Does Elite Sport Degrade Sleep Quality? A Systematic Review

Energy intake, hydration status, and sleep of world-class male archers during competition

BACKGROUND

Nutritional intake and sleep, play an important role for recovery and performance in elite sport but little work has been undertaken in archery. The present study aimed to assess energy intake (EI), hydration status, and sleep parameters in world-class male archers over the course of a four-day competition.

METHODS

Results, Conclusions Six male, elite-standard archers participated in the study and measurements of hydration status, EI, competition load, and sleep were recorded throughout each day of competition.

RESULTS

Daily energy, carbohydrate, and protein intake ranged between 2,563 and 3,986 kcal, 4 and 7.1 g/kg BM, 2.2 and 3.6 g/kg BM per day, respectively. Thus, archers practiced elements of periodized nutrition such that energy and carbohydrate intake was greater on the high-volume competition days (i.e. days 1 and 3; more numbers of arrows, longer duration, and walking distance) in comparison to low-volume days (days 2 and 4) over the tournament (all p > 0.01). Additionally, urine specific gravity was higher after waking, compared to pre- and post-competition, and before bed (all p < 0.05). This indicates that archers were euhydrated pre- and post-competition and before bedtime, while they were slightly hypohydrated after waking up. Sleep data show that disturbances were kept to a minimum.

CONCLUSIONS

Collectively, archers appear capable of periodizing their nutritional intake according to daily physical loading during a tournament whilst, staying euhydrated and maintaining sleep quality. In part, such data can help to explain why these archers experience a sustained level of success.

Behavioral interventions and behavior change techniques used to improve sleep outcomes in athlete populations: A scoping review

BACKGROUND

Athletes display a high prevalence of undesired sleep characteristics that may affect both performance and wellbeing.

OBJECTIVES

This scoping review aimed to identify and map the existing evidence of behavioral sleep interventions and their effects on sleep outcomes in athletes, and retrospectively code the behavior change techniques (BCTs) implemented using the Behavior Change Technique Taxonomy (BCTTv1).

METHODS

Conducted following the JBI methodology for scoping reviews, four online databases were used to identify prospective interventions with at least one behavioral component in competitive athletes, and reporting a sleep outcome pre- and post-intervention.

RESULTS

Thirty-three studies met the inclusion criteria, encompassing 892 participants with a median age of 23. Five intervention categories were identified (education, mind-body practices, direct, multi-component, and other), with each demonstrating mixed efficacy but the potential to improve sleep outcomes. The BCTs varied in type and frequency between each category, with only 18 unique BCTs identified across all studies.

CONCLUSIONS

The varied efficacy of previous studies at improving sleep outcomes may be attributed to the lack of behavior change theory applied during intervention development. Designing interventions following a targeted specification of the behavioral problem, and the integration of corresponding BCTs should be considered in future research.

Snooze it or Lose it: Understanding Sleep Disturbance and Injuries in Soccer and Basketball Student-Athletes

OBJECTIVES

To assess the sleep characteristics of collegiate soccer and basketball student-athletes and explore the associations between sleep and injury risk.

DESIGN

Cohort study.

SETTING

NCAA D1 and NAIA Tier 1.

PARTICIPANTS

One hundred eighty-one collegiate soccer and basketball student-athletes (42% female; mean age: 20.0 ± 1.7 years).

INDEPENDENT VARIABLES

Questionnaires were administered during the 2020/2021 and 2021/2022 preseason, collecting demographic, injury history, medical history, and sleep information, including sleep difficulty category scores of 0 to 4 (none), 5 to 7 (mild), and ≥8 (moderate/severe) and other sleep disturbance measures derived from the Athlete Sleep Screening Questionnaire (ASSQ), including insufficient sleep duration (<7 hours of sleep) and poor subjective sleep quality.

MAIN OUTCOME MEASURES

All-complaint knee and ankle injuries.

RESULTS

According to the ASSQ, 25.4% (95% confidence interval [CI], 17.9-34.3) of the student-athletes had mild sleep difficulty and 12.7% (95% CI, 7.3-20.1) had moderate/severe sleep difficulty. 36.1% (95% CI, 29.1-43.6) had insufficient sleep duration. 17.1% (95% CI, 11.7-23.7) were not satisfied with the quality of their sleep (poor sleep quality), and 13.8% (95% CI, 9.1-19.7) had an "eveningness" chronotype. Based on multivariable logistic regression models, student-athletes with poor sleep quality had significantly higher odds for injury (OR: 2.2, 95% CI, 1.04-4.79, P = 0.039).

CONCLUSIONS

Clinically relevant dysfunctional sleep patterns are prevalent among collegiate soccer and basketball student-athletes. Poor sleep quality was significantly associated with injury risk among student-athletes. Findings suggest a substantial sleep problem in collegiate soccer and basketball student-athletes and warrant that student-athletes are regularly screened and timely interventions applied.

Relationship between Workload, Psychological State and Recovery in Female Soccer Athletes

This study assessed the multifaceted relations between measures of workload, psychological state, and recovery throughout an entire soccer season in female collegiate soccer athletes (19.8±1.2 yrs, 132±12.3 lbs, 63±3.2 in). A prospective longitudinal study was utilized to measure workload (GPS training load, Rate of Perceived Exertion (RPE), psychological state (mental stress, mental fatigue, and mood), and recovery (sleep duration, sleep quality, and soreness), during 90 observations (59 training sessions and 21 games). Separate linear-mixed effect models were used to assess outcomes of RPE, soreness, and sleep duration. A linear mixed-effects model explained 59% of the variance in RPE following each session. Specifically, each standard deviation increase in GPS load and mental stress in the morning prior to training increased RPE by 1.46 (SE=0.08) and 0.29 (SE=0.07), respectively, following that day's training. Furthermore, a significant interaction was found between several predictor variables and chronological day in the season while predicting RPE. Specifically, for each standard deviation increase in GPS load, RPE went up by 0.0055 per day during the season suggesting that load had a higher impact on RPE as the season progressed. In contrast, the interaction of day by mental stress, sleep duration, and soreness continued to be stronger as the season progressed. Each linear mixed-effect model predicted a larger amount of variance when accounting for individual variations in the random effects.

The Sleep Parameters of Olympic Athletes: Characteristics and Assessment Instruments

This systematic review aims to identify the sleep parameters of Olympic athletes and the instruments used to assess and monitor the sleep of these athletes. The search was conducted until February 2023 and was performed in PubMed, Web of Science, and Scopus databases. This systematic review has included studies that investigated at least one of the following sleep parameters: total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), awakenings after sleep onset (WASO), quality of sleep, daytime sleepiness, and chronotype; the participants were Olympic athletes. The search returned a total of 280 studies. After screening based on exclusion and inclusion criteria, 11 studies were included. The main results demonstrate that Olympic athletes have TST of 06:10 h, SE of 84%, SOL of 28 min, and WASO of 49 min. The most predominant chronotype is indifferent; over half of the athletes have poor sleep quality and complaints. Furthermore, actigraphy was the most used method to assess sleep. It is concluded that Olympic athletes have TST, SE, and WASO poor than the recommended values. In addition, sleep complaints and poor sleep quality were also observed. Among the objective sleep assessment methods, actigraphy was the method most frequently used in this population.

Higher Levels of Morning and Daytime Light Exposure Associated with Positive Sleep Indices in Professional Team Sport Athletes

Objective

Light exposure techniques have been recommended to combat sleep issues caused by disruption to circadian regularity in the athletic population, although studies are lacking.

Methods

A total of 17 professional male Australian Football athletes (age ± SD: 22 ± 3 years) wore a wrist actigraph to measure sleep parameters, and a wearable light sensor to measure melanopic equivalent daylight illuminance (mEDI, in lux) for 14 days. Participants completed three sleep questionnaires at the end of the data collection period and completed well-being surveys 6 times. The Sleep Regularity Index (SRI) for each player was also calculated from actigraphy data. Light exposure data were organised into three different timeframes: morning (wake time + 2 hours), daytime (end of morning to 6 pm), and evening (2 hours leading up to bedtime) for analysis. Repeated measures correlation was conducted for objective sleep measures and mEDI values per timeframe. Pearson's correlation was conducted on subjective sleep measures and well-being measures against mEDI values per timeframe.

Results

Higher morning light was associated with significantly (p < 0.001) greater total sleep time (r = 0.31). Higher daytime light exposure was associated with higher subjective sleep quality (r = 0.48, p < 0.05). Higher evening light exposure was associated with higher Athlete Sleep Screening Questionnaire (ASSQ) global scores (r = 0.52, p < 0.05). There were no other significant correlations between light exposure and sleep or well-being measures (p > 0.05).

Conclusion

Higher morning and daylight exposure levels were associated with various positive objective and subjective sleep measures in professional team sport athletes, supporting the need for education on optimising light exposure to improve circadian function, sleep, and health.

The association between diet and sleep with internalising symptoms in young athletes: a serial multiple mediation models

Introduction

Athletes frequently experience anxiety and depression at rates similar to or higher than non-athletes. A balanced diet can alleviate athletes internalizing symptoms. Moreover, diet and sleep are all associated with internalising symptoms. Our study investigates how sleep quality mediates the impact of dietary habits on internalizing symptoms in athletes.

Methods

The current cross-sectional study involved 758 Chinese young athletes. The adapted Australian Athletes Diet Index was used to assess dietary patterns, and sleep was measured using the Athletes Sleep Screening Questionnaire. The Generalised Anxiety Disorder 7 scale and the Patient Health Questionnaire 9-item scale were used to assess symptoms of anxiety and depression. Structural Equation Modelling (SEM) analysis was used to examine the mediating role of sleep quality in young athletes. Raw scores of chronotypes, sleep quality, anxiety and depression were calculated for the statistical analysis.

Results

No significant indirect effects were found in adolescents. In adult athletes, diet mediated the relationship between chronotype and sleep quality (β = -0.028, p  <  0.001). Sleep quality mediated the association between diet and anxiety (β = -0.060, p = 0.001), and depression (β = -0.076, p = 0.001). Additionally, diet and sleep quality mediated the association between chronotypes and anxiety (β = -0.028, p = 0.001), and depression (β = -0.028, p = 0.001).

Conclusion

Sleep quality mediated the relationship between dietary patterns and internalising symptoms in young adult athletes. Additionally, diet and sleep quality mediated the association between chronotypes and internalising symptoms in young adult athletes.

Are Adolescent Athletes Sleeping Enough? An Observational Study of Sleep Parameters during Schooldays and Holidays

Background: Inconsistent sleep schedules, frequent awakening after sleep onset (WASO), and decreased sleep efficiency (SE) are common issues among adolescent team sports athletes. Moreover, research indicates that sleep problems are enhanced across schooldays. The aim of the present study was to assess sleep patterns of adolescent athletes and compare sleep parameters between schooldays and holidays. Methods: The chronotype and sleep quality of twelve adolescent basketball players (mean age: 15.58 ± 0.67 years) were assessed. Objective sleep parameters were then analyzed using actigraphy over a 12-day period, which included six days during the school period and six days during holidays. Results: Data showed that total sleep time (TST), SE, and WASO (382.48 min, 81.81%, and 66.70 min, respectively) did not meet international recommendations for sleep quantity and quality. During school weekdays, time in bed (TIB), TST, and SE significantly decreased compared to weekends (p < 0.001, d = -1.49; p < 0.001, d = -1.64; and p = 0.01, d = -0.89, respectively). On weekdays, TIB, TST, and WASO were significantly lower on schooldays compared to holidays (p < 0.001, d = -1.83; p < 0.01, d = -1.01; and p = 0.02, d = -0.77, respectively). While no significant difference was observed in social jetlag, the mid-point of sleep was significantly later on holiday weekdays compared to school weekdays (p < 0.05, d = 0.65). Conclusions: Adolescent athletes experience insufficient sleep, especially on school weekdays, which is partially improved during weekends and holidays. Although sleep duration was longer during holidays, our results suggest that adolescent athletes' sleep was more fragmented. Consequently, it remains crucial to implement strategies to enhance their sleep health (e.g., napping).

The effect of electro-magnetic-energy-regulation therapy on subjective sleep among elite players in Norwegian women's football

The current study investigated if Bio-Electro-Magnetic-Energy-Regulation (BEMER) therapy is affecting subjective sleep among a sample of 21 elite female football players in a Norwegian top series club. Subjective sleep was measured each day over a period of 273 consecutive days by using a smartphone application, PM Reporter Pro, which scheduled push messages to remind the participants to report sleep every morning. The study was conducted as a quasi-experimental design, with a control period before the introduction of BEMER therapy that lasted for 3 months, followed by an intervention period where BEMER therapy was used that lasted for 5 months. The collected data from the players in the control period served as their control compared to the data collected from the players in the intervention period. Analyses of variance (ANOVA) with False Discovery Rate adjusted p-values show that subjective sleep duration and subjective sleep quality are significantly reduced on game nights, both in the control period and in the experiment period. The results also show that subjective sleep duration and subjective sleep quality significantly increase in the experiment period compared to the control period. The findings indicate that BEMER therapy might serve as a tool to improve sleep.

The training times of athletes could play a role in clinical sleep problems due to their associations with sleep difficulty scores

OBJECTIVES

Sleep is a key component of athletic recovery, yet training times could influence the sleep of athletes. The aim of the current study was to compare sleep difficulties in athletes across different training time groups (early morning, daytime, late evening, early morning plus late evening) and to investigate whether training time can predict sleep difficulties.

METHODS

Athletes from various sports who performed at a national-level (n = 273) answered the Athlete Sleep Screening Questionnaire (ASSQ) along with several other questionnaires related to demographics, exercise training, and mental health. From the ASSQ, a Sleep Difficulty Score (SDS) was calculated. Transformed SDS (tSDS) was compared across different training time categories using multiple one-way ANOVAs. A stepwise regression was then used to predict tSDS from various sleep-related factors.

RESULTS

SDSs ranged from none (31%), mild (38%), moderate (22%), and severe (9%). However, the one-way ANOVAs revealed training earlier or later vs. training daytime shifted the tSDS in a negative direction, a trend toward increased sleep difficulty. In particular, athletes training in the late evening (>20:00 or >21:00) had a significantly higher tSDS when compared to daytime training (p = .03 and p < .01, respectively). The regression model (p < .001) explained 27% of variance in the tSDS using depression score, age, training time, and chronotype score.

CONCLUSION

Among a heterogeneous sample of national-level athletes, 31% displayed moderate to severe SDSs regardless of their training time. However, when athletes trained outside daytime hours there was a tendency for the prevalence of sleep difficulties to increase.

Managing daily responsibilities among collegiate student-athletes: Examining the roles of stress, sleep, and sense of belonging

Objectives: Student-athletes are unique in their undertaking of full-time academic and athletic roles. Their dual roles impose a multitude of responsibilities in their daily lives, yet little is known about the factors that may negatively impact their ability to effectively manage these responsibilities. Participants: Data from a large sample of Canadian varsity athletes (N = 1,353) were used for the present study. Methods: The association between stress and difficulties managing daily responsibilities, while simultaneously investigating the roles of sleep difficulties and sense of belonging as contributing factors was examined. Results: Findings indicated that the moderated mediation model was significant, revealing that sleep difficulties were a significant mediator in the relationship between stress and difficulties managing daily responsibilities and that sense of belonging moderated the relationship between stress and sleep difficulties. Conclusions: The results expose complex ways that student-athletes' performances (academic and athletic) can be impaired, signaling the need to develop strategic actions toward prevention and management of stress among student-athletes.

The Limitations of Using the Pittsburgh Sleep Quality Index to Assess Athletes' Sleep Quality: Evidence from Reliability and Validity in Chinese Professional Athletes

Purpose

This study aimed to assess the structural validity of the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) among Chinese professional athletes and examine its test-retest reliability and convergent validity across different timeframes.

Methods

581 Chinese professional athletes participated. Exploratory and confirmatory factor analyses were conducted on the Chinese version of the PSQI. Test-retest reliability was assessed over 2 weeks, 1 week, and 2-3 days within a 1-month timeframe. Additional reliability analysis over a 2-day interval was conducted within a 1-week timeframe. Convergent validity was assessed using Chinese versions of the Insomnia Severity Index (ISI), the Athlete Sleep Screening Questionnaire (ASSQ), and actigraphy. A 1-month tracking was conducted, with weekly completion of the PSQI using a one-week timeframe, supplemented by assessments in the second and fourth week using two-week and one-month timeframes. Relationships between weekly results and those over two weeks and one month examined, along with convergent validity, using sleep diary and actigraphy.

Results

The PSQI exhibited a two-factor structure (sleep quality and sleep efficiency), with good model fit (CFI = 0.960, AGFI = 0.924, TLI = 0.925, RMSEA = 0.085). Test-retest reliability was satisfactory for intervals of one week or more (r = 0.721 ~ 0.753). Using a one-week timeframe, the total score and two dimensions exhibited good reliability (r = 0.769 ~ 0.881), but only the total score and sleep quality showed high correlations with ISI and ASSQ (r = 0.701 ~ 0.839). Throughout the tracking, monthly responses correlated well with the most recent weeks (r = 0.732 ~ 0.866).

Conclusion

The PSQI demonstrates a two-factor structure in Chinese athletes, with sleep quality being predominant. Test-retest reliability within a one-month timeframe is unstable, suggesting a one-week timeframe performs better. Distinguishing between the two dimensions, employing shorter timeframes, and incorporating objective measures are recommended.

Adapting the athlete sleep behavior questionnaire (ASBQ) for Arabic-speaking populations: Translation, reliability testing, and validation using classical theory and item response theory

Sleep is essential for athletes' physical performance as well as their general health, well-being, and quality of life. To assess athletes' sleep behaviors, the Athlete Sleep Behavior Questionnaire (ASBQ) was developed in the English language. However, a validated Arabic-version of the ASBQ is lacking. This study aimed to translate the ASBQ into Arabic (ASBQ-AR) and evaluate its reliability and validity among Arabic-speaking athletes. A total of 458 participants (254 athletes, 202 non-athletes) from four Arabic countries completed the ASBQ-AR and the Insomnia Severity Index (ISI) questionnaires. The psychometric properties of the ASBQ-AR were examined using unidimensional reliability analysis, confirmatory factor analysis (CFA), Item Response Theory (IRT), and convergent validity. The ASBQ-AR had acceptable internal consistency (Cronbach's α = 0.723, McDonald's ω = 0.725) and a factorial structure, confirming its construct validity. CFA demonstrated improved model fit indices after the removal of two potentially misfitting items (items 4 and 13); however, the model's fit to the data remains suboptimal. IRT results indicated that the majority of items demonstrated a good model fit, suggesting effective measurement of the intended construct without significant interference, except for ASBQ-AR 4. Additionally, ASBQ-AR 4 appears to present the highest level of difficulty for respondents. In terms of convergent validity, the mean ASBQ-AR global score was correlated with the mean ISI global score (r = 0.5, p < 0.0001). The ASBQ-AR is a reliable and valid tool for assessing maladaptive sleep practices among Arabic-speaking athletes. Additional refinements to the ASBQ-AR are warranted to optimize its psychometric properties.

Baseline Sleep Characteristics in NCAA Division I Collegiate Athletes

OBJECTIVE

The authors report no conflicts of interest.To determine baseline sleep characteristics of male/female student-athletes across multiple sports using objective and subjective measures.

DESIGN

Prospective study.

SETTING

Division I college.

PARTICIPANTS

Eighty-two male and female Division I student-athletes.

INTERVENTIONS

Participants completed 2 validated sleep questionnaires (Epworth Sleepiness Scale [ESS] and Single-Item Sleep Quality Scale [SISQS]) to assess subjective sleep. They also wore a validated sleep monitoring device (WHOOP 4.0 band) for at least 14 nights to collect objective data on total sleep time (TST) and sleep architecture.

MAIN OUTCOME MEASURES

Overnight sleep variables, including TST, time spent awake in bed after falling asleep, time spent in light sleep, rapid eye movement (REM) sleep, and slow-wave sleep (SWS) cycles. Sleep quality and daytime sleepiness were also assessed.

RESULTS

There were no statistical differences between male and female student-athletes in average TST, sleep architecture, sleep consistency, SISQS, and ESS scores. The average TST was 409.2 ± 36.3 minutes. Sleep architecture consisted of 25.6% REM, 19.9% SWS, and 54.4% light sleep. The average sleep consistency was 61.6% ± 8.9%. The average SISQS score was 6.48 ± 1.71, and the average ESS score was 7.57 ± 3.82. A significant difference was found in average wake time between males and females (55.0 vs 43.7 min, P = 0.020), with an overall average of 50.2 ± 16.2 minutes.

CONCLUSIONS

College student-athletes do not typically obtain the recommended amount of sleep. Optimizing sleep can positively affect academic and athletic performance.

Sleep Difficulties in Swiss Elite Athletes

For athletes, sleep is essential for recovery and performance. Yet, up to two-thirds of athletes report poor sleep quality. Comprehensive data across all sports disciplines on the underlying causes of sleep problems are missing. We reanalyzed a data set of N = 1004 Swiss top athletes across an extensive array of 88 sports to gain knowledge on the specific deficits in sleep health with respect to gender, sport classes, sport-related factors, and well-being. We found that 18% of athletes were affected by at least two out of five high-risk sleep factors: 9% of athletes slept less than 6 h per day, 30% were dissatisfied with their sleep, 17% showed problems falling asleep within 30 min, 18% of athletes reported difficulty maintaining sleep more than three times a week, and 6% of athletes used sleeping pills more than once a week. We found sleep health strongly linked to overall well-being and mental health (22% showed at least moderate symptoms of either depression or anxiety). Therefore, screening and treating sleep disorders might effectively improve mental health and general well-being as well as performance among athletes around the globe.

Exploring the impact of sleep on emotional and physical well-being in professional cricketers: a cohort study over an in-season training period

Background

Professional athletes navigate a multitude of unique challenges associated to sport-specific factors (e.g., training, travel and competition) and non-sport factors (e.g., performance pressure, stress and anxiety) that can interfere with healthy sleep behaviors. Sleep plays a key role in proper biopsychosocial development as well as short- and long-term biological, physical, psychological, and cognitive health. As poor sleep quality is known to impair proper brain function, this study aimed to investigate the effect of sleep quality on a professional athlete's ability to train, recover, and perform, as well as their overall emotional and physical well-being.

Methods

A cohort study was performed in 40 professional male cricket athletes from the Dutch national cricket team (mean age 26.5 ± 5.1 years). The athletes were monitored across a 22 weeks in-season training period. Sleep quality and overall emotional and physical well-being were assessed using daily sleep diaries and questionnaires which scored the readiness to train, stress levels, fatigue, muscle soreness and flu symptoms respectively. Quality of sleep and subsequent association with the consecutive elements of the well-being questionnaire were assessed through statistical using the student t-test and clinical differences with the methodology of Osoba and colleagues: <5% "no change", 5%-10% "little change"; 10%-20% "moderate change"; and >20% "very much change".

Results

The results demonstrated that the professional athletes assessed their sleep quality as average with a mean score of 3.4 out of 5. Lower perceived quality of sleep (<75th percentile) was correlated with a decreased readiness to train (mean score 3.2 [IQR: 3.0-4.0] vs. 3.5 [IQR: 3.0-5.0]; P < 0.001) and increased extent of muscle soreness (2.7 [IQR: 2.0-3.0] vs. 2.3 [IQR: 2-3]; P < 0.001), stress level (mean score 2.3 [IQR: 2.0-3.0] vs. 1.9 [IQR: 1.0-2.0]; P < 0.001) and perceived fatigue (mean score 2.9 [IQR: 2.0-3.0] vs. 2.3 [IQR: 2.0-3.0]; P < 0.001). Likewise, in patients with lower perceived quality of sleep, the proportion of players presenting with flu symptoms increased over 4-fold (4.1% vs. 17%; P < 0.001).

Conclusions

This study highlights that good sleep quality positively influences the overall emotional and physical well-being of professional athletes. Our results emphasize the importance of targeted sleep interventions to improve sleep quality and subsequently optimize psychological and physiological wellness.

Does overreaching from endurance-based training impair sleep: A systematic review and meta-analysis

BACKGROUND

Overreaching is often linked to a deterioration in sleep quality, yet a comprehensive review is lacking. The aim of this systemic review and meta-analysis was to synthesise the literature and quantify the effect of overreaching from endurance-based training on sleep quality.

METHOD

The review was conducted following the PRISMA guidelines. The final search was conducted in May 2023 using four electronic databases (Web of Science Core Collection, MEDLINE, Cochrane Central Database, SPORTDiscus). Studies were included for a qualitative review, while random-effects meta-analyses were conducted for objective and subjective sleep.

RESULTS AND DISCUSSION

The search returned 805 articles. Fourteen studies were included in the systematic review; Three and eight articles were eligible for the meta-analyses (objective and subjective, respectively). On average, the overreaching protocols were sixteen days in length (6 to 28 days) and included exercise modalities such as cycling (number of studies [k] = 5), rowing (k = 4), triathlon (k = 3), running (k = 2), and swimming (k = 1). Actigraphy was the only form of objective sleep measurement used across all studies (k = 3), while various instruments were used to capture subjective sleep quality (k = 13). When comparing objective sleep quality following the overreaching intervention to baseline (or a control), there was a significant reduction in sleep efficiency (mean difference = -2.0%; 95% CI -3.2, -0.8%; Glass' Δ = -0.83; p < 0.01). In contrast, when comparing subjective sleep quality following the overreaching intervention to baseline (or a control), there was no effect on subjective sleep quality (Glass' Δ = -0.27; 95% CI -0.79, 0.25; p = 0.08). Importantly, none of the included studies were judged to have a low risk of bias. While acknowledging the need for more high-quality studies, it appears that overreaching from endurance-based training can deteriorate objective sleep without influencing the perception of sleep quality.

PROTOCOL REGISTRATION

This protocol was registered in The International Prospective Register of Systematic Reviews (PROSPERO) on 21st November 2022, with the registration number CRD42022373204.

Comparing the healthy development of youth Australian Rules Footballers across talent development and community settings

Objectives

This study aimed to compare talent development athletes to community-level athletes in Australian Rules Football across various markers of healthy youth development.

Methods

Survey data were collected from 363 youth athletes (126 women, 232 men, 5 not reported; Mage=18.69 years, SDage=2.62 years, age range 16-25 years) playing Australian Rules Football at a talent development (recruited from Australian Football League Talent Pathway, n=220) or community (n=143) level. Measures included markers of physical health (eg, general health, risk-taking behaviours), psychological and emotional well-being (eg, mental health symptoms, life satisfaction), family and social relationships (eg, social support, relationship status), educational and occupational attainment/engagement (eg, career satisfaction, education), ethical behaviour (eg, moral self-image), civic engagement, life skills (eg, self-mastery, coping), and demographics.

Results

Based on regression models, relative to community-level athletes, talent development athletes reported better physical health (d=0.51), lower injury rates (OR=0.50) and less problematic drug use (d=-0.46). Talent development athletes also reported better psychological and emotional well-being, evidenced by lower stress (d=-0.30), higher life satisfaction (d=0.47) and less problematic gambling (d=-0.34). Additionally, talent development athletes reported higher family support (d=0.49), lower likelihood of poor educational outcomes (less than expected educational stage; OR=0.37), lower intention to complete less than year 12 education (OR=0.18), higher career satisfaction (d=0.42), higher self-mastery (d=0.37) and higher perfectionistic striving (d=0.59).

Conclusion

Findings demonstrate markers of healthier development within talent development athletes relative to community athlete peers. Investment in community-level sports may be warranted to improve healthy development. However, further causal evidence is required.

Sleep duration is associated with overnight changes in perceived fatigue in elite women soccer players

The current study aimed to describe sleep habits and analyze the associations between sleep indices, changes in perceived fatigue (Δ Fatigue) and external training load measures in women soccer players during a 7-day training camp. Sixteen elite women soccer players (age: 25.4 ± 3.6 years; mean ± SD) from the Portuguese Women's National Team participated in the study. Sleep indices (sleep duration and efficiency) were measured using a wrist-worn accelerometer. External training loads measures were measured using GPS devices. Players also reported perceived fatigue using a Likert scale (1 - very, very low to 7 - very, very high) before and immediately after sleep. Players' within-subject coefficient of variation for sleep duration was 5.6%, and 4.6% for sleep efficiency. Individually, 8 players (50%) slept less than 7 h per night throughout the training camp, and the same number of athletes had a sleep efficiency lower than 85%. Similar values (p<0.05) were measured for sleep duration and efficiency between training and match days. A moderate negative within-subjects correlation was found between Δ Fatigue and sleep duration (adjusted for pre-sleep fatigue) [r = -0.32; 95% Confidence Interval (-0.51 - -0.08); p = 0.04]. These findings reinforce the importance of sleep in the recovery process of elite women soccer players, showing that more sleep may help to attenuate fatigue.

Assessing sleep quality in elite and junior cyclists

In the pursuit of optimal recovery, the significance of sleep cannot be overstated for elite cyclists, including high-level cyclists within the junior category. This study aims to assess the sleep quality of elite athletes of different categories and disciplines, including junior. The sleep quality of 112 high-level cyclists (males n = 80; females n = 32) participating in endurance and sprint disciplines was evaluated using the Pittsburgh Sleep Quality Index (PSQI). A noteworthy 41% of both elite and junior cyclists displayed poor sleep quality. No significant differences were observed between elite and junior cyclists in terms of sleep quality, but there was a medium effect size, indicating greater sleep efficiency in junior cyclists [0.36 (0.16, 0.53)]. Gender differences were found, with females exhibiting worse PSQI scores (males = 4.00 [2.25]; females 5.00 [3.00]; p = 0.035). Endurance cyclists spent more time in bed compared to cyclists from sprinting disciplines (8:30 [1.00] and 8:00 [1:03], respectively; p = 0.019). These findings reveal poor sleep habits, even among individuals classified as good sleepers by the PSQI, emphasizing the importance of preventing sleep disorders in cyclists. This study provides valuable insights into athlete sleep quality, encompassing various categories, genders, and cycling disciplines. In conclusion, elite cyclists demonstrate suboptimal sleep quality, suggesting the potential for interventions utilizing the PSQI. These findings advocate for the incorporation of sleep quality assessments into routine evaluations for athletes.

Interval training has more negative effects on sleep in adolescent speed skaters: a randomized cross controlled trial

Objective

Sleep is an essential component of athletic performance and recovery. This study aimed to investigate the effects of different types of high-intensity exercise on sleep parameters in adolescent speed skaters.

Methods

Eighteen male adolescent speed skaters underwent aerobic capacity testing, Wingate testing, and interval training in a randomized crossover design to assess strength output, heart rate, and blood lactate levels during exercise. Sleep quality after each type of exercise was evaluated using the Firstbeat Bodyguard 3 monitor.

Results

The results showed that Wingate testing and interval training led to decreased sleep duration, increased duration of stress, decreased RMSSD, and increased LF/HF ratio (p < 0.01). Conversely, aerobic capacity testing did not significantly affect sleep (p > 0.05). The impact of interval training on sleep parameters was more significant compared to aerobic capacity testing (p < 0.01) and Wingate testing (p < 0.01).

Conclusion

High-intensity anaerobic exercise has a profound impact on athletes' sleep, primarily resulting in decreased sleep duration, increased stress duration, decreased RMSSD, and increased LF/HF ratio.

Effects in Sleep and Recovery Processes of NESA Neuromodulation Technique Application in Young Professional Basketball Players: A Preliminary Study

The competitive calendars in sports often lead to fluctuations in the effort-recovery cycle and sleep quality. NESA noninvasive neuromodulation, achieved through microcurrent modulation of the autonomic nervous system, holds promise for enhancing sleep quality and autonomic activation during stressful situations. The objective of this study was to analyze the sleep and recovery responses of basketball players over six weeks of training and competition, with the integration of NESA noninvasive neuromodulation. A preliminary experimental study involving 12 participants was conducted, with a placebo group (n = 6) and an intervention group (n = 6) treated with NESA noninvasive neuromodulation. Sleep variables and biomarkers such as testosterone, cortisol, and the cortisol:testosterone ratio were analyzed to assess player recovery and adaptations. Significant differences were observed in total, duration, and REM sleep variables (p-value= < 0.001; 0.007; <0.001, respectively) between the intervention and placebo groups. The intervention group demonstrated increased duration of sleep variables. Cortisol levels showed normalization in the experimental group, particularly in the last two weeks coinciding with the start of playoffs. This study highlights the potential of NESA noninvasive neuromodulation to enhance sleep quality despite challenging circumstances, providing valuable insights into the management of athlete recovery in competitive sports settings.

Sleep architecture of elite soccer players surrounding match days as measured by WHOOP straps

This study aimed to quantify and compare sleep architecture before and after home and away matches in elite soccer players from the English Premier League. Across two seasons, 6 male players (age 28 ± 5 y; body mass 85.1 ± 9.5 kg; height 1.86 ± 0.09 m) wore WHOOP straps to monitor sleep across 13 matches that kicked off before 17:00 h. For each, sleep was recorded the night before (MD-1), after (MD) and following the match (MD +1). Across these 3 days total sleep time (TST), sleep efficiency (SE), sleep disturbances, wake time, light sleep, deep sleep, REM sleep, sleep and wake onsets, alongside external load, were compared. TST was reduced after MD versus MD +1 (392.9 ± 76.4 vs 459.1 ± 66.7 min, p = 0.003) but no differences existed in any other sleep variables between days (p > 0.05). TST did not differ after home (386.9 ± 75.7 min) vs. away matches (401.0 ± 78.3 min) (p = 0.475), nor did other sleep variables (p > 0.05). GPS-derived external load peaked on MD (p < 0.05). In conclusion, despite reduced TST on MD, sleep architecture was unaffected after matches played before 17:00 h, suggesting sleep quality was not significantly compromised.

Early morning sport scheduling is associated with poorer subjective sleep characteristics in British student-athletes

This study presents the sleep characteristics of British student-athletes and examines the relationships between sport scheduling and time demands on sleep outcomes. Student-athletes (n = 157, 51% male) completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the Sleep Hygiene Index (SHI). Self-reported sleep characteristics on weekdays and weekends, weekly frequencies of early morning and late evening sport sessions, and academic-related and sport-related time demands were also collected. Questionnaires revealed a high prevalence of undesired sleep characteristics including poor sleep quality (global PSQI >5 in 49.0%) and low sleep durations on weekdays (25% reporting <7 h). Paired t-tests revealed significant differences in bedtime, waketime, sleep duration, and sleep onset latency between weekdays and weekends (all p < 0.01). Hierarchical regression analyses indicated that early morning sport frequency was a significant predictor of PSQI (β = 0.30) and SHI (β = 0.24) global scores, weekday waketimes (β = -0.17), and weekday sleep durations (β = -0.25; all p < 0.05) in models adjusted for participant characteristics. Late evening sport frequency, and academic-related and sport-related time demands, were not significant predictors of any sleep outcome. Adjusting sport scheduling to avoid early start times could provide a means to improve sleep outcomes and may improve sporting performance and academic attainment.

Promotion of Para Athlete Well-being (PROPEL II): A Cross-sectional Study of Sleep in Para Athletes Across Two Nations

OBJECTIVE

Limited research exists on the sleep profiles of South African Para athletes. The aims of this study are to describe sleep quality, day-time sleepiness, and chronotype of South African Para athletes and to compare the relationship between sleep-related outcomes and demographic factors to athletes from a higher-resource country.

DESIGN

A descriptive, cross-sectional survey was conducted. Sleep-related characteristics were assessed with the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Morningness-Eveningness Questionnaire. Multiple regression models were run with and without country as independent variable.

RESULTS

One hundred twenty-four South African athletes and 52 Israeli athletes were included. Thirty percent of South African athletes presented with excessive daytime sleepiness, 35% slept 6 hrs or less per night, and 52% reported poor sleep quality. Thirty-three percent of Israeli athletes reported excessive daytime sleepiness, 29% slept 6 hrs or less, and 56% reported poor sleep quality. Chronotype was the only variable that differed significantly between countries (overrepresentation of morning types in South African athletes, and intermediate types in Israeli athletes). Intermediate chronotypes had significantly greater odds of excessive daytime sleepiness ( P = 0.007) and poor sleep quality ( P = 0.002) than morning types, irrespective of country.

CONCLUSIONS

The high prevalence of poor sleep among both South African and Israeli Para athletes warrants further investigation.

Association between Low Energy Availability (LEA) and Impaired Sleep Quality in Young Rugby Players

Low energy availability (LEA) has been associated with several physiological consequences, but its impact on sleep has not been sufficiently investigated, especially in the context of young athletes. This study examined the potential association between energy availability (EA) status and objective sleep quality in 42 male rugby players (mean age: 16.2 ± 0.8 years) during a 7-day follow-up with fixed sleep schedules in the midst of an intensive training phase. Participants' energy intake was weighed and recorded. Exercise expenditure was estimated using accelerometry. Portable polysomnography devices captured sleep on the last night of the follow-up. Mean EA was 29.3 ± 9.14 kcal·kg FFM-1·day-1, with 47.6% of athletes presenting LEA, 35.7% Reduced Energy Availability (REA), and 16.7% Optimal Energy Availability (OEA). Lower sleep efficiency (SE) and N3 stage proportion, along with higher wake after sleep onset (WASO), were found in participants with LEA compared to those with OEA (p = 0.04, p = 0.03 and p = 0.005, respectively, with large effect sizes). Segmented regression models of the EA-sleep outcomes (SE, sleep onset latency [SOL]), WASO and N3) relationships displayed two separate linear regions and produced a best fit with a breakpoint between 21-33 kcal·kg FFM-1·day-1. Below these thresholds, sleep quality declines considerably. It is imperative for athletic administrators, nutritionists, and coaches to conscientiously consider the potential impact of LEA on young athletes' sleep, especially during periods of heavy training.

Collagen peptide supplementation before bedtime reduces sleep fragmentation and improves cognitive function in physically active males with sleep complaints

PURPOSE

The primary aim of this study was to examine whether a glycine-rich collagen peptides (CP) supplement could enhance sleep quality in physically active men with self-reported sleep complaints.

METHODS

In a randomized, crossover design, 13 athletic males (age: 24 ± 4 years; training volume; 7 ± 3 h·wk1) with sleep complaints (Athens Insomnia Scale, 9 ± 2) consumed CP (15 g·day1) or a placebo control (CON) 1 h before bedtime for 7 nights. Sleep quality was measured with subjective sleep diaries and actigraphy for 7 nights; polysomnographic sleep and core temperature were recorded on night 7. Cognition, inflammation, and endocrine function were measured on night 7 and the following morning. Subjective sleepiness and fatigue were measured on all 7 nights. The intervention trials were separated by ≥ 7 days and preceded by a 7-night familiarisation trial.

RESULTS

Polysomnography showed less awakenings with CP than CON (21.3 ± 9.7 vs. 29.3 ± 13.8 counts, respectively; P = 0.028). The 7-day average for subjective awakenings were less with CP vs. CON (1.3 ± 1.5 vs. 1.9 ± 0.6 counts, respectively; P = 0.023). The proportion of correct responses on the baseline Stroop cognitive test were higher with CP than CON (1.00 ± 0.00 vs. 0.97 ± 0.05 AU, respectively; P = 0.009) the morning after night 7. There were no trial differences in core temperature, endocrine function, inflammation, subjective sleepiness, fatigue and sleep quality, or other measures of cognitive function or sleep (P > 0.05).

CONCLUSION

CP supplementation did not influence sleep quantity, latency, or efficiency, but reduced awakenings and improved cognitive function in physically active males with sleep complaints.

Circadian rhythm in sportspersons and athletic performance: A mini review

Circadian rhythms in the physiological and behavioral processes of humans play a crucial role in the quality of living and also in the magnitude of success and failure in various endeavors including competitive sports. The rhythmic activities of the body and performance in sportspersons do have a massive impact on their every cutthroat competition. It is essential to schedule sports activities and training of players according to their circadian typology and time of peak performance for improved performance and achievement. In this review, the focus is on circadian rhythms and diurnal variations in peak athletic performance in sportspersons. Accuracy and temporal variability in peak performance in an individual could be attributed to various factors, namely chronotype, time of the day, body temperature, jetlag, hormones, and prior light exposure. Circadian rhythm of mood, alertness, T-core, and ultimately athletic performance is not only affected by sleep but also by circadian variations in hormones, such as cortisol, testosterone, and melatonin. There are, however, a few reports that are not consistent with the conclusions drawn in this review. Nevertheless, circadian rhythm and performance among sportspersons and athletes are important areas of research. This review might be useful to the managers and policymakers associated with competitive sports and athletic events.

Does a self-reported sleep duration reflect actigraphy reported sleep duration in female football players?

Sleep is often compromised in female athletes, and the monitoring of female athletes' sleep is an important preventative and educational tool. With self-reporting of sleep common practice for athletes as part of a daily wellness assessment, there is a need to understand whether sleep indices are being reported accurately, and thus whether self-report data are useful. This study aimed to compare the agreement between self-reported and actigraphy reported sleep duration in female football players, with the intention of informing best practice for athlete monitoring. Twenty-two female footballers (mean age 19.5 ± 1.3 years) provided a daily self-report across 7 days, whilst also wearing an actigraph across the same testing period. Agreement between the two measures was assessed using Bland-Altman limits of agreement, with acceptable limits of agreement defined as <30 minutes. Results showed evident disagreement between the two methods, with a mean bias of -0.54 (32 min, 95% CI -0.66 to -0.43) and a potential disagreement range of over 2 h (Lower 95% limits of agreement -1.49 to upper 95% limits of agreement 0.40). Coaches using self-reported sleep durations as a monitoring tool for female footballers should interpret the results with caution and be aware of the potential for inaccuracies in this measure. As such, where possible, coaches should consider other methods of sleep monitoring, rather than solely relying on a self-report, to ensure they are operating with optimal practice within situational constraints.

Evaluating the reliability of the athlete sleep behavior questionnaire (ASBQ): a meta-analysis of Cronbach's alpha and intraclass correlation coefficient

BACKGROUND

The Athlete Sleep Behavior Questionnaire (ASBQ) was designed to identify maladaptive sleep practices among athletes. The aim of this meta-analysis was to evaluate the internal consistency and the test-retest reliability coefficients of the ASBQ.

METHODS

A systematic search across 10 databases from inception of the ASBQ to August 2023 was performed. Publications that reported estimates of internal consistency and/or test-retest reliability of the ASBQ were included. A random-effects model was employed to estimate the overall reliability measures of the ASBQ.

RESULTS

Meta-analytic results demonstrated a good level of internal consistency within the ASBQ, evidenced by a Cronbach's alpha of 0.73 (95% CI: 0.63 to 0.80). This suggests a modest correlation among the questionnaire items, supporting its reliability as an effective measure of sleep behavior. In terms of test-retest reliability, our meta-analysis revealed a very good degree of consistency (ICC = 0.88; 95% CI: 0.87 to 0.89), suggesting that the ASBQ can serve as an instrument for monitoring and evaluating changes in athletes' sleep behavior over time. No evidence of publication bias was identified.

CONCLUSION

While the ASBQ demonstrates a moderate level of internal consistency, its test-retest reliability suggests that it can serve as an instrument for longitudinal assessments of athletes' sleep behavior. Future studies focusing on refining the ASBQ to optimize its internal consistency and validate its applicability across diverse athletic populations are warranted.

Sleep in the Athlete

Sleep is important for not only general health but also for lowering injury risk and maintaining athletic performance. Sleep disorders are prevalent in athletes, and taking a sleep history, evaluating sleep quality, and addressing other related factors including mental health are essential in diagnosing and understanding sleep disorders. Other methods such as polysomnography, actigraphy, and sheet sensors can also be used. Treatment options for sleep disorders include sleep hygiene, cognitive behavioral therapy, medication, and addressing contributing factors. For athletes, sleep can also be affected by factors such as travel fatigue and jet lag, which should be taken into consideration.

Waking Up to the Issue! Research Inattention and Sex-Related Differences Warrant More Sleep Studies in Female Athletes

Understanding sleep patterns and behaviors of athletes is essential for developing targeted sleep-based interventions for implementation in practice. However, more than double the number of sleep studies have examined male athletes compared with female athletes, making the current understanding of sleep patterns, behaviors, and interventions among athletes disproportionately indicative of men. Consequently, this review demonstrates the need for more female-specific sleep data among athlete populations due to research inattention and sex-related differences. Specifically, this review identifies variations in sleep patterns and behaviors between male and female athletes, as well as physiological and lifestyle factors that potentially affect sleep patterns and behaviors across the lifespan, specifically in female athletes. In this regard, evidence suggests some female athletes experience longer sleep durations and better objective sleep quality, but similar or worse subjective sleep quality compared with male athletes. Additionally, scheduling training in the morning or throughout the day may benefit sleep in some female athletes. Considering sleep disorders, women may be at greater risk for insomnia and restless legs syndrome compared with men, which may be attributed to pregnancy, as well as a higher prevalence of anxiety and depressive symptoms, iron deficiency without anemia, and use of psychotropic medication among women. Finally, the menstrual cycle, menstrual disorders, oral contraceptive use, and the postpartum period have been shown to exert detrimental effects on sleep patterns and behaviors and should theoretically be considered when monitoring and managing sleep in female athletes.

Athlete Sleep Behavior Questionnaire in Japanese (ASBQ-J): An Adaptation and Validation Study

Purpose

The Athlete Sleep Behavior Questionnaire (ASBQ) is an 18-item self-reported questionnaire that can be used to screen for sleep disorders in athletes and assess environmental, behavioral, and sports-related factors along with sleep disorders. This study aimed to analyze the reliability and validity of the ASBQ translated into Japanese (ASBQ-J).

Patients and Methods

111 female collegiate athletes completed both the initial test and retest. Independent variables were what kind of sports they perform, level as an athlete, grade (freshman, sophomore, junior, senior), and age. The reliability of the survey was assessed using Cronbach's alpha and intraclass correlation, and Pearson's correlation coefficient was calculated to determine the correlation between the total ASBQ scores and three components which were routine/environmental, behavioral, and sports factors.

Results

A total of 37.8% of athletes had ASBQ scores equal or less than 36 indicating good sleep. However, 19.8% of athletes scored more than 42, indicating poor sleep. Cronbach alpha was 0.62 and 0.65 for test and retest, respectively. Intraclass correlation was 0.78 (P < 0.01), indicating sufficient internal consistency and test-retest validity. Mean ASBQ scores were 38.5 ± 5.0 and 37.0 ± 6.5 for test and retest, respectively, and it was not significantly different between the two groups (P = 0.37). The correlation coefficients between the ASBQ-J and component scores were all statistically significant (all P < 0.01).

Conclusion

ASBQ-J is a reliable questionnaire for assessing sleep disorders in athletes whose primary language is Japanese.

Sleep patterns before and after competition: A real-world examination of elite athletes

Good sleep before and after competitions is crucial to cognitive, physiological performance and recovery. Yet, elite athletes face a unique set of challenges when acquiring good sleep before and after competitions, and indeed commonly report sleep problems when it matters most. This study examined the sleep of elite athletes before and after competition compared to before and after free days. A total of 1808 unique nights of actigraphy (n = 1495) and sleep diary (n = 1335) data from elite Australian Football League and National Rugby League male athletes (N = 85, M-age = 24.4 ± 3.6) were collected and analysed using multi-level mixed models. On nights before competitions, athletes advanced sleep timings (p < .001, d = 0.63) and increased total sleep time (p < .001, d = 0.65) compared to nights before free days. On nights after competitions, athletes delayed sleep timings (p < .001, d = 1.64), reduced total sleep time (p < .001, d = 1.28), and had significantly worse quality sleep (p < .001, d = 0.71) compared to nights after free days. Sleep was especially worse following night competitions. While elite athletes and organisations may be implementing effective sleep strategies to optimise sleep the night before competitions, strategies to improve sleep after competitions may be lacking. We discuss potential factors contributing to this asymmetry and propose areas for research moving forward.

The impact of long haul travel on the sleep of elite athletes

In order to manage and implement strategies to alleviate the symptoms of jet lag it is essential to assess the impact of jet lag in athletes. The aim of this study was to assess the impact of long haul eastward travel on elite athletes' (n = 7 elite national track cyclists; male n = 3, and female n = 4) sleep. The athletes' sleep was monitored before, during and after travel using both actigraphy and self-report measures. Participants wore an activity monitor for 5 days prior to travel, during the long haul travel and 5 days upon arrival at their destination and completed a daily online sleep diary Actigraphy highlighted significant reductions in time in bed, total sleep time and sleep efficiency (%) due to long haul eastward travel, particularly in the 48 h after travel. Sleep diary data exhibited significant reductions in time in bed, total sleep time, sleep efficiency, sleep quality and a significant increase in fatigue going to bed as a result of long haul eastward travel. In order to facilitate the development of interventions to reduce the symptoms and severity of jet lag objective and subjective assessments of sleep should be coupled with assessments of chronotype and perceived sleep need.

The effects of body dissatisfaction, sleep duration, and exercise habits on the mental health of university students in southern China during COVID-19

Following the outbreak of COVID-19 at the end of 2019, universities around the world adopted a closed management model and various restrictive measures intended to reduce human contact and control the spread of the disease. Such measures have had a profound impact on university students, with a marked increase in depression-related psychological disorders. However, little is known about the specific status and factors influencing the impact of the pandemic on student mental health. Addressing this gap, this study examines the body dissatisfaction, physical activity, and sleep of university students during the pandemic, and uses their levels of depression to provide a theoretical basis for the development of mental health interventions for university students in the post-epidemic era. To achieve this, a total of 1,258 university students were randomly recruited for this cross-sectional study. Collected data included respondents' anthropometric measurements, body dissatisfaction levels, dietary habits, sleep status, physical activity levels, and depression levels. The overall detection rate of depression was 25.4%, with higher levels of depression among women. Multiple regression analysis showed that the PSQI score (β = 1.768, P < 0.01) and physical activity scores (β = -0.048, P < 0.01) were significant predictors of depression in men, while the PSQI score (β = 1.743, P < 0.01) and body dissatisfaction scores (β = 0.917, P < 0.01) were significant predictors of depression in women. Mental health problems were prevalent among university students during the COVID-19 pandemic. Results indicate the possibility of alleviating depression among university students by improving their body dissatisfaction, physical activity, and sleep. However, as this study was limited to Ganzhou City, it is challenging to extrapolate the findings to other populations. As this was a cross-sectional study, a causal relationship between depression levels and lifestyle habits cannot be determined.

Effect of training load on sleep parameters and biochemical fatigue markers in elite swimmers

The effect of strenuous exercise on sleep patterns in swimmers is equivocal. Therefore, the purpose of the study was to describe possible changes in sleep parameters among elite swimmers subjected to different training loads (TL). Methods: Eighteen elite swimmers (8 females) were monitored across two high-volume preparatory 1-wk periods (P1, P2) and a lower-volume tapering 1-wk period (P3) before a major competition. Internal (the session rating of perceived exertion [sRPE]) and external TL (training duration and volume) were measured, along with several sleep indices (e.g., bedtime, get-up time, sleep time, wake after sleep onset [WASO]). Serum measurements of urea, creatine kinase (CK), testosterone and cortisol were taken before and after training sessions at the beginning (Mondays) and end (Fridays) of each micro cycle. Athlete TL decreased significantly in a stepwise manner from P1 to P2 and from P2 to P3. Of all sleep parameters, only significant differences in bedtime and get-up time emerged (P3 > P1 and/or P2). Sleep duration (~6.3 h) or quality (WASO: 41-45 min) were also unaffected by TL. CK levels declined from P1 to P3 (d = -0.8), and from P2 to P3 (d = -0.6). Positive exercise-induced changes in CK were also seen in each training period. The other biomarkers did not show the same temporal or acute patterns. Irrespective of the TL, the monitored swimmers experienced insufficient and fragmented sleep across this study. Neither sleep quality nor quantity were affected by different magnitudes of TL. Among the biochemical markers of fatigue, baseline plasma CK activity best reflected the physiological response to TL.

Acute and long-term sleep measurements produce opposing results on sleep quality in 8 and 12 hour shift patterns in law enforcement officers

The occupational demands of law enforcement increase the risk of poor-quality sleep, putting officers at risk of adverse physical and mental health. This cross-sectional study aimed to characterise sleep quality in day workers, 8 and 12 h rotating shift pattern workers. One hundred eighty-six officers volunteered for the study (37 female, age: 41 ± 7). Sleep quality was assessed using the Pittsburgh sleep quality index, actigraphy and the Leeds sleep evaluation questionnaire. The maximal aerobic capacity (VO2max ) was measured on a treadmill via breath-by-breath analysis. There was a 70% overall prevalence of poor sleepers based on Pittsburgh sleep quality index scores, where 8 h shifts exhibited the worst prevalence (92%, p = 0.029), however, there was no difference between age, gender, or role. In contrast, 12 h shifts exhibited the poorest short-term measures, including awakening from sleep (p = 0.039) and behaviour following wakefulness (p = 0.033) from subjective measures, and poorer total sleep time (p = 0.024) and sleep efficiency (p = 0.024) from the actigraphy. High VO2max predicted poorer wake after sleep onset (Rsq = 0.07, p = 0.05) and poorer sleep latency (p = 0.028). There was no relationship between the Pittsburgh sleep quality index scores and any of the short-term measures. The prevalence of poor sleepers in this cohort was substantially higher than in the general population, regardless of shift pattern. The results obtained from the long- and short-term measures of sleep quality yielded opposing results, where long-term perceptions favoured the 12 h pattern, but short-term subjective and objective measures both favoured the 8 h pattern.

Sleep in marathon and ultramarathon runners: a brief narrative review

Introduction

Sleep is considered a fundamental biological function in humans necessary for recovery from daily physical activities. Considering the increasing popularity of long-distance running and participation in races such as marathons and ultramarathons, the aim of the present study was to review the relationship of such strenuous physical activities with sleep.

Methods

A search of Scopus was performed on 24/6/2023 using the syntax [ABS (sleep) AND ABS (marathon)] to identify relevant papers, the references of which were hand-searched to find additional sources.

Results

Optimal sleep has been shown to affect injury prevention and susceptibility to infection positively. In turn, participation in a marathon race may influence nocturnal autonomic modulation and disturb homeostasis. Ultramarathon races may have such a long duration that results in sleep deprivation even for several days, where sleep duration is quite below the physiological range. It seems that for ultramarathons of short duration, continuous running and sleep deprivation are beneficial for performance. In contrast, for races longer than 200 miles, it is necessary to develop sleep strategies to sustain performance.

Conclusion

In summary, the longer the distance of a running race, the greater the importance of an optimal sleep for race performance as well as the impact of a race on sleep.

Daytime sleepiness in Chinese professional, semi professional and students soccer players in the Shanghai lockdown

PURPOSE

April-May 2021 Shanghai city was under strict lockdown. Soccer players suffered from the restrictions, being unable to train and have a social life. The aim of this study was to compare differences in daytime sleepiness between genders and qualification levels in a cohort university Chinese soccer player under 0 Covid policy restrictions in the urban area of Shanghai.

METHODS

491 questionnaires of Epworth Sleepiness Scales (ESS) were compiled online by male and female Soccer Students (SS), Semi-Professional players (SP) and Professional Players (PP) during the ongoing restriction measures post Shanghai lockdown. ANOVA was performed for players levels and gender.

RESULTS

Significant differences were found between the 3 levels and between males and females. PP showed a very low score in the ESS (5,97) well below the threshold of 8 for daytime sleepiness, while SS and SP showed an ESS score above the threshold. Female showed higher scores in comparison to males. Differences between males and females reflect the confinement conditions in the ESS items, showing more difference in the item of ESS which are related with indoor situations.

CONCLUSIONS

This study shows the first data on sleepiness in Chinese soccer players of different level of qualification immediately post lockdown condition. Professional male's players sleepiness was lower, than females, SS and SP after the exceptional lockdown measures. The reasons can reside in the more ordered lifestyle of PP in comparison to SS and SP, which mitigated the effects of the lockdown. Our results suggest that measures to improve sleep in females' soccer player should be adopted if these exceptional conditions will happen again.

Reliability and validity of the Chinese version of the Athens insomnia scale for non-clinical application in Chinese athletes

Purpose

This study aimed to revise and examine the reliability and validity of the Chinese version of the Athens Insomnia Scale for Non-clinical Application (AIS-NCA) among Chinese athletes. Additionally, the study tested the scale in non-athlete individuals with similar sleep management practices to further analyze its cultural specificity among Chinese athletes and make preliminary inferences about its applicability in other Chinese populations.

Methods

Four hundred twenty-six Chinese professional athletes and 779 high school students participated in this research. Both athletes and students were divided into two parallel groups for exploratory and confirmatory factor analyses. Additionally, three athlete samples and one student sample were established for reliability and validity assessments. Among athletes, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Athlete Sleep Screening Questionnaire, and the Warwick-Edinburgh Mental Well-Being Scale were employed to evaluate convergent and discriminant validity. Re-test reliability was evaluated at intervals of 1 and 2 weeks. In the case of students, convergent and discriminant validity were tested using the Pittsburgh Sleep Quality Index and the General Self-Efficacy Scale, with re-test reliability assessed at two-week intervals.

Results

The Chinese version of the AIS-NCA consists of six items, categorized into two dimensions: sleep problems and daytime functioning. This structure explained 65.08% (athletes) and 66.22% (students) of the variance. Confirmatory factor analysis revealed good model fit, with values of χ2/df = 2.217, CFI = 0.975, AGFI = 0.929, TLI = 0.953, and RMSEA = 0.076 among athletes, and χ2/df = 3.037, CFI = 0.979, AGFI = 0.947, TLI = 0.961, and RMSEA = 0.072 among students. The scale demonstrated a reasonable degree of measurement invariance. The overall scale and two subscales exhibited strong reliability and validity among athletes. Similar results in terms of reliability and validity were also observed within the student sample.

Conclusion

The Chinese version of the AIS-NCA shows promise as an assessment tool for evaluating the sleep quality of Chinese athletes. It effectively captures both sleep-related concerns and daytime functionality within the athlete population. The scale demonstrates solid reliability and validity in professional athletes and holds potential for application across various other demographic groups in China.

The effect of short-term cranial electrotherapy stimulation on sleep quality in athletes: A pilot study

BACKGROUND

To verify the effect of a 5-day cranial electrotherapy stimulation (CES) intervention on sleep quality in professional athletes.

METHODS

25 professional athletes with poor sleep quality participated in the study. Athletes belonging to the CES group (12 athletes) received a 5-day CES intervention, and those in the control group did not receive any intervention. Objectively and subjected assessed sleep quality was measured 1 week before and after the intervention using an Actigraphy activity recorder, Pittsburgh sleep quality index (PSQI), and Insomnia Severity Index (ISI).

RESULTS

Objectively measured sleep efficiency increased after CES intervention (P = .013), while the difference between the pretest and posttest of the control group was not significant. For total sleep time (TST), the main effects and interaction were not significant. However, the analysis on wake after sleep onset showed wake after sleep onset decreased after CES intervention (P = .015). No significant interaction was found in subjectively assessed sleep quality but only revealed an improvement in both groups.

CONCLUSION

The CES intervention of 30 minutes per day for 5 consecutive days enhanced objective sleep quality in athletes with sleep quality problems. The intervention increased sleep efficiency by lowering awake time after falling asleep.

Mental health problems in elite sport: the difference in the distribution of mental distress and mental disorders among a sample of Norwegian elite athletes

Objectives

To, based on diagnostic interviews, investigate the distribution of mental disorders among a sample of Norwegian elite athletes with 'at-risk scores' on a self-report questionnaire measuring symptoms of mental health problems. Then, to investigate the relationship between 'at-risk scores' and diagnosed mental disorders.

Methods

A two-phase, cross-sectional design was used. In phase 1, 378 elite athletes completed a questionnaire, including validated self-report psychiatric instruments assessing symptoms of mental disorders. In phase 2, we assessed the 30-day presence of the same disorders through diagnostic interviews with the athletes with 'at-risk scores' using the fifth version of the Composite International Diagnostic Interview.

Results

Two hundred and eighty athletes (74.1%) had an 'at-risk score,' and 106 of these athletes (37.9%) completed diagnostic interviews. Forty-seven athletes (44.3%) were diagnosed with a mental disorder. Sleep problems (24.5%) and obsessive-compulsive disorder (OCD) and OCD-related disorders (18.9%), mainly represented by body dysmorphic disorder (BDD), were most common. Anxiety disorders (6.6%), eating disorders (5.7%) and alcohol use disorder (≤4.7%) were less frequent. Affective disorders, gambling and drug use disorder were not present. Results from self-report questionnaires did not, in most cases, adequately mirror the number of mental disorders identified using diagnostic interviews.

Conclusions

Using self-report questionnaires to map mental distress among elite athletes can be beneficial. If the aim, however, is to investigate mental disorders, one should move beyond self-report questionnaires and use diagnostic interviews and diagnostic instruments. In our study, sleep problems and BDD were the most prevalent. Longitudinal studies are needed to investigate these findings further.

The Impact of Sleep Interventions on Athletic Performance: A Systematic Review

BACKGROUND

Sleep is essential for maximal performance in the athletic population. Despite that, the sport context has many factors that can negatively influence athletes' sleep and subsequent recovery.

OBJECTIVES

The purpose of this systematic review was to synthesize the most recent literature regarding sleep interventions aimed at improving sleep and subsequent performance in athletes.

METHODS

The present systematic review was conducted based on the PRISMA guidelines and the PICOS approach. The search was conducted in May 2022 using the electronic database PubMed, SPORTDiscus via EBSCOhost, and Web of Science. Once extracted, studies were included if they met the following criteria: (1) participants were athletes of individual or team sports; (2) implemented an intervention aimed at improving sleep; (3) measured at least one objective performance/recovery outcome; and (4) reported the relationship between sleep and performance.

RESULTS

The search returned 1584 records. Following the screening, a total of 25 studies met our inclusion criteria. All the included articles were intervention studies published between 2011 and 2021. The included studies implemented various sleep interventions, such as sleep hygiene, naps, sleep extension, light manipulation, cold water immersion, mindfulness, or a combination of two or more strategies. Sleep extension and naps were the most representative and most effective strategies to improve sleep and performance. Mindfulness and light manipulation demonstrated promising results, but more studies are needed to confirm these findings. Sleep hygiene, removing electronic devices at night, and cold water immersion had no effects on sleep and subsequent performance/recovery, but these results are based on a few studies only.

CONCLUSION

While acknowledging the limited amount of high-quality evidence reviewed, it appears that increasing sleep duration at night or through napping was the most effective interventions to improve physical and/or cognitive performance. Protocol Registration This protocol was registered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on May 11, 2022, with the registration number INPLASY202250069.

Psychological changes in athletes infected with Omicron after return to training: fatigue, sleep, and mood

Background

This study aims to analyze the changes of approximately 1 month in fatigue, sleep, and mood in athletes after returning to training following infection with the COVID-19 Omicron strain and provide recommendations for returning to training after infection.

Methods

Two hundred and thirty professional athletes who had returned to training after being infected with COVID-19 in December 2022 were recruited to participate in three tests conducted from early January 2023. The second test was completed approximately 1 week after the first, and the third was completed about 2 weeks after the second. Each test consisted of completing scales and the exercise-induced fatigue measure. The scales included a visual analog scale, the Athens Insomnia Scale for non-clinical application, and the Depression-Anxiety-Stress scale. The exercise task was a six-minute stair climb test, and athletes evaluated subjective fatigue levels before and after exercise using another Visual Analog Scale and the Karolinska Sleepiness Scale.

Results

After returning to training, athletes' physical fatigue decreased initially but increased as training progressed. Cognitive fatigue did not change significantly. The exercise task led to elevated levels of physical fatigue after a longer duration of training. Sleep quality problems decreased rapidly after the start of training but remained stable with prolonged training. Depression levels continued to decline, while anxiety levels only reduced after a longer duration of training. Stress levels decreased rapidly after the start of training but did not change with prolonged training.

Conclusion

Athletes who return to training after recovering from COVID-19 experience positive effects on their fatigue, sleep, and mood. It is important to prioritize anxiety assessment and interventions during the short period after returning and to continue monitoring fatigue levels and implementing recovery interventions over a longer period of time.

Sleep Assessment in Competitive Athletes: Development and Validation of French Versions of the Athens Insomnia Scale and the Athlete Sleep Behavior Questionnaire

Objective  The purpose of this study was to develop and validate French versions of two questionnaires assessing competitive athletes' sleep: the Athens Insomnia Scale (AIS-FR) and the Athlete Sleep Behavior Questionnaire (ASBQ-FR). Methods  Four complementary studies were carried out, with a total sample of 296 French competitive athletes from different sports and expertise levels. The studies aimed to develop preliminary versions of the AIS-FR and the ASBQ-FR (study 1), and then to examine their respective dimensionality and reliability (study 2), temporal stability (study 3), and concurrent validity (study 4). The dimensionality was established using confirmatory factor analysis. Similar and correlated psychological factor scales were used to examine the concurrent validity (the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the State-Trait Anxiety Inventory and the Positive and Negative Affect Schedule). Results  The AIS-FR consists of eight items with two subfactors: nocturnal symptoms and diurnal symptoms, assessed by a uniformized 4-point Likert-type scale. The ASBQ-FR is composed of 15 items with three subfactors, which differs from the original English version: behaviors affecting sleep, behaviors related to anxiety, and sleep disturbances. Due to the Covid context and curfews, three items of the original scale were excluded from the statistical analyses because non-applicable. Both scales presented satisfactory psychometric properties. Discussion  The AIS-FR and ASBQ-FR appear to be valid and reliable tools that can be used with competitive athletes for everyday training and research purposes. An ASBQ-FR version that includes the three excluded items should undergo validation testing once pandemic restrictions are eased.

Translation and Validation of the Arabic Version of the Athlete Sleep Screening Questionnaire

Sleep improves the cognitive and physical performance of athletes. A detailed questionnaire that detects sleep disruptions is required to identify sleep-deprived athletes. This study evaluates the translated Athlete Sleep Screening Questionnaire (ASSQ), a tool suggested by the International Olympic Committee, among Arabic-speaking athletes. The ASSQ was translated into Arabic and examined for floor or ceiling effects, internal consistency, and validity among Arabic-speaking athletes. The Arabic Pittsburgh Sleep Quality Index (PSQI) was employed to assess convergent validity. Ninety athletes (28.9% women) participated and completed this study's questionnaires. The Cronbach's alpha for the ASSQ-Sleep Difficulty Score (SDS) was 0.435, and that of the ASSQ-chronotype was 0.632. The SDS and chronotype subset of the ASSQ demonstrated excellent test-retest reliability, with intraclass correlation coefficients of 0.84 and 0.938, respectively. The ASSQ-SDS correlated positively with the PSQI (0.734, p = 0.001). The ASSQ-chronotype was inversely associated with the PSQI (p = 0.001). This study's findings can assist clinicians in assessing sleep disorders in sports. The Arabic version of the ASSQ has satisfactory psychometric qualities and can identify clinically relevant sleep problems in athletes.

The Impact of Kiwifruit Consumption on the Sleep and Recovery of Elite Athletes

BACKGROUND

Poor sleep and resultant under-recovery can negatively impact training adaptations, increase the risk of injury and reduce subsequent performance. Due to the 'food first' approach adopted by many athletes, there is scope for investigation of 'functional food' based interventions (i.e., kiwifruit contains melatonin which plays a role in circadian rhythm regulation) designed to promote athlete recovery and/or enhance sleep quality and quantity.

METHODS

Following the baseline assessment (Week 1) all subjects began the intervention (Weeks 2-5). During the 4-week intervention, participants were asked to consume 2 medium-sized green kiwifruit (Actinidia Deliciosa) an hour before bed. Participants completed a questionnaire battery at baseline and post-intervention, and a daily sleep dairy for the duration of the study.

RESULTS

The results demonstrated a positive impact of kiwifruit consumption on key aspects of sleep and recovery in elite athletes. From baseline to post-intervention, there were clinically significant improvements in sleep quality (i.e., improved PSQI global scores and sleep quality component scores) and improvements in recovery stress balance (reduced general stress and sports stress scales). Moreover, the intervention improved sleep as evidenced by significant increases in total sleep time and sleep efficiency % and significant reductions in number of awakenings and wake after sleep onset.

CONCLUSION

The findings broadly suggested that kiwifruit does impact positively on sleep and recovery in elite athletes.

Chronotype and quality of sleep in alpine skiers

Alpine skiing is among the most demanding sporting activities in terms of physical effort and mental workload. The aim of the study was to compare sleep quality and chronotype distribution between 84 highly trained alpine skiers and a control sample of 84 non-athletes matched by age and sex ratio. Quality of sleep was assessed by the Pittsburgh Quality of Sleep Index (PSQI), and chronotype was assessed by the Morningness-Eveningness Questionnaire (MEQ). Additional questions assessed sleep management during training or competitions. The results showed a marked skewed chronotype distribution towards morningness in alpine skiers (52.4% morning type, 42.8% intermediate, and 4.8% evening type) in comparison to the control group. The midpoint of sleep was significantly anticipated among alpine skiers. Differently from the previous literature that showed poor sleep quality and quantity in competitive athletes, the quality and quantity of sleep in alpine skiers was within the normal range in all the PSQI subcomponents.

Tracking sleep in the field: sleep quality and sleep behaviours of elite track and field athletes during preparation and competition

Elite athletes are susceptible to inadequate sleep, which may peak during competition and be exacerbated by poor sleep behaviours. This study sought to characterise and compare the sleep quality and sleep behaviours of elite track and field athletes during preparation and major competitions. Forty elite international track and field athletes (50% female, aged 25.1 ± 3.9 years) completed the Athlete Sleep Screening Questionnaire and the Athlete Sleep Behaviour Questionnaire on three separate occasions: during habitual training, during a pre-meet training camp and during a major international competition. Overall, 62.5% of athletes reported at least mild sleep difficulty during competition. Athletes reported higher sleep difficulty and poorer sleep behaviour during major competitions and the pre-meet training camp compared to habitual training (P = .001-.025). No significant differences were observed between the training camp and major competition. Global sleep behaviour scores were underpinned by unique characteristics at each timepoint. Sleep behaviour (R² = .330, P = .017), injury status (R² = .253, P = .003) and major championship experience (R² = .113, P = .034) were associated with sleep difficulty during competition. Sleep quality and behaviours vary according to stage of the track and field season, providing a foundation for targeted intervention.