Short-term maximal performance, alertness, dietary intake, sleep pattern and mood states of physically active young men before, during and after Ramadan observance

Experiences of fasting during Ramadan in British Muslims: Psychological, social and health behaviours

Ramadan is a month-long religious festival observed by Muslim worldwide, characterised by intermittent fasting. This qualitative study addressed the need to understand how fasting is experienced by Muslims residing in Western cultures, aiming to inform policies that create a more supportive environment. Practicing Muslims, both men and women, were recruited in the North of England in the United Kingdom (UK). Data were collected by individual interviews (N = 7) and focus group discussion (N = 4) and then analysed using Social Ecological Theory as a framework. Fasting was managed at the individual level through instrumental food choice and eating practices, and by adapting sleep routines. Disrupted sleep routines posed a challenge for those who had to adhere to Western working schedules, leading to perceived detriments to cognitive function and mood. The sense of belonging associated with Ramadan was seen as a motivating factor for fasting. Breaking the fast (Iftar) was marked by social activity and the availability of traditional fried foods. Participants identified the wider Western culture and environment as challenging for those who are fasting. These findings imply a need for policies that enable flexible working practices for Muslims during Ramadan.

Ramadan-Induced Lifestyle Changes: Effects on Sleep and Physical Activity in Nonfasting Individuals With Type 1 Diabetes

OBJECTIVES

In this study, we aimed to identify sleep patterns, physical fitness, and barriers to physical activity (PA) during Ramadan observance in a cohort of nonfasting individuals with type 1 diabetes (T1D).

METHODS

Sixty-one nonfasting individuals with T1D, age 28.34±9.43 years (ranging from 15 to 54 years), completed questionnaires before and during Ramadan. The questionnaires included 3 assessment instruments: the Barriers to Physical Activity in Type 1 Diabetes (BAPAD1), the Pittsburgh Sleep Quality Index (PSQI), and the International Physical Activity Questionnaire.

RESULTS

During Ramadan, there was no significant change in BAPAD1 scores compared to before Ramadan (p=0.378). The primary barriers encompassed hypoglycemia risk, work schedules, diabetes control, and fatigue. Moreover, subjective sleep quality deteriorated during Ramadan compared to the pre-Ramadan period (p<0.001). Sleep duration decreased by 58 minutes (p<0.01) and was associated with later bedtimes and more awakenings. There was a notable decrease in PA levels (p=0.042), particularly for vigorous activities (p=0.017), whereas sedentary time showed a significant increase (p=0.008).

CONCLUSIONS

Ramadan observance did not affect barriers to PA in individuals with T1D despite alteration of sleep patterns and PA levels. Lifestyle alterations associated with Ramadan observance significantly impact individuals with T1D who are not fasting, resulting in reduced PA, shortened sleep duration, and increased sedentary time.

Changes in energy and macronutrient intakes during Ramadan fasting: a systematic review, meta-analysis, and meta-regression

CONTEXT

Ramadan fasting (RF) is associated with various physiological and metabolic changes among fasting Muslims. However, it remains unclear whether these effects are attributable to changes in meal timing or changes in dietary energy and macronutrient intakes. Furthermore, the literature on the associations between RF, meal timing, and energy and macronutrient intakes is inconclusive.

OBJECTIVES

This systematic review aimed to estimate the effect sizes of RF on energy and macronutrient intakes (carbohydrates, protein, fats, dietary fiber, and water) and determine the effect of different moderators on the examined outcomes.

DATA SOURCES

The Cochrane, CINAHL, EMBASE, EBSCOhost, Google Scholar, PubMed/MEDLINE, ProQuest Medical, Scopus, ScienceDirect, and Web of Science databases were searched from inception to January 31, 2022.

DATA EXTRACTION

The studies that assessed energy, carbohydrate, protein, fat, fiber, and water intakes pre- and post-fasting were extracted.

DATA ANALYSIS

Of the 4776 identified studies, 85 relevant studies (n = 4594 participants aged 9-85 y) were selected. The effect sizes for the studied variables were as follows: energy (number of studies [K] = 80, n = 3343 participants; mean difference [MD]: -142.45; 95% confidence interval [CI]: -215.19, -69.71), carbohydrates (K = 75, n = 3111; MD: -23.90; 95% CI: -36.42, -11.38), protein (K = 74, n = 3108; MD: -4.21; 95% CI: -7.34, -1.07), fats (K = 73, n = 3058; MD: -2.03; 95% CI: -5.73, 1.67), fiber (K = 16, n = 1198; MD: 0.47; 95% CI: -1.44, 2.39), and water (K = 17, n = 772; MD: -350.80; 95% CI: -618.09, 83.50). Subgroup analyses showed age significantly moderated the 6 dietary outcomes, and physical activity significantly moderated water intake. There were significant reductions in energy, carbohydrate, and protein intakes during RF.

CONCLUSIONS

The change in meal timing rather than quantitative dietary intake may explain various physiological and health effects associated with RF.

Ramadan fasting observance is associated with decreased sleep duration, increased daytime sleepiness and insomnia symptoms among student-athletes

OBJECTIVE

To examine the relationships between Ramadan fasting observance (RFO) and sleep-wake patterns, daytime sleepiness, and insomnia levels in student-athletes.

METHODS

Sleep was measured using wrist-actigraphy in 25 semi-professional student-athletes (mean ± SD; age = 22 ± 2 years, height = 182.0 ± 5.8 cm, body mass = 81.3 ± 15.2 kg) during seven nights before RFO (academic study period), during the first half of RFO (14 nights, holiday period), and the second half of RFO (14 nights, academic study period). Additionally, participants completed the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires seven days before RFO and on the last day of RFO.

RESULTS

Actigraphy results indicated RFO was associated with significant decreases in sleep duration during the second half of RFO vs. before and during the first half of RFO (p < 0.001). However, the first half of RFO was associated with a delay of ⁓ 2.5 h in sleep onset compared to before RFO; this delay persisted during the second half of RFO (p < 0.001). The total PSQI score before RFO (6.6 ± 2.3 AU) and during RFO (8.2 ± 2.3 AU) suggested poor overall sleep quality. ISI and ESS scores were greater during than before RFO (p = 0.002 and p = 0.041, respectively).

CONCLUSIONS

The second half of RFO was associated with decreases in objectively assessed sleep duration among student-athletes. RFO was also associated with impaired sleep quality, excessive daytime sleepiness, and increased insomnia symptoms. Personalized interventions to address sleep-related issues in student-athletes during RFO are warranted.

The effect of last meal "Suhoor" timing on diurnal variations in cognitive performance during Ramadan fasting among female athletes

The present study aimed to investigate the effect of the timing of the last meal, "Suhoor", on diurnal variation in cognitive performance during Ramadan intermittent fasting (RIF). In a randomized order, 26 adolescent female athletes (aged 15.9 ± 0.9 y) were tested in three sessions at 7:00 a.m., 12:00 p.m., and 5:00 p.m. across four different conditions: the 10 days preceding Ramadan (PR); the final 12 days of Ramadan (RO): two different conditions: Early Suhoor (SEarly), and Late Suhoor (SLate); and, ultimately, the 10 days immediately after Ramadan (AR) with an in-between recovery period of ≥24 h. During each test session, the oral temperature (OT), simple reaction time test (SRT), choice reaction time test (CRT), attention test (ATT), and mental rotation test (MRT) were evaluated. The Pittsburgh Sleep Quality Index (PSQI) and daily diary intake were assessed across the three periods. Compared to PR, the sleep parameters assessed by the PSQI were significantly lower during the RO and AR periods. However, neither total dietary intake nor OT showed any changes due to RIF. Compared to PR, the afternoon performances of SRT, CRT, ATT, and MRT significantly declined under both the SEarly and SLate conditions. Notably, midday performance decreased only during SLate, while morning performance remained unaffected in both conditions. Additionally, compared to SEarly, these performances were better during SLate in the afternoon and at midday. In summary, nutrient intake timing had a significant effect on the diurnal fluctuations in cognitive functions during Ramadan fasting, particularly around noon and in the afternoon. Our results illustrate the benefits of a late last meal (Suhoor) in preserving optimal morning cognitive abilities and preventing any impairment during the fasted state at midday or in the afternoon, which could affect overall athletic performance.

Ramadan Fasting and Short-Term Maximal Physical Performance: Searching for Optimal Timing of the Last Meal "Suhoor" in Female Pre-University Handball Players

Aiming to identify the ideal suhoor timing for maintaining optimal physical performance and health indicators during Ramadan intermittent fasting, the present study compares the effects of early vs. late Suhoor on short-term high-intensity physical exercise while controlling the body mass index (BMI) oral temperature (OT), dietary intake, and sleep patterns. In a randomized design, 19 female pre-university handball players (age: 16.8 ± 0.4 y; height: 1.70 ± 0.9 m; and body mass: 61.5 ± 6.9 kg) underwent two test sessions (at 08:00 a.m. and 05:00 p.m.) at four different conditions: ten days prior to Ramadan (R - 10), the final ten days of Ramadan (R) including both Early Suhoor R(ES) and Late Suhoor R(LS) conditions, and the ten days immediately following Ramadan (R + 10). A recovery period of at least 48 h has been set between successive test sessions at each period. Outcome measures included the Countermovement Jumps Test (CMJ), Modified Agility t-Test (MATT), Repeated Sprint Ability (RSA), and Rating of Perceived Exertion (RPE). The Pittsburgh Sleep Quality Index (PSQI), OT, BMI, and daily diary intake were assessed across the three periods. The total scores of PSQI decreased significantly during R and R + 10 compared to R - 10. When performed in the afternoon, CMJ, MATT, and RSA performance decreased significantly at R(ES) and R(LS) conditions compared to R - 10. However, these performances decreased only after R(ES) when performed in the morning. Furthermore, performances were lower during R(ES) compared to R(LS) in the afternoon for all tests and the morning for MATT and RSA tests. These findings support prior research showing a deterioration of physical performance during Ramadan fasting and indicate a more pronounced impact following early Suhoor condition. Therefore, consuming a late suhoor, closer to pre-dawn time, could be suggested as an effective strategy to minimize physical performance decline during short-term high-intensity exercise.

Pre-Exercise Caffeine Intake Attenuates the Negative Effects of Ramadan Fasting on Several Aspects of High-Intensity Short-Term Maximal Performances in Adolescent Female Handball Players

The aim of this investigation was to determine whether, after Ramadan, pre-exercise caffeine intake can reduce any possible negative effects of this month on short-term maximal performances in young female handball players. A randomized study involved thirteen young female handball players. Participants performed a squat jump (SJ), Illinois agility test (AG), and 5 m run shuttles test (total (TD) and peak (PD) distances) at 08:00 AM and 06:00 PM on three different occasions: one week before Ramadan (Pre-R), the last week of Ramadan (R), and the week after Ramadan (Post-R). A placebo (Pla) or caffeine (Caff) (6 mg·kg-1) was administered 60 min before exercise test sessions at two distinct times of day (08:00 AM and 06:00 PM) during the two periods: Pre and Post-R. The PSQI and dietary intake were assessed during all testing periods. The results revealed that Pre-R, (SJ, AG, TD, and PD) test performances were greater in the evening (PM) than in the morning (AM) (all p < 0.001). However, compared with Pre-R, PM performances declined significantly during R (all p < 0.001) and Post-R (p < 0.05, p < 0.01, p < 0.01 and p < 0.001, respectively). In addition, Pre-R, AM Caff produced moderate significant improvements compared with AM Pla, with small-to-no beneficial effects observed with PM Caff in SJ (4.8% vs. 1%), AG (1.8% vs. 0.8%), TD (2.8% vs. 0.3%), and PD (6% vs. 0.9%). Nevertheless, Caff produced moderate ergogenic effects during both AM and PM sessions during Post-R in SJ (4.4% vs. 2.4%), AG (1.7% vs. 1.5%), TD (2.9% vs. 1.3%), and PD (5.8% vs. 3%) with values approaching those of Pre-R Pla within the same time of day (p > 0.05, p > 0.05, p < 0.05, and p < 0.05, respectively). In summary, pre-exercise Caff intake with a dose equivalent to 6 mg·kg-1 reduced the negative effects of Ramadan fasting in several aspects of short-term maximal performances in young female handball players at both times of the day.

Perceived changes in the mental well-being among Nigerians due to Ramadan Intermittent Fasting during the COVID-19 pandemic

INTRODUCTION

Muslims fast every year during the month of Ramadan from dawn until dusk. This study examined mental well-being and correlating factors among Nigerian adults who observed Ramadan intermittent fasting (RIF).

METHODS

A validated generalized anxiety disorder-2 and Patient Health Questionnaire-2, the four-item spiritual well-being index, and the Islamic intrinsic religiosity questionnaire were used to collect data about mental well-being (depression, anxiety), spirituality, and intrinsic religiosity through a web-based survey between the May 9, 2021 (27th of Ramadan, 1442) and the June 4, 2021 (29th of Shawwal, 1442). We studied the mental well-being of respondents over a period of 4 weeks before Ramadan (BR) and during the 4 weeks of Ramadan between the April 12, 2021 and the May 12, 2021(DR). Multinomial regression analysis was used to determine the factors associated with depression and anxiety. This research did not receive any grant or funding.

RESULTS

A total of 770 adult Nigerians who observed RIF study were included in this cross-sectional study. When compared to mental well-being BR, observing RIF by Nigerian adult respondents was associated with a significant improvement in their mental well-being. A higher proportion of respondents felt less depressed DR (61.3% vs. 56.5%. < .001). Interest and pleasure in doing things improved DR than BR (p= 0.007) and respondents felt less nervous and anxious (60.7% vs. 57.1%, respectively; p <.001). Mental well-being was independently associated with sociodemographic characteristics, physical activity, and perceived relationships.

CONCLUSIONS

This study found significant improvement in mental well-being DR compared to BR despite the ongoing COVID-19 pandemic. The effect of RIF on mental well-being needs further research with multicentric studies among different sets of ethnic populations.

Timing of Resistance Training During Ramadan Fasting and Its Effects on Muscle Strength and Hypertrophy

PURPOSE

During Ramadan month, Muslims often continue training to maintain their muscle performance. However, trainers should stress the importance of the time of day chosen for practicing resistance training (RT) during Ramadan fasting to avoid health and performance alteration. Thus, this study aimed to investigate the effects of the timing of RT during Ramadan intermittent fasting (RIF) on muscle strength and hypertrophy in healthy male adults.

METHODS

Forty men were randomly allocated to 2 matched groups: 20 practicing whole-body RT in the late afternoon in a fasted state and 20 training in the late evening in a fed state (FED). Both groups performed 4 days per week of whole-body RT (∼75%-85% 1-repetition maximum, 12 repetitions/3-4 sets) during RIF. Anthropometric measurements and 1-repetition-maximum test for the squats, deadlift, and bench press were measured. A cross-sectional area of the quadriceps and biceps brachii was examined using ultrasound scans. All measurements were taken at 4 time points: 24 hours before the start of Ramadan, on the 15th day of Ramadan, on the 29th day of Ramadan, and 21 days after Ramadan.

RESULTS

Post hoc tests indicated significant preimprovement to postimprovement in FED at the 29th day of Ramadan for the 1-repetition-maximum test for the squats (P = .02; effect size = 0.21) and deadlift (P = .03; effect size = 0.24) when compared to 24 hours before the start of Ramadan. No significant changes were observed in the fasted-state group or for cross-sectional area for both groups.

CONCLUSIONS

Practicing RT during RIF appears not to have adverse effects on muscle hypertrophy and strength no matter whether it is practiced in FED or fasted state. However, RT had greater effects on muscle strength when applied in FED. Our findings suggest that training sessions should be scheduled after breaking the fast during Ramadan.

A Thirty-Minute Nap Enhances Performance in Running-Based Anaerobic Sprint Tests during and after Ramadan Observance

The purpose of this study was to determine the impact of a 30 min nap (N30) on the Running-Based Anaerobic Sprint Test (RAST) both during and after Ramadan. Ten physically active kickboxers (age: 21.20 ± 1.61 years, height: 174.80 ± 4.34 cm, body mass: 73.30 ± 7.10 kg and body mass index (BMI): 24.00 ± 2.21 kg/m²) voluntarily performed the RAST test after an N30 and in a no-nap condition (NN) during two experimental periods: the last ten days of Ramadan (DR) and ∼3 weeks after Ramadan (AR). During each DR-NN, DR-N30, AR-NN and AR-N30 protocol, kickboxers performed RAST performance. A statistically significant difference was found between Ramadan periods (DR vs. AR) in terms of max power (W) (F = 80.93; p₁ < 0.001; η²_p = 0.89), minimum power (W) (F = 49.05; p₁ < 0.001; η²_p = 0.84), average power (W) (F = 83.79; p₁ < 0.001; η²_p = 0.90) and fatigue index (%) results (F = 11.25; p₁ = 0.008; η²_p = 0.55). In addition, the nap factor was statistically significant in terms of the max power (W) (F = 81.89; p₂ < 0.001; η²_p = 0.90), minimum power (W) (F = 80.37; p₂ < 0.001; η²_p = 0.89), average power (W) (F = 108.41; p₂ < 0.001; η²_p = 0.92) and fatigue index (%) results (F = 16.14; p₂ = 0.003; η²_p = 0.64). Taking a daytime nap benefits subsequent performance in RAST. The benefits of napping were greater after an N30 opportunity for DR and AR.

COVID-19 lockdown: Impairments of objective measurements of selected physical activity, cardiorespiratory and sleep parameters in trained fitness coaches

The COVID-19 outbreak resulted in the shutdown of athletic training facilities. Although the effects of these restrictions on daily activity and sleep patterns have been widely analyzed, the employed tools often lacked accuracy, and were based on subjective measures. This study assessed the effects of home confinement on objective physical activity (PA), physiological and sleep parameters in active individuals. Sixteen male elite fitness coaches (age: 29±3 years; height: 183±6 cm; body mass: 82±5 kg, body mass index: 24.7±1.8 kg/m2) participated in this retrospective study. One-way analysis of variance was conducted to analyze selected PA, physiological and sleep parameters collected by smartwatch (Garmin Fenix 6 pro, USA) data during four consecutive months [i.e., pre-confinement, 1st and 2nd months of confinement, and post-confinement, year 2020]. Ramadan intermittent fasting (RIF) month occurred during the 2nd month of confinement. Compared to pre-confinement, significant changes were registered for almost all parameters during the 1st and/or the 2nd month of confinements (p<0.001), with (i) higher values for resting heart rate, sleep latency, and total, light and rapid eye movements sleep times (% change=7-523 %), and (ii) lower values for PA parameters, calories/day spent, average and highest respiratory rates, and deep sleep time during the home confinement period (% change=5-36 %). During the post-confinement month, all parameters regained pre-confinement values. In conclusion, home confinement-induced detraining negatively influenced the objective measurements of cardiorespiratory and sleep parameters among fitness coaches with a deeper effect during the 2nd month of home confinement, possibly due to the effect of RIF.

Longer Nap Duration During Ramadan Observance Positively Impacts 5-m Shuttle Run Test Performance Performed in the Afternoon

It is well-documented that changes in the rhythm of life during Ramadan affect sleep schedules (i.e., interruption of night sleep patterns) and are likely to have negative effects on physical and cognitive performances. The aim of the present study was to examine the effect of different naps opportunities' durations during Ramadan on performance of short-duration repetitive maximal exercise and perception of effort. Fifteen physically active men (age: 21 ± 3 years, height: 177 ± 6 cm, body-mass: 73 ± 10 kg) performed a 6 × 30-s shuttle run test after a 25-min nap (N25), a 45-min nap (N45), and in a no-nap condition (NN) during three experimental periods: ∼2 weeks before Ramadan (BR), the last ten days of Ramadan (ER), and ∼3 weeks after Ramadan (AR). During the shuttle run test performed in the late afternoon, the greatest distance (GD), the total distance (TD) and a fatigue index (FI) were assessed. Rating of perceived exertion (RPE) was determined after each 30-s effort. Dietary intake and sleep quality were assessed in each of the three periods. Compared to BR, GD and TD were lower in the ER testing period (p = 0.005; d = 0.54) but returned to BR levels in the AR period. During ER, carbohydrate intake was lower (p = 0.04; d = 0.2), and sleep duration and sleep quality were reduced (d = 0.27 and 0.54, respectively), although other aspects of dietary intake and sleep pattern were not affected. Compared to NN, GD and TD were higher after N25 (d = 0.57 and 0.34, respectively) and N45 (d = 0.93 and 0.88 respectively). RPE was lower in N45 (p = 0.035, d = 0.84). N45 resulted in higher TD (p = 0.021, d = 0.13) and lower RPE (p = 0.004; d = 0.57) compared to N25 during ER. Taking a daytime nap benefits subsequent performance in a shuttle run test, whether sleep the previous night was normal (as in BR) or compromised (as in ER). The benefits of napping were greater after a 45-min nap opportunity than after a 25-min nap opportunity.

Does observance of Ramadan affect sleep in athletes and physically active individuals? A systematic review and meta-analysis

The purpose of this systematic review and meta-analysis is to provide an accurate description of the effect of Ramadan observance on sleep duration, sleep quality, daily nap duration, and daytime sleepiness in athletes and physically active individuals. Five electronic databases (PubMed, Web of Science, Scopus, Wiley, and Taylor and Francis) were used to search for relevant studies conducted with athletes or physically active individuals during Ramadan, published in any language, and available before May 23, 2021. Studies that included assessments of sleep quantity and/or quality, and/or daytime sleepiness, and/or daily naps in athletes and physically active individuals were included. The methodological quality of the studies was assessed using "QualSyst". Of the 18 papers included in this study (298 participants in total), 14 were of strong quality, two were moderate, and the remaining two were rated as weak. Individuals who continued to train during Ramadan experienced a decrease in sleep duration (number of studies, K = 17, number of participants, N = 289, g = -0.766, 95% confidence interval [CI] -1.199 to -0.333, p = 0.001). Additionally, the global score of the Pittsburgh Sleep Quality Index increased from 4.053 (K = 5, N = 65, 95% CI 3.071-5.034) pre-Ramadan, to 5.346 (95% CI 4.362-6.333) during Ramadan, indicating a decrease in sleep quality. The duration of daytime naps increased during compared to pre-Ramadan (K = 2, N = 31, g = 1.020, 95% CI 0.595-1.445, p = 0.000), whereas Epworth Sleepiness Scale scores remained unchanged during versus pre-Ramadan (K = 3, N = 31, g = 0.190, 95% CI -0.139-0.519, p = 0.257). In conclusion, individuals who continued to train during Ramadan experienced a decrease in sleep duration, impairment of sleep quality, and increase in daytime nap duration, with no change in daytime sleepiness levels.

The effects of Ramadan intermittent fasting on sleep-wake behaviour and daytime sleepiness in team sport referees

The aim of the present study was to evaluate the impact of Ramadan fasting on sleep quality and daytime sleepiness in team sport referees. Seventy-eight male amateur team sport referees (age: 31.1 ± 10.8 years) participated in this study. Participants responded to the Arabic version of the Pittsburgh Sleep Quality Index (PSQI) and the Epworth sleepiness scale (ESS) questionnaires before (10-days prior) and during (last 7-days) the month of Ramadan.PSQI and ESS scores increased significantly during Ramadan (both p < .001, ES = 0.56 and 0.54, respectively) with 83.3% of participants scoring ≥5 in the PSQI. The percentage of participants suffering from severe excessive daytime sleepiness (ESS score ≥ 16) was 3.8% before vs. 7.7% during Ramadan (p < 0.001). Sleep duration decreased by ~ 1 h during Ramadan (p < .001, ES = 0.61) and was associated with a delay in bedtime of ~ 2 h (p < 0.001, ES = 0.7) and of wake-up time of ~ 1 h (p < 0.001, ES = 0.5). The score for daytime dysfunction and subjective sleep perception, as components of the PSQI, increased (both p < 0.001; ES = 0.79, ES = 0.57, respectively), whereas the score for the use of sleep medication decreased during vs. before Ramadan (p = 0.041, ES = 0.47). Ramadan fasting impaired sleep quality and increased daytime sleepiness in team sport referees. Future studies, using objective assessment tools, are warranted.

The effect of time of day and chronotype on the relationships between mood state and performance in a Wingate test

The purpose of this study was to investigate the effects of time-of-day and morning vs. evening chronotype on the relationships between mood state and performance of extreme intensity cycling exercise. A quasi-experimental between-groups design was used to test the hypothesis that there would be an effect of time-of-day on mood state and physical performance, that mood state and physical performance would be interrelated, and that the relationships would be influenced by participants' morning vs. evening chronotype. From 74 university students who volunteered, 7 were identified as morning types (M-types) and 7 as evening types (E-types). They completed the Profile of Mood States (POMS) questionnaire and performed a 30 s Wingate test on three different days, once at 08h00, once at 14h00, and once at 20h00. The main performance measure, work done in the Wingate test, increased across the day (16.4 ± 4.8 kJ < 17.0 ± 5.0 kJ < 17.6 ± 5.2 kJ; p < .01). For the M-types, individual changes in performance from the morning to the afternoon were correlated with individual changes in the POMS score for vigor (r = 0.81; p = .03) and changes in performance from the afternoon to the evening were correlated with individual changes in fatigue (r = - 0.85, p = .02). For the E-types, the opposite was true, as morning-to-afternoon changes in performance were correlated with individual changes in fatigue (r = - 0.70, p = .08) and afternoon-to-evening changes in performance were correlated with individual changes in vigor (r = 0.78, p = .04). Results demonstrate a time-of-day effect on morning vs. evening chronotype-dependent relationships between mood state and cycling performance.

A Thirty-Five-Minute Nap Improves Performance and Attention in the 5-m Shuttle Run Test during and Outside Ramadan Observance

Ramadan observance is characterized by several changes in behaviors, such as food and sleep, which could affect physical and cognitive performance. The aim of the present study was to investigate the effects of a 35-min nap (N35) opportunity on physical performance during the 5-m shuttle run test (5mSRT); attention; feelings; mood states; and perceptual measures of stress, fatigue, and muscle soreness during Ramadan observance. Fourteen physically active men (22 ± 3 years, 177 ± 4 cm, 76 ± 5 kg) were tested after a no-nap condition (N0), N35 15 days before Ramadan (BR), the last 10 days of Ramadan (DR), and 20 days after Ramadan (AR). Measures included the digit cancellation test (attention estimation), the profile of mood state (POMS), and the Hooper questionnaires. After a 5-min standard warm-up, participants performed the 5mSRT (6 × 30 s with 35 s in between; best distance (BD), total distance (TD), and fatigue index (FI) were recorded), along with the rating of perceived exertion (RPE) after each test repetition. After the 5mSRT test, participants responded to the feeling scale (FS). The results showed that TD and FI during the 5mSRT were not affected by Ramadan observance. However, BD was significantly lower than DR compared to AR after N0 (∆ = -4.3 ± 1.3%; p < 0.01) and N35 (∆ = -2.6 ± 1.0%; p < 0.05). After N0, attention decreased significantly at DR in comparison with BR (p < 0.05) and AR (p < 0.001). BD and TD improved after N35 compared to N0 at BR (∆ = +4.4 ± 2.1%, p < 0.05 for BD and ∆ = +4.8 ± 1.6%, p < 0.01 for TD), DR (∆ = +7.1 ± 2.2%, p < 0.05 for BD and ∆ = +5.1 ± 1.6%, p < 0.01 for TD), and AR (∆ = +5.5 ± 1.5%, p < 0.01 for BD and ∆ = +5.2 ± 1.2%, p < 0.001 for TD). A significant increase in attention was observed after N35 in comparison with N0 at DR (p < 0.01) and AR (p < 0.01). However, no changes were found for the perception of mood states, stress, sleep, muscle soreness, and the FI during the 5mSRT. Also, N35 was better than N0 for RPE at DR (p < 0.05), feelings at AR (p < 0.05), and fatigue estimation at AR (p < 0.01). A 35-min nap opportunity may have beneficial effects on physical and cognitive performances before, during, and after Ramadan.

Effect of diurnal fasting on sleep during Ramadan: a systematic review and meta-analysis

PURPOSE

The current meta-analysis aimed to obtain a more stable estimate of the effect size of Ramadan diurnal intermittent fasting (RDF) on sleep duration and daytime sleepiness.

METHODS

Databases (Scopus, ScienceDirect, ProQuest Medical, PubMed/MEDLINE, Web of Science, EBSCOhost, Cochrane, CINAHL, and Google Scholar) were searched from database inception to the end of June 2019. The sleep quality measures analyzed were excessive daytime sleepiness (EDS) measured by the Epworth sleepiness scale (ESS) and total sleep time (TST). Subgroup analyses for age, sex, and levels of physical activity were conducted.

RESULTS

We identified 24 studies (involving 646 participants, median age 23.7 years, 73% men) conducted in 12 countries from 2001 to 2019. The results revealed that TST decreased from 7.2 h per night [95% confidence interval (CI) 6.7-7.8] before Ramadan to 6.4 h (95% CI 5.3-7.5) during Ramadan, while the ESS score increased slightly from 6.1 (95% CI 4.5-7.7) before Ramadan to 7.0 (95% CI 5.2-8.8) during Ramadan. Effect sizes on sleep quality measures during RDF demonstrated a moderate reduction in TST (number of studies, K = 22; number of subjects, N = 571, Hedges' g value of -0.43, 95% CI - 0.64 to -0.22, Q = 90, τ2 = 0.15, I2 = 78%, P < 0.001), while ESS score showed negligible effect on EDS (K = 9, N = 362, Hedges' g value of -0.06, 95% CI -0.43 to 0.28, Q = 21, τ2 = 0.13, I2 = 76%, P value = 0.001).

CONCLUSION

During the month of Ramadan, there is approximately a 1 hour reduction in TST and nearly a 1 point increase in the ESS score.

Effects of 25-Min Nap Opportunity during Ramadan Observance on the 5-m Shuttle Run Performance and the Perception of Fatigue in Physically Active Men

We aimed to investigate the effects of a 25-min nap opportunity on physical performance during the 5-m shuttle run test (5mSRT), feelings (i.e., evaluated by the feeling scale), attention (i.e., evaluated by the digit cancellation test) and the perception of fatigue (i.e., recorded by the rating of perceived exertion (RPE)) during Ramadan observance. Twelve physically active men (age: 21.1 ± 3.2 yrs, height: 1.76 ± 0.05 m, body-mass: 71.2 ± 9.3 kg) voluntarily participated in five test sessions: 15 days before Ramadan (BR), the first 10 days of Ramadan (FR), the last 10 days of Ramadan (ER), 10 days after Ramadan (10AR) and 20 days after Ramadan (20AR). During each test session, participants performed the digit cancellation test, a 5-min standard warm-up, the 5mSRT (6 × 30-s with 35-s intervals-between) and the rating of perceived exertion (RPE) after no-nap (N0) and 25-min nap opportunity (N25) conditions. Participants also completed the Pittsburgh Sleep Quality Index (PSQI) during each period. The total distance covered during the 5mSRT did not differ significantly before, during or after Ramadan, but was significantly greater after N25 compared to N0 at 10AR (687.5 ± 23.0 m vs. 725.6 ± 41.1 m; p = 0.018) and 20AR (698.3 ± 19.8 m vs. 742.6 ± 58.3 m; p = 0.003). The attention scores were higher after N25 in comparison with N0 at 10AR (p = 0.04) and 20AR (p = 0.02). RPE scores were not significantly different between N25 and N0 conditions. Feelings scores were higher after N25 compared to N0 during both FR (p = 0.007) and 20AR (p = 0.04). A significant deterioration of sleep quality was recorded during Ramadan (i.e., PSQI scores were significantly higher during and after compared to BR (p < 0.0005)). A 25-min nap opportunity was beneficial for physical and cognitive performance after Ramadan observance; however, any effect is insufficient to show significant beneficial impacts during Ramadan.