Sleep apnea may be more prevalent in younger female athletes, especially among those with higher levels of training, than previously believed, according to research presented at ACC's Care of the Athletic Heart.

In the study of 68 female collegiate athletes at two U.S. universities, 25% were found to have mild sleep apnea, defined as an apnea-hypopnea index (AHI) score of 5-15 (measured by apnea events per hour). Participants generally ranged from an AHI score of 2.1-7.7, with none crossing the line into moderate apnea (AHI score >15). Pulse wave velocity was higher in athletes with mild apnea and associated with a higher AHI, with both greater age and lean mass being independent predictors.

"Ensuring good sleep hygiene among these athletes is low-hanging fruit for improving overall health in this population," says Austin J. Rim, MD, a cardiology fellow at Emory University in Atlanta and the study's lead author. "Accurately diagnosing sleep apnea is important, as a range of treatment options – such as CPAP, mandibular advancement devices, or even surgery – can significantly improve quality of life and, depending on disease severity, potentially reduce long-term cardiovascular risk."

This work by Rim, et al., was just one of the presentations featured at Care of the Athletic Heart, held at ACC's Heart House in Washington, DC, and virtually. Other presentations and clinical cases include:

• The Cost of Gains: Testosterone-Induced Cardiomyopathy in a Bodybuilder
• From Standing Ovation to Cardiac Complication: A Case of Testosterone-Induced Heart Failure in a Professional Dancer and Former Track and Field Athlete
• Atrial Fibrillation in a U.S. Navy Submariner: Navigating Fitness for Duty

With cardiologists now seeing an estimated five athlete patients a week, the conference highlights a need for a robust discussion on strategies for improving their cardiovascular care.

For the first time, it is partnering with the European Association of Preventative Cardiology. "This international collaboration uniquely allows us to bring not just the U.S., but the world's experts together as faculty," says course co-chair Meagan Wasfy, MD, MPH, FACC. "Our focus is on putting together case-based, interactive learning that covers core sports cardiology tools such as ECG, imaging and CPET and how to apply these tools in the care of competitive and tactical athletes."

"Sports cardiology is relevant to the daily practice of all physicians who prescribe exercise as part of healthy living, for cardiovascular disease prevention or those with cardiovascular disease. Whether you care for elite athletes or recreational exercisers, this is the course for you," adds her co-chair Michael Papadakis, MBBS, MD, MRCP.

On Friday, Jared Butler, point guard for the Philadelphia 76ers, participated in a discussion on shared decision-making and spoke on his own journey after diagnosis of hypertrophic cardiomyopathy. He emphasized the "trust factor," and the relationship his cardiologists built with him and his family as instrumental in guiding him forward. He described it as adding "more Avengers to my team."

"I think it's great what you all are doing," he told the room. "It's going to impact so many lives."

Care of the Athletic Heart will continue over the weekend, June 12-14. In-person registration has sold out, but there is still time to attend sessions virtually. Learn more about the meeting and see the full agenda .