person study that oversampled former players with zero, one, or more than three chronic health afflictions. Data collection included overnight polysomnography and self-reported sleep questionnaires. Primary outcomes included PROMIS Sleep Disturbance and Sleep-Related Impairment scores, and Apnea-Hypopnea Index (AHI). Secondary outcomes included fatigue and restless legs symptoms. Exploratory outcomes included polysomnographic- total sleep time, sleep efficiency, periodic limb movements, and arousal index. Results The sample included 62 linemen and 49 non-linemen, with similar mean age between groups (48.1 vs. 48.4 years; p = 0.844). Participants demonstrated mildly elevated Sleep Disturbance scores (51.9 ± 8.7) with normative Sleep-Related Impairment (49.3 ± 9.1) Race differed by position (p = 0.002), with linemen more often White (59.7%) and non-linemen more often Black (69.4%). Linemen had higher BMI than non-linemen (35.5 vs. 29.8 kg/m2; p < 0.001). Diagnosed sleep apnea was more prevalent among linemen (14.5%) than non-linemen (0%; p = < 0.01). Despite differences in BMI and OSA diagnoses, PROMIS sleep disturbance, sleep-related impairment, and fatigue scores were similar between groups. Non-linemen reported a higher frequency of restless leg symptoms (36.0% vs. 17.2%), though results were imprecise. Median AHI (8.5 linemen, non-lineman 9.2), sleep architecture, and exploratory outcomes did not differ by lineman status. Conclusion Although linemen had higher BMIs and history of diagnosed OSA, sleep disturbance and sleep-related impairment were similar across positions. Future characterization former AFL players could further identify the associations between sleep and commonly comorbid conditions, including pain, concussion history, post-career psychosocial stressors, or cardiometabolic disease to identify sleep intervention targets. Support (if any)