Sleep and Athletic Performance: Impacts on Physical Performance, Mental Performance, Injury Risk and Recovery, and Mental Health: An Update

Testing in Intermittent Sports-Importance for Training and Performance Optimization in Adult Athletes

ABSTRACT

Performance in intermittent sports relies on the interplay between multiple physiological systems determining the capacity to perform short explosive efforts as well as repeated intense actions with limited recovery over the course of an entire game. Testing should reflect these demands to allow for sport- and position-specific capacity analyses that eventually may translate into optimized training and improved performance. This may include individual load management and optimized training prescription, intensity targeting for specific positions or individual athletes, as well as benchmarking for monitoring of training progression and enhanced engagement of athletes. This review provides an overview of available tests in different exercise domains identified as relevant (from assessment of single explosive actions to intermittent endurance capacity), forming the basis for recommendations on how to compose a comprehensive yet feasible test battery that may be integrated into the seasonal competition and training plan. The test procedures should cover the performance spectrum of relevance for the individual athlete-also in team sports to account for positional differences. We emphasize the benefits of sport-specific tests, highlight parameters of importance for test standardization, and discuss how the applied test battery may be supplemented with secondary tests directed toward specific energy systems to allow for more in-depth analyses when required (e.g., in terms of an underperforming athlete). The synergy between testing and tracking of match performance (utilizing time-motion or global positioning systems) is highlighted, and although tracking cannot substitute for testing, combining the tools may provide a comprehensive overview of the physiological demands and performance during competition contextualized to the athletes' maximal exercise capacity.

Sleep and lucid dreaming in adolescent athletes and non-athletes

During lucid dreaming (LD), dreamers are aware of experiencing a dream and may consciously influence its content. This study used an online questionnaire to investigate the LD frequency and applications in 193 adolescent athletes and non-athletes (17.40 ± 2.09 years; 46% athletes, 54% controls). Given the critical role that sleep plays in adolescent health, development, and performance, associations of LD with various sleep parameters were also explored. LD is prominent in adolescents (67.4% experienced it at least once, 30.0% once a month or more, 12.9% at least once a week), but similar in terms of frequency and uses between athletes and non-athletes. A higher proportion of those who practiced sports/dance during LD reported improved waking self-efficacy (57.1%) over sport performance (42.9%). There was no indication that chronotype preference may influence LD nor that LD may be detrimental to adolescent sleep. Athletes and controls had similar sleep durations, daytime sleepiness, and sleep disturbances frequency, but athletes reported higher sleep quality. Despite, on average, meeting the minimum sleep recommendation guidelines for their age, a relatively large proportion of adolescents did not attain sufficient sleep, particularly on weeknights (47.4% 14-17 years; 20.0% 18-21 years), suggesting that restricted sleep remains prevalent in adolescent populations.

Insomnia and other sleep disorders in adolescence

Sleep is important for our survival. Research suggests that getting 'good' sleep is a problem for a proportion of adolescents. The paper advocates for holistic treatment of sleep disorders incorporating expertise from a multidisciplinary team. Much of the assessment and treatment of sleep disorders in adolescents comes from research within adult populations, therefore, there is a need for further research to be completed within the adolescent population to ensure there is a robust evidence base for assessment and treatment of sleep disorders.

Social jetlag affects jump skills in sub-elite volleyball players

Social jetlag (SJL), resulting from misalignment between biological rhythms and social schedules, has emerged as a prevalent phenomenon in modern society, particularly among young athletes. However, the effect of SJL on performance is poorly studied. Jump and dynamic balance are two key skills in volleyball, as the first allows the player to perform better both during the offense and defense phase, and the second is fundamental in landing and in injury prevention. Therefore, our aim was to investigate the effect of SJL on jump skill performance and balance in female volleyball players. Thirty female volleyball players (mean age: 17.3 ± 0.88 years) participated in the study. SJL was assessed using the Munich ChronoType Questionnaire (MCTQ), integrated with Jankowsky's sleep-corrected formula. Jump skill performance was evaluated using a standardized jump test, the Vertec Jump Test, while balance was assessed with the Y Balance Test. The tests were performed at 09:00 a.m. and at 06:00 p.m. The results revealed that players with greater SJL exhibited decreased jump performance, characterized by lower vertical jump height (p = 0.02). Furthermore, players with lower SJL showed the typical difference between morning and afternoon performance (p = 0.001), demonstrating their synchronization between biological rhythms and social commitments, while no statistically significant difference between the two sessions was shown in players with higher SJL. Regarding balance, no significant association with SJL was found, but the morning session yielded lower results than the afternoon one (p = 0.01). These findings highlight the detrimental impact of SJL on jump skill performance, underscoring the importance of optimizing sleep-wake schedules and circadian alignment to enhance athletic performance. Future research should explore targeted interventions, such as sleep hygiene education, to minimize social jetlag and promote optimal performance in adolescent athletes.

Behavioral and psychological aspects of coffee consumption

The chapter "Behavioral and Psychological Aspects of Coffee Consumption" delves into the complex interplay between coffee drinking and cognitive functions, human behavior, and health-related effects. It starts by looking at coffee's physiological impacts, such as how it affects the body's neurotransmitter systems, metabolism, cardiovascular health, liver health, mental health, and bone health. The larger framework of behavioral and psychological variables impacting patterns of coffee drinking provides further context for these effects. The chapter explores a range of behavior change interventions designed to encourage moderate coffee use. It also covers the role that technology, customized methods, and environmental alterations might play in supporting healthier choices. The statement underscores the significance of attending to the requirements of heterogeneous populations, surmounting obstacles to behavior modification, and guaranteeing the enduring viability of intervention results. The chapter also outlines new directions in neuroscience and behavioral science research, including developments in neuroimaging methods and the application of digital health technology to the delivery of interventions. Additionally, it emphasizes how coffee use affects public health and policy, arguing in favor of evidence-based guidelines and treatments that encourage sensible coffee consumption habits and enhance population health outcomes. Ultimately, the chapter offers a thorough summary of the behavioral and psychological effects of coffee drinking, highlighting the significance of multidisciplinary studies and cooperative efforts to deepen our comprehension of this intricate phenomenon.

Nightmares in Swiss elite athletes: Associated factors

Nightmares, defined as extremely dysphoric dreams, can cause significant distress in everyday life if they occur frequently. Their aetiology is based on a disposition-stress model. As elite athletes often experience high stress levels, the present study investigated factors that might be associated with nightmare frequency in a large cohort of 2297 Swiss elite athletes (1066 women, 1231 men) with a mean age of 22.05 ± 7.53 years. In total, about 6% of the athletes reported frequent nightmares (once a week or more often). We found that well-established factors like female gender and general stress levels were related to nightmare frequency. To a smaller extent, the number of training hours, lost training days due to illness, and having early training sessions were also associated with nightmare frequency. Sport discipline was not related to nightmare frequency. An unexpected finding was the association between late alcohol intake 4 hr prior to bedtime and nightmare frequency. Our findings support the idea that stress related to practicing sports might affect nightmare frequency. Future research should study whether inventions designed for athletes suffering from frequent nightmares are beneficial for them and might even improve their athletic performance.

Household food insecurity among child and adolescent athletics practitioners: A cross-sectional, descriptive, and exploratory study

OBJECTIVE

The aim of the study was to explore the prevalence of food insecurity among child and adolescent athletics practitioners and to investigate factors associated with exercise performance, dietary habits, body composition, sleep, and socioeconomic status based on food security status.

METHODS

This was a cross-sectional, descriptive, and exploratory study conducted in Campinas, São Paulo, Brazil, between June and July 2023. The convenience sample included children and adolescents (7-17 y old) of both sexes. We evaluated exercise performance, household food insecurity (HFI), dietary-related parameters, and other body composition, lifestyle, and social-related variables. Exercise performance was assessed using the counter movement jump (CMJ), squat jump (SJ), horizontal long jump (HLJ), 50-m sprint test (50-m ST) and throwing strength test (TST). The assessment of HFI was conducted using the food insecurity experience scale (FIES). Comparisons and associations were investigated based on food security status.

RESULTS

The total sample size was comprised of 138 children (n = 42; 30.4%) and adolescents (n = 96; 69.6%). We found an association between food security status and sex (X2(138,1) = 4.42; P = 0.036). SJ was higher in the food security group than in the HFI group (t(117) = 2.112; P = 0.037; ES = 0.39). Sleep- and dietary-related factors did not differ between the groups.

CONCLUSIONS

In summary, the prevalence of HFI among child and adolescent athletics participants was approximately 40%. Regarding exercise performance, SJ was better in the food security group than in the HFI group. Concerning dietary-related data, the HFI group had a lower number of meals per day than the food security group, and other dietary data did not differ between the groups. Body composition and sleep-related parameters were similar between the groups.

Advancing a U.S. navy shipboard infrastructure for sleep monitoring with wearable technology

Development of fatigue management solutions is critical to U.S. Navy populations. This study explored the operational feasibility and acceptability of commercial wearable devices (Oura Ring and ReadiBand) in a warship environment with 845 Sailors across five ship cohorts during at-sea operations ranging from 10 to 31 days. Participants were required to wear both devices and check-in daily with research staff. Both devices functioned as designed in the environment and reliably collected sleep-wake data. Over 10,000 person-days at-sea, overall prevalence of Oura and ReadiBand use was 69% and 71%, respectively. Individual use rates were 71 ± 38% of days underway for Oura and 59 ± 34% for ReadiBand. Analysis of individual factors showed increasing device use and less device interference with age, and more men than women found the devices comfortable. This study provides initial support that commercial wearables can contribute to infrastructures for operational fatigue management in naval environments.

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.

Chronotype characteristics of professional athletes in China: a comprehensive descriptive study

BACKGROUND

Chronotype has gained recognition as a significant factor in enhancing athletic performance. This study aimed to deepen our understanding of athletes' sleep chronotypes and provide a foundation for developing evidence-based training and competition programs. By comprehensively describing and analyzing the chronotype characteristics of Chinese professional athletes, considering individual and sports factors, sleep quality and habits, and mental energy, this research aimed to contribute valuable insights to the field.

METHODS

A sample of 1069 professional athletes from sports teams in Shanghai completed the Athlete Sleep Screening Questionnaire and the Athlete Mental Energy Scale to assess chronotype, sleep quality, sleep-influencing habits, and mental energy.

RESULTS

Among athletes, sleep typology fell within the intermediate range, slightly leaning toward morningness. Male athletes and those who engaged in static sports displayed a greater propensity for morningness. Age correlated with a preference for eveningness. High-level athletes exhibited a stronger inclination toward eveningness. Sleep quality issues were associated with an inclination toward eveningness. Daily caffeine intake and the habit of using electronic devices before bedtime are also linked to eveningness. Chronotype demonstrated the ability to predict various dimensions of athletes' mental energy. It was the strongest predictor of vigor, but the loadings were smaller than those of sleep quality.

CONCLUSION

Chinese athletes' chronotypes primarily exhibit distinct characteristics related to individual factors such as gender, sports discipline, and ranking, as well as habits like caffeine consumption and electronic device use. Moreover, these sleep patterns demonstrate predictive capabilities across all dimensions of athletes' mental energy. This study sheds light on Chinese athletes' unique sleep chronotype attributes, enriching our understanding of sleep patterns among professional athletes under various systems. These insights offer an initial basis for enhancing the effectiveness of athlete scheduling and training management.

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 Combination of Quantitative Proteomics and Systems Genetics Analysis Reveals that PTN Is Associated with Sleep-Loss-Induced Cognitive Impairment

Sleep loss is associated with cognitive dysfunction. However, the detailed mechanisms remain unclear. In this study, we established a para-chlorophenylalanine (PCPA)-induced insomniac mouse model with impaired cognitive function. Mass-spectrometry-based proteomics showed that the expression of 164 proteins was significantly altered in the hippocampus of the PCPA mice. To identify critical regulators among the potential markers, a transcriptome-wide association screening was performed in the BXD mice panel. Among the candidates, the expression of pleiotrophin (Ptn) was significantly associated with cognitive functions, indicating that Ptn-mediates sleep-loss-induced cognitive impairment. Gene co-expression analysis further revealed the potential mechanism by which Ptn mediates insomnia-induced cognitive impairment via the MAPK signaling pathway; that is, the decreased secretion of Ptn induced by insomnia leads to reduced binding to Ptprz1 on the postsynaptic membrane with the activation of the MAPK pathway via Fos and Nr4a1, further leading to the apoptosis of neurons. In addition, Ptn is genetically trans-regulated in the mouse hippocampus and implicated in neurodegenerative diseases in human genome-wide association studies. Our study provides a novel biomarker for insomnia-induced cognitive impairment and a new strategy for seeking neurological biomarkers by the integration of proteomics and systems genetics.

Dawn of a New Dawn: Advances in Sleep Health to Optimize Performance

Optimal sleep health is a critical component to high-level performance. In populations such as the military, public service (eg, firefighters), and health care, achieving optimal sleep health is difficult and subsequently deficiencies in sleep health may lead to performance decrements. However, advances in sleep monitoring technologies and mitigation strategies for poor sleep health show promise for further ecological scientific investigation within these populations. The current review briefly outlines the relationship between sleep health and performance as well as current advances in behavioral and technological approaches to improving sleep health for performance.

Sleep and Performance in Professional Athletes

Purpose of Review

Sleep is an essential human behavior that plays a key role in proper biopsychosocial development as well as short- and long-term biological, physical, psychological, and cognitive health. Sleep plays a key role in athletic performance, influencing an athlete's ability to train, recover, and perform, as well as their overall wellness. Over the recent decade, the awareness of sleep's import has penetrated just about every professional sport domain. The purpose of the review was to identify and synthesize the literature published within the past 5 years (2018-2022) that relates to sleep and performance in professional athletes. Literature related to nonprofessional, high-level athletes (e.g., collegiate; Olympic) was omitted as well as those associated with non-traditional professional sports (e.g., eSports).

Recent Findings

Results from 38 articles were incorporated into this review, which covered (1) the sleep's role in the training, physical injury prevention and recovery, competitive performance, and mental health of professional athletes, (2) common sleep problems and disorders in professional athletes, and (3) the impact of unique challenges from training, travel, competition, and other factors on sleep health. Additionally, we provide an orientation to utilized strategies and interventions to assist with sleep health in professional athletes, as well as conclude with a commentary on critical steps forward.

Summary

Sleep plays a critically important role in the training, recovery, performance, and overall wellness of professional athletes. Professional athletes are vulnerable to a variety of sleep-related problems and disorders, due to unique factors related to training, travel, and competition, among other factors. Improved, standardized research methodology and partnerships between professional athletes, coaches, teams, and organizations and researchers are necessary to advance the knowledge of sleep and performance in professional athletes, including identifying sport-specific differences and variation across individual characteristics, as well as developing individualizable, dynamic, and appropriate interventions for improving sleep health among professional athletes.

Schlaf und Wettkämpfe bei jungen AthletInnen

Hintergrund

Schlaf spielt auch für SportlerInnen eine wichtige Rolle, vor allem vor Wettkämpfen.

Ziel der Arbeit

In einer Stichprobe von NachwuchsathletInnen soll erfasst werden, ob ein gestörter Schlaf vorliegt und welche Ursachen und Auswirkungen ein gestörter Schlaf vor Wettkämpfen aus subjektiver Sicht hat.

Material und Methode

Mittels eines Online-Fragebogens wurden 46 SchülerInnen eines Sportgymnasiums (Tenero, Schweiz) befragt.

Ergebnisse

Über zwei Drittel der jugendlichen Athletinnen berichten über einen schlechteren Schlaf vor wichtigen Wettkämpfen oder Spielen. 40 % dieser AthletInnen gaben an, dass der schlechte Schlaf vor dem Wettkampf/Spiel ihre Leistung beeinträchtigt hat.

Diskussion

Da aus subjektiver Sicht schlechter Schlaf die Wettkampfleistungen beeinträchtigen kann, ist es sinnvoll, dieses Thema intensiver zu beforschen (kontrollierte Studien) und Schlafinterventionen für diese Zielgruppe zu entwickeln.

Benzodiazepines in sport, an underestimated problem: Recommendations for sports medicine physicians' practice

In the last years, only few studies in literature have focused on the use and abuse of benzodiazepines (BZDs) in sport. Benzodiazepine-related problems include misuse, addiction, driving impairments, and morbidity and mortality related to overdose and withdrawal. Two clinical cases regarding elite endurance athletes evidenced that they had started to use BZDs to counteract insomnia, to recover faster from training sessions and to manage muscle pain. One of the important points that emerged from their stories was that their sports doctors did not recognize the drugs' addictive properties, and did not intervene to gradually reduce the dosage. Experts have previously provided recommendations for BZD therapy management in clinical practice. In this article, we would like to address sports medicine physicians specifically and provide guidelines to help them manage situations involving BZD prescription, the recognition of addiction, and intervention strategies.