Sleep and Health Among Collegiate Student Athletes

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.

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 in NCAA Division I collegiate athletes: Relations with self-compassion, stress, and rumination

The purpose of the present study was to investigate whether the benefits of self-compassion on sleep difficulties extend to a sample of National Collegiate Athletic Association (NCAA) Division I college athletes, and to examine the unique contributions of two possible pathways that have been separately evidenced to underlie the self-compassion and sleep difficulties association in non-athlete populations - namely perceived stress and rumination. A total of 412 NCAA Division I college athletes (M = 19.88, SD = 1.50) from 16 different West, Midwest, South, and North-eastern universities completed the Self-Compassion Scale, Perceived Stress Scale-10, Rumination-Reflection Questionnaire, and the Pittsburgh Sleep Quality Index. Findings indicated that self-compassion is associated with fewer sleep difficulties in college athletes, and that lower levels of perceived stress and rumination are independent mechanisms through which self-compassion is associated with sleep difficulties. Further, a comparison of the indirect effects revealed that perceived stress had a significantly stronger indirect effect on the relation between self-compassion and sleep difficulties than rumination. This study provides initial support for self-compassion training as a potentially relevant and important resource for promoting mental health and sleep health in the context of collegiate sport.

A Biopsychosocial Model for Understanding Training Load, Fatigue, and Musculoskeletal Sport Injury in University Athletes: A Scoping Review

ABSTRACT

McClean, ZJ, Pasanen, K, Lun, V, Charest, J, Herzog, W, Werthner, P, Black, A, Vleuten, RV, Lacoste, E, and Jordan, MJ. A biopsychosocial model for understanding training load, fatigue, and musculoskeletal sport injury in university athletes: A scoping review. J Strength Cond Res 38(6): 1177-1188, 2024-The impact of musculoskeletal (MSK) injury on athlete health and performance has been studied extensively in youth sport and elite sport. Current research examining the relationship between training load, injury, and fatigue in university athletes is sparse. Furthermore, a range of contextual factors that influence the training load-fatigue-injury relationship exist, necessitating an integrative biopsychosocial model to address primary and secondary injury prevention research. The objectives of this review were (a) to review the scientific literature examining the relationship between training load, fatigue, and MSK injury in university athletes and (b) to use this review in conjunction with a transdisciplinary research team to identify biopsychosocial factors that influence MSK injury and develop an updated, holistic biopsychosocial model to inform injury prevention research and practice in university sport. Ten articles were identified for inclusion in this review. Key findings were an absence of injury surveillance methodology and contextual factors that can influence the training load-fatigue-MSK injury relationship. We highlight the inclusion of academic load, social load, and mental health load as key variables contributing to a multifactorial, gendered environmental, scientific inquiry on sport injury and reinjury in university sport. An integrative biopsychosocial model for MSK injury in university sport is presented that can be used to study the biological, psychological, and social factors that modulate injury and reinjury risk in university athletes. Finally, we provide an example of how causal inference can be used to maximize the utility of longitudinally collected observational data that is characteristic of sport performance research in university sport.

Physical symptoms among professional gamers within eSports, a survey study

BACKGROUND

There is a need to establish the prevalence of self-reported physical symptoms such as pain in professional gamers (PGs) and to analyse whether there are correlations between lifestyle factors and self-reported physical symptoms. The purpose of this study was to analyse the prevalence of self-reported physical symptoms including eye-related problems in PGs. A further aim was to analyse the association between physical symptoms and lifestyle factors such as sleep time, play time and physical activity.

METHODS

This study was designed as a cross-sectional study with data based on an electronic survey, created specifically for this study, through discussion and screening of established validated questionnaires for physical symptoms in musculoskeletal conditions: the Karolinska Sleep Questionnaire and the Nordic Musculoskeletal Questionnaire. The survey comprised age and years of experience as a PG as descriptive variables, as well as questions on sleep, play time, physical activity and physical symptoms for the purpose of analysis. The directors of 10 professional gaming corporations were contacted by email with a link to the study-specific survey to distribute to all employees.

RESULTS

A total of 40 answers to the electronic survey were retrieved from 40 PGs, of which 62.5% (n = 25) had experienced at least one physical symptom in the three months prior to answering the survey. There was a significant association between playing time and physical symptoms (OR = 8.0; 95% CI 1.4-44.6, p = 0.018), where playing for more than 35 h a week was positively associated with eight times higher odds of experiencing physical symptoms.

CONCLUSION

There is a high prevalence of physical symptoms, such as headache and eye symptoms, in professional eSports gamers. There was an association between playing more than 35 h per week with the prevalence of physical symptoms.

Using a socioecological approach to explore healthy lifestyle in elite sport: a qualitative study of French athletes', coaches', and managers' perspectives

Elite athletes are continually subjected to a range of constraints specific to high performance, and these can have a negative impact on their health. Although many studies have explored the individual factors related to risky behaviours and disorders in elite sport contexts, few have focused on health promotion. Consequently, the interpersonal, institutional, and policy factors of the health-related behaviours of elite athletes are still poorly explored. Based on the socioecological model, this study aimed to identify the factors involved in the health-related lifestyle of elite athletes. Semi-structured interviews were conducted with 45 participants: athletes (N = 32), their coaches (N = 6) and the managers of elite sport centres (N = 7). Both deductive and inductive thematic analyses were performed. Our results highlight the views of the actors. Regarding intrapersonal factors, resilience qualities and health literacy appeared as key factors in influencing the health-related lifestyle of elite athletes. At the interpersonal level, parents and coaches emerged as the main sources of educational support. Regarding institutional factors, the health policies of the elite sport centres were key factors in supporting the athletes' healthy lifestyle. These results encourage the development of health promotion programs at different levels of intervention.

Sleep disturbances and depression are bidirectionally associated among college student athletes across COVID-19 pandemic exposure classes

College athletes may be vulnerable to sleep disturbances and depression during the COVID-19 pandemic as a result of large shifts in social and athletic obligations. In a national sample of college athletes, we examined the associations between sleep disturbances and depression across two timepoints, using COVID-19 exposure as a moderator. Data were collected from 2098 NCAA Division I, II, and III college athletes during two timepoints, from April 10 to May 23, and from August 4 to September 15, 2020. First, a latent class analysis was conducted with five indicators of levels of COVID-19 exposure to determine different exposure profiles. Second, to examine the directionality of associations between sleep disturbance and depression, a cross-lagged panel model was added to the latent class membership structural equation model; this allowed for testing of moderation by COVID exposure class membership. Four highly homogeneous, well-separated classes of COVID-19 exposure were enumerated: Low Exposure (57%); Quarantine Only (21%); High Other, Low Self Exposure (14%); and High Exposure (8%). COVID-19 exposure class membership did not significantly moderate associations between sleep disturbances and depression. However, student athletes significantly differed in T2 depression by their COVID-19 exposure class membership. Depression and sleep disturbances were positively correlated at both timepoints (r _T1 = 0.39; r _T2 = 0.30). Additionally, cross-lagged associations were found such that T2 depression was associated with T1 sleep disturbances (β = 0.14) and vice versa (β = 0.11). These cross-lagged associations were not significantly affected by athletes' level of COVID-19 exposure during the beginning of the pandemic.

Prospective Implications of Insufficient Sleep for Athletes

CONTEXT

Poor sleep is common in collegiate student-athletes and is associated with heterogeneous self-reported complaints at baseline. However, the long-term implications of poor sleep at baseline have been less well studied.

OBJECTIVE

To examine the implications of insufficient sleep at baseline, as well as factors such as symptom reporting and neurocognitive performance at baseline associated with insufficient sleep, for the risk of sport-related concussion (SRC).

DESIGN

Cross-sectional study.

SETTING

Undergraduate institution.

PATIENTS OR OTHER PARTICIPANTS

Student-athletes (N = 614) were divided into 2 groups based on the hours slept the night before baseline testing: sufficient (>7.07 hours) or insufficient (≤5.78 hours) sleepers. Athletes who went on to sustain an SRC during their athletic careers at our university were identified.

MAIN OUTCOME MEASURE(S)

Four symptom clusters (cognitive, physical, affective, and sleep) and headache were examined as self-reported outcomes. Four neurocognitive outcome measures were explored: mean composite of memory, mean composite of attention/processing speed, memory intraindividual variability (IIV), and attention/processing speed IIV.

RESULTS

Insufficient sleepers at baseline were nearly twice as likely (15.69%) as sufficient sleepers (8.79%) to go on to sustain an SRC. Insufficient sleepers at baseline, whether or not they went on to sustain an SRC, reported a higher number of baseline symptoms than did sufficient sleepers. When compared with either insufficient sleepers at baseline who did not go on to incur an SRC or with sufficient sleepers who did go on to sustain an SRC, the insufficient sleep group that went on to incur an SRC performed worse at baseline on mean attention/processing speed.

CONCLUSIONS

The combination of insufficient sleep and worse attention/processing speed performance at baseline may increase the risk of sustaining a future SRC.

Examination of clinical sleep difficulties in college student-athletes

BACKGROUND

Due to the rising concern of inadequate sleep, critical analysis is needed for the presence of sleep problems in diverse populations. Research has shown that college athletes may be one such population at risk for sleep disturbances. Poor sleep may lead to physiological, psychological, and cognitive deficits that can impact college athletes academically and athletically. This investigation was performed to examine the relationship of age, sex, and history of concussion on sleep disturbance in college athletes.

METHODS

A total of 191 collegiate athletes between the ages of 18-26 from a single academic NCAA institution in the Rocky Mountain region of the USA, consented to participate in the study. Participants completed a demographic questionnaire and the Athlete Sleep Screening Questionnaire (ASSQ). Results were analyzed using SPSS Version 27.

RESULTS

Primary results revealed that female athletes reported higher sleep disturbance scores when compared to males (U=3643.0, P=0.016). Self-reported sleep disturbances when traveling for sport were higher for females (<inf>X</inf>(1) = 23.800, P<0.001). Males were also less likely to report daytime dysfunction when traveling for sport (<inf>X</inf>(1) =22.988, P<0.001). Sleep disturbance had a significant association with age (<inf>X</inf>(1) =4.145, P=0.042), with older participants (20+ years of age) reporting greater sleep disturbance. Concussion history did not associate with sleep disturbance in the present study.

CONCLUSIONS

Results suggest that sophomore or older female may be at higher risk for sleep disturbances. Clarifying sex-specific sleep health and understanding the role of age and academic class is crucial to enhance and personalize interventions.

Is insufficient sleep duration a risk indicator for periodontal disease? A systematic review

OBJECTIVES

In this study, we conducted a systematic review and meta-analysis to assess whether people who achieved <7 h of sleep were more likely to develop periodontal disease (PD).

SOURCES

We executed electronic searches in the PubMed, EMBASE and Cochrane Library, as well as a manual search of articles published by leading journals in related fields, for observational studies, published in English from 1 January 1966 to 31 March 2021.which evaluated the relationship between sleep duration and PD. The Agency for Healthcare Research and Quality (AHRQ) quality evaluation scale was used for the cross-sectional studies, and the random effects model was used to summarize the effect sizes in the included studies with a 95% confidence interval (CI).

RESULTS

A total of six cross-sectional studies met the inclusion criteria, totaling 107,777 participants, of which 69,773 had PD. The results of the present indicated that shorter sleep duration (<7 h) is significantly associated with PD (Odd ratio [OR], 1.19; 95% CI, 1.16-1.23; p < 0.001; I² , 0.0%, I² interval, 0%-75%). The strength of the sensitivity analysis and cumulative meta-analysis confirmed the reliability of the results.

CONCLUSION

Although the inclusion of only six studies makes it difficult to explore whether there is a publication bias, we found that insufficient sleep duration was closely related to PD, and we therefore speculated that getting enough sleep may help prevent PD.

Sleep regularity in athletes: Comparing sex, competitive level and sport type

This study aims to describe the athletes' sleep regularity using the Sleep Regularity Index (SRI) and determine whether factors, such as sex, competitive level and sport type, could affect the sleep/wake rhythm. It is a descriptive, cross-sectional study consisting of 172 athletes (25 ± 7 y old; 45 women). Seventy-three competed in team sports and 99 in individual sports. Furthermore, 56 competed in the international level, 95 in the national and 21 in the regional. We recorded the SRI values for at least 5 d via continuous actigraphy. We recorded a mean SRI value of 73 ± 12. We found no significant differences between athletes' sleep parameters in relation to sleep regularity. Furthermore, SRI data showed no correlations (Spearman's ρ) with sleep parameters, bed time and wake time. Female athletes (p = 0.001) and individual sport athletes (p = 0.001) reported better sleep regularity than their counterparts. International-level athletes reported better sleep regularity than those in other competitive levels (national: p = 0.001; regional: p = 0.024). Our study showed that international level athletes, female athletes and individual sport athletes reported better sleep regularity. Additionally, SRI data showed no correlation with athletes' sleep parameters, bed and wake time.

Psychological Resilience in Young Female Athletes

Psychological resilience is an important construct that can enhance athletic performance and foster valuable life skills. Through positive adaptation to adversity and stressors in the athletic arena, athletes are able to cultivate their ability to effectively respond to negative stimuli, ultimately evolving to personal growth. For young female athletes, development of resilience may be particularly important. Young female athletes face distinct challenges in sport including sport inequity, body image issues, eating disorders, increased mental distress, and internalization of emotions. The aim of this review is to define and describe the construct of resilience and discuss the implications and applications relevant to young female athletes. By understanding how to foster resilience strategies in this population, we can enhance sport performance and enjoyment, as well as bolster valuable life skills that facilitate personal growth.

Mental Health in Student Athletes: Associations With Sleep Duration, Sleep Quality, Insomnia, Fatigue, and Sleep Apnea Symptoms

PURPOSE

To quantify the relationship between sleep difficulties and poor mental health among student athletes using validated measures.

METHODS

Data were collected from 190 National Collegiate Athletic Association Division I student athletes. Sleep assessments included measures of sleep duration, sleep quality, insomnia, fatigue, and sleep apnea symptoms. Mental well-being was assessed as depression, anxiety, mental health days, stress, and social support from family, friends, significant other, and teammates.

RESULTS

Shorter sleep duration, poor sleep quality, insomnia, and fatigue were consistently and independently associated with stress, depression, anxiety, mental health days, and social support. Sleep apnea symptoms were associated with stress, depression, and social support.

CONCLUSIONS

Short sleep duration, poor sleep quality, and daytime fatigue in student athletes are all associated with depression, anxiety, stress, poor mental health days, and decreased social support. These associations are not accounted for solely by stress.

Comparison of sleep between youth elite amateur athletes and professional athletes

Recent studies suggest that professional athletes seem to experience significant sleeping problems. However, little is still known about the occurrence of sleeping challenges at different stages of an athletic career. This descriptive study aimed to compare the sleep of professional athletes with younger elite amateur athletes. A total of 401 sportsmen, 173 youth elite amateur athletes and 228 professional athletes fulfilled a validated questionnaire. The self-estimated quality of sleep (on a linear scale 0–10) was significantly better in youth, being 7.9 compared to 7.4 (p < 0.001). The professional athletes had a significantly higher risk for sleeping problems, especially during the competitive season (OR = 7.3, 95% confidence interval 4.1–12.9) and they also used significantly more sleep medications (OR = 8.3, 95% confidence interval 1.7–4.1). Interestingly, majority of youth athletes (85.4%) had received adequate sleep counselling compared with professional athletes (58.1%), (p < 0.001). Furthermore, 75.8% of professional athletes considered that additional sleep counselling would improve their performance compared with only 45.6% of youth athletes (p < 0.001). Our study demonstrates that compared with the younger counterparts, professional athletes experience impaired sleep quality and significantly more sleeping problems. There may be various underlying factors to induce the problems. The early intervention with sleep counselling may play an important role in preventing these problems and, therefore, it is recommended to be integrated in athletes’ overall training process.

Melatonin supplementation improves psychomotor and physical performance in collegiate student-athletes following a sleep deprivation night

Several studies report sleep deprivation negatively impacts post-cognitive and physical performance, and other functions. Recent findings indicate ingestion of melatonin prior to exercise enhances tolerance to training and improves competition. We investigated the effects of melatonin supplementation on psychomotor performance and selected physical fitness measures of collegiate student-athletes following 4 h and 24 h of sleep deprivation. The study employed a repeated-measures, double-blind, randomized controlled protocol with posttest control group design with six conditions [3 sleep conditions (without sleep deprivation, 4 h sleep deprivation (4SD) and 24 h sleep deprivation (24SD)) × 2 supplementation conditions (melatonin and placebo)]. Ten trained male collegiate student-athletes (mean ± SD; age: 20 ± 2 y) attended the laboratory on six occasions with 72 h between successive visits. Placebo or 6 mg of melatonin were administered orally in capsules 30 min before the tests of: static and dynamic balance, reaction time, and anaerobic power. Also, blood lactate was measured before and 3 min after the anaerobic power exercise. During the placebo session, the results indicated that 4SD and 24SD had negative effect on the measured parameters, with higher impacts of the 24SD condition. Compared to placebo and during both 4SD and 24SD conditions, melatonin had a positive effect on static and dynamic balance, anaerobic power, blood lactic acid, and reaction time (p < .05). However, 6 mg melatonin ingestion had no significant effect on all dependent variables in collegiate student-athletes after the night without a sleep deprivation (p > .05). In conclusion, 6 mg of melatonin may be used by student-athletes to improve balance and psychomotor and physical performances after 4 h or 24 h of sleep deprivation.

High-Intensity Interval Exercise Performance and Short-Term Metabolic Responses to Overnight-Fasted Acute-Partial Sleep Deprivation

People practicing high-intensity interval exercise (HIIE) fasted during the morning hours under a lack of sleep. Such a habit may jeopardize the health benefits related to HIIE and adequate sleep. Fifteen habitually good sleeper males (age 31.1 ± 5.3 SD year) completed on a treadmill two isocaloric (500 kcal) HIIE sessions (3:2 min work:rest) averaged at 70% VO2reserve after 9-9.5 h of reference sleep exercise (RSE) and after 3-3.5 h of acute-partial sleep deprivation exercise (SSE). Diet and sleep patterns were controlled both 1 week prior and 2 days leading up to RSE and SSE. HIIE related performance and substrate utilization data were obtained from the continuous analysis of respiratory gases. Data were analyzed using repeated measures ANOVA with the baseline maximum oxygen uptake (VO2max) and body fat percentage (BF%) as covariates at p < 0.05. No difference was observed in VO2max, time to complete the HIIE, VE, RER, CHO%, and FAT% utilization during the experimental conditions. Whether attaining an adequate amount of sleep or not, the fasted HIIE performance and metabolism were not affected. We propose to practice the fasted HIIE under adequate sleep to receive the pleiotropic beneficial effects of sleep to the human body.

Effects of sleep disturbance on functional and physiological outcomes in collegiate athletes: A scoping review

OBJECTIVE

To investigate sleep disturbances and circadian timing changes on functional and physiological correlates specifically in collegiate athletes.

DESIGN

Scoping Review.

DATA SOURCES

PubMed MEDLINE, SPORT-Discus, CINAHL, ERIC ProQuest, Web of Science.

ELIGIBILITY CRITERIA

Articles in English, studying college athletes 18-24 years old, employing a sleep measurement, and a comparison measure of cognitive, academic performance, athletic performance, injury rate, biomarkers and physiological measures, or imaging.

RESULTS

Thirty articles met inclusion criteria. There was wide range of study design, sport studied, modality used to measure sleep, frequency of sleep measurements, and functional and physiological outcomes across studies. Sleep measurements varied greatly in frequency of data collection and type of measurement tool, with the majority using a sleep questionnaire. While all variables of interest were represented within the review, most had a focus on cognitive performance, athletic performance, or injury rate as a function of sleep. Studies using biomarkers and physiological measures or imaging were largely underrepresented. Few studies used biomarkers and physiological measures, and one study used imaging measures. Most studies in this review reported negative cognitive and academic outcomes with worse sleep quality and quantity.

CONCLUSIONS

Sleep is critical to maintaining optimal health and collegiate athletes represent a unique population given their unique time constraints, stresses, and sleep behaviors. Findings on athletic performance and injury rate as a function of sleep were mixed. Employing standardized objective methodologies in future work will allow for better understanding of the influence of sleep on the overall well-being and performance of college athletes.

Training and academic demands are associated with sleep quality in high-performance "dual career" student swimmers

Dual career collegiate athletes, who combine sporting endeavours with academic studies, are commonplace in high-performance sport. Sleep is an important aspect of physical and psychological recovery for athletes, plays a role in memory and learning and is associated with academic achievement. The aim of this study was to assess variations in sleep characteristics of collegiate swimmers to understand the incidence of poor sleep, and which stressors might contribute towards this. A total of 22 (male n = 13, female n = 9) high-performance student swimmers (mean ± SD; age 20 ± 2 years) participated in this study. Sleep/wake behaviour was assessed using the Pittsburgh Sleep Quality Index each month over a 12-month period. Additionally, academic and sporting commitments were quantified on a monthly basis and summarised as 4 stressors: average weekly training hours, total number of competitive races, total number of academic assessments, and average weekly learning hours. On average across the 12-month period, 41.7% of athletes reported poor sleep. The latest bedtimes, wake times and longest sleep durations were found in the months where academic and training demands were lowest. A statistically significant positive association was identified between median sleep quality scores and mean number of academic assessments (ρ₍₁₂₎ = 0.71, p=0.005). Hierarchal linear modelling analysis determined that number of academic assessments best predicted sleep quality within this cohort. The present study highlights the need for those working with athletes who have competing academic demands to consider sleep quality, and its potential impact on performance and wellbeing.

Geographically based risk assessment of sleep disorders and disease states impacting medical readiness across active duty army installations from military medical databases in fiscal year 2017

BACKGROUND

The impact of sleep disorders on active duty Soldiers' medical readiness is clinically significant. Sleep disorders often present high comorbidity with disease states impacting readiness ranging from obesity and drug dependence. Patient data generated from military health databases can be accessed to examine such relationships. The current study performed a risk assessment of sleep disorders, obesity, tobacco use, and substance abuse based on geographical distribution of active duty Army installations through a comprehensive analysis of the Office of the Army Surgeon General Health of the Force report, specifically for Fiscal Year 2017, which summarizes data collected during 2016.

METHODS

Health incidences (percent active duty per installation) were queried from the Health of the Force Fiscal Year 2017 (n = 471,000; 85.5% male, >70% between 18 and 34). Nonparametric ranked tests identified active duty Army installations at low risk (green; <25% percentile relative to mean rank), moderate risk (amber; 25%-50% percentile relative to mean rank), and high risk (red; >75% percentile relative to mean rank). Pearson's correlations determined extent of generalized comorbidity of sleep disorders with obesity, tobacco use, and substance abuse across all installations.

RESULTS

Large combat arms and training installations of the Southern U.S. were at highest risk for sleep disorder. Mean rank comparisons for sleep disorders versus obesity (P = .306), tobacco use (P = .378), and substance abuse (P = .591) did not differ for each installation. There was a high degree of generalized comorbidity of diagnosed sleep disorder with obesity (P < .001; r² = 0.963), tobacco use (P < .001; r² = 0.928), and substance abuse (P < .001; r² = 0.968).

CONCLUSIONS

These risk assessments mirror geographical risk data from civilian populations which is surprising because there is a large degree of inter-individual variability in geographical origin, race/ethnicity, and socioeconomic statuses within a single Army installation. Nevertheless, these data demonstrate strong geographical influences on medical readiness in active duty Soldiers comparable to civilian sectors.

Mental Health in the Young Athlete

PURPOSE OF REVIEW

The goal of the present paper is to provide a comprehensive overview of mental health concerns in young athletes, with a focus on common disorders, as well as population-specific risk factors.

RECENT FINDINGS

Athletes experience similar mental health concerns as non-athlete peers, such as anxiety, depression and suicidal ideation, ADHD, eating disorders, and substance abuse. However, they also experience unique stressors that put them at risk for the development or exacerbation of mental health disorders. Student athletes have to balance academics with rigorous training regimens while focusing on optimal performance and managing high expectations. Physical injuries, overtraining, concussion, sleep disorders, and social identity are some of the factors that also impact the mental health of student athletes. Existing literature highlights the need to develop proactive mental health and wellness education for young athletes, and to develop services that recognize the unique needs of this population.

Mindfulness-Based Stress Reduction Benefits Psychological Well-Being, Sleep Quality, and Athletic Performance in Female Collegiate Rowers

Factors such as psychological well-being, sleep quality, and athletic coping skills can influence athletic performance. Mindfulness-based interventions, including mindfulness-based stress reduction (MBSR), have been shown to benefit these factors, suggesting they may, at least indirectly, benefit athletic performance. Moreover, while mindfulness training has been linked to better accuracy in some high-precision sports, whether it can improve non-precision elements of athletic performance is unclear. The objective of this study was to investigate the influence of MBSR on psychological well-being, sleep, athletic coping skills, and rowing performance in collegiate rowers in a controlled experimental design. Members of a Division I NCAA Women's Rowing team completed either an 8-week MBSR course along with their regular athletic training program (Intervention group) or the athletic training program alone (Control group). Measurements of interest were taken at baseline and again either during or shortly following the intervention. In contrast to the Control group, the Intervention group showed improvements in psychological well-being, subjective and objective sleep quality, athletic coping skills, and rowing performance as measured by a 6,000-m ergometer test. Improvements in athletic coping skills, psychological well-being, and subjective sleep quality were all correlated with increases in mindfulness in the Intervention group. These results suggest that mindfulness training may benefit non-precision aspects of athletic performance. Incorporating mindfulness training into athletic training programs may benefit quality of life and performance in student athletes.

Assessment of sleep health in collegiate athletes using the Athlete Sleep Screening Questionnaire

STUDY OBJECTIVES

The objective of this study was to characterize sleep health in a large, diverse population of college athletes. The study utilized the Athletic Sleep Screening Questionnaire, a clinically validated questionnaire, designed to screen athletes for a clinically significant degree of poor sleep health, and to determine if they require intervention.

METHODS

College athletes from 4 different National College Athletic Association institutions were surveyed using the Athletic Sleep Screening Questionnaire. Descriptive information including sex, sport, and college year was also collected. The Athletic Sleep Screening Questionnaire was scored according to prior clinically validated methods to determine a sleep difficulty score, clinical sleep problem category (none, mild, moderate, or severe), and need for assessment by a physician due to poor sleep health.

RESULTS

A total of 1055 surveys were collected with a 95% response rate. Respondents were 36% female, 64% male, and included athletes competing in 15 different sports. Approximately 25% of participants were found to have a clinically meaningful problem with their sleep. Athletes entering their second or higher year of college were more likely to report worse sleep compared to those entering their first year (one-way analysis of variance, Kruskall-Wallis P < .001).

CONCLUSIONS

A substantial portion of college athletes experience poor sleep health and would benefit from interventions aimed at improving sleep. The Athletic Sleep Screening Questionnaire appears to be a cost- and time-efficient way to evaluate sleep health in a large athletic population.

Objectively-Assessed Physical Activity, Sedentary Behavior, Smartphone Use, and Sleep Patterns Pre- and during-COVID-19 Quarantine in Young Adults from Spain

This study assessed the effects of COVID-19 home confinement on physical activity, sedentary behavior, smartphone use, and sleep patterns. Data was collected in a sample of 20 young adults (mean age ± SD: 22.6 ± 3.4 years; 55% males) over seven days pre- and during the COVID-19 lockdown. Objective and subjective physical activity (Accelerometer and the International Physical Activity Questionnaire (IPAQ), respectively), the number of hours sitting (IPAQ), objectively-measured smartphone use (smartphone screen time applications), and objective and subjective sleep (accelerometer and the Pittsburgh Sleep Quality Index, respectively) were assessed. Results revealed significantly greater walking time and mean steps (p < 0.001, d = 1.223 to 1.605), and moderate and vigorous physical activity (p < 0.05, d = 0.568 to 0.616), in the pre- compared with the during-COVID-19 lockdown phase. Additionally, smartphone use (p = 0.009, d = 0.654), sitting time (p = 0.002, d = 1.120), and total sleep (p < 0.004, d = 0.666) were significantly greater in the during- compared with the pre-COVID-19 lockdown phase. Multiple regressions analyses showed associations between physical activity and sedentary behavior and sleep quality. The number of hours sitting per day and moderate-to-vigorous physical activity significantly predicted deep sleep (adj.R2 = 0.46). In conclusion, this study revealed that during the COVID-19 outbreak, behaviors changed, with participants spending less time engaging in physical activity, sitting more, spending more time using the smartphone, and sleeping more hours. These findings may be of importance to make recommendations, including lifestyle modifications during this time.