Sleep and performance in Eathletes: for the win!

Comparing the cognitive performance of action video game players and age-matched controls following a cognitively fatiguing task: A stage 2 registered report

Recent work demonstrates that those who regularly play action video games (AVGs) consistently outperform non-gamer (NG) controls on tests of various cognitive abilities. AVGs place high demands on several cognitive functions and are often engaged with for long periods of time (e.g., over 2 h), predisposing players to experiencing cognitive fatigue. The detrimental effects of cognitive fatigue have been widely studied in various contexts where accurate performance is crucial, including aviation, military, and sport. Even though AVG players may be prone to experiencing cognitive fatigue, this topic has received little research attention to date. In this study, we compared the effect of a cognitively fatiguing task on the subsequent cognitive performance of action video game players and NG control participants. Our results indicated AVGs showed superior spatial working memory and complex attention abilities while showing no difference from NGs on simple attention performance. Additionally, we found that our cognitive fatigue and control interventions did not differentially affect the cognitive performance of AVGs and NGs in this study. This pre-registered study provides evidence that AVGs show superior cognitive abilities in comparison to a non-gaming population, but do not appear more resilient to cognitive fatigue.

The impact of videogames on the mood of amateur youth players during consecutive games

Introduction

Esports have experienced tremendous growth in recent years. In the scientific field, previous research has shown the determining role of psychology in competitive performance, but little is known about the factors that may be more determinant. In addition, in the amateur field, where fun and enjoyment are the most important factors, it has been observed that players can see their psychological state altered due to different factors, but it is not known if the outcome of the game (win or lose) can be influential. For this reason, the aim of the present investigation was to analyze changes in players' mood between three consecutive games as a function of the outcome of each game.

Methods

A total of 14 amateur players participated in the research, all of them with previous experience and being regular League of Legends players. The participants completed the POMS questionnaire before the start of each game and the outcome of each game was recorded at the end.

Results

The results showed that no significant pre-game differences were found in any of the games, regardless of winning or losing. Significant differences were found in the pre-game mood between the first and second game, according to the outcome of the first game, and between the second and third game, according to the outcome of the second game. Between the first and second games, there was a significant increase in depression (p = 0.038) and anger (p = 0.003) when the first game was lost; and between the second and third games, there was a decrease in tension (p = 0.003) and anger (p = 0.022) when the second game was won. In addition, it should be noted that fatigue increased significantly after each game, regardless of the outcome, and with respect to the change in mood, this was more noticeable when the first game was lost and the second was won, as significant changes were observed in tension (p = 0.028), depression (p = 0.030) and anger (p = 0.006).

Conclusion

Pre-match mood does not influence post-match performance, but mood changes do occur between successive matches depending on the outcome of the match.

The eSports Medicine: Pre-Participation Screening and Injuries Management-An Update

Recently, electronic sports (eSports) became one of the growing forms of new media due to the wide diffusion of games and online technologies. Even if there is still a debate about the definition and characterization of eSports, eAthletes train heavily, compete in tournaments, must abide by competition, association, and governing body rules, just like all other athletes. Furthermore, as in any other competitive discipline, there can be injuries. Aberrant sitting posture, repetitive movements, screen vision, prolonged playing hours, and a sedentary lifestyle can lead to several medical hazards in musculoskeletal, ophthalmology, neurological, and metabolic systems. Moreover, several cardiovascular changes occur in eAthletes. This paper aims to explore the different injuries that can occur in a professional eAthlete, suggesting how every high-level gamer could benefit from a pre-participation evaluation and a correct injury prevention strategy.

Health Consequences of Intensive E-Gaming: A Systematic Review

The aim of this review is to examine the links among the different factors that determine harmful or even deadly events in professional and semiprofessional intensive Esports players. Cases of serious injuries or even death in young (<35 years old) male professional Esports players are reported every year. Fatalities and injuries in professional Esports players (PEGS) have only affected male players, and these events have mostly been concentrated in Asia. Studies in the literature have reported several causes and mechanisms of injuries. Links between injuries and previous comorbidities have emerged from the extant literature; obesity and/or metabolic disorders, seizures (associated with overstimulation of the eyes), heart malfunctions, high basal and abrupt increases in systolic blood pressure (SBP), prolonged stress, and poor posture have been associated with injuries. Several clinical signs have been identified and the question emerges whether or not self-regulation by Esports associations or public health authorities is necessary.

Characteristics of the gut microbiome in esports players compared with those in physical education students and professional athletes

Introduction

Esports is a category of competitive video games that, in many aspects, may be similar to traditional sports; however, the gut microbiota composition of players has not been yet studied.

Materials and methods

Here, we investigated the composition and function of the gut microbiota, as well as short chain fatty acids (SCFAs), and amino acids, in a group of 109 well-characterized Polish male esports players. The results were compared with two reference groups: 25 endurance athletes and 36 healthy students of physical education. DNA and metabolites isolated from fecal samples were analyzed using shotgun metagenomic sequencing and mass spectrometry, respectively. Physical activity and nutritional measures were evaluated by questionnaire.

Results

Although anthropometric, physical activity and nutritional measures differentiated esports players from students, there were no differences in bacterial diversity, the Bacteroidetes/Firmicutes ratio, the composition of enterotype clusters, metagenome functional content, or SCFA concentrations. However, there were significant differences between esports players and students with respect to nine bacterial species and nine amino acids. By contrast, all of the above-mentioned measures differentiated professional athletes from esports players and students, with 45 bacteria differentiating professional athletes from the former and 31 from the latter. The only species differentiating all three experimental groups was Parabacteroides distasonis, showing the lowest and highest abundance in esports players and athletes, respectively.

Conclusion

Our study confirms the marked impact of intense exercise training on gut microbial structure and function. Differences in lifestyle and dietary habits between esports players and physical education students appear to not have a major effect on the gut microbiota.

The Relationship Between Basic Needs Satisfaction, Self-determined Motivation, and Burnout in Korean Esports Players

This article aims to understand the relationship between basic needs satisfaction, self-determined motivation, and burnout in esports players. To achieve this, we investigate three research hypotheses: (1) The three dimensions of basic needs satisfaction have a positive effect on the self-determined motivation of esports players, (2) The self-determined motivation of esports players has a negative effect on their burnout, and (3) All three dimensions of basic needs satisfaction affect esports player's burnout, indirectly via self-determined motivation. Data were collected through an online questionnaire (n = 608) administered to Korean esports players who play online games as a leisure activity. Results indicate that player competence has a negative relationship with self-determined motivation, suggesting that Korean players do not associate increased levels of competence with their intrinsic motivation. The results show that intrinsic motivation is negatively associated with burnout, particularly exhaustion and reduced sense of accomplishment. It should be noted that Korean players' high level of competence can result in reduced levels of self-determined motivation, which can lead them to burnout. This should be addressed by the industry, practitioners, and researchers considering the cultural context and the relationship between the factors, which will contribute to the sustainable growth and prosperity of the esports.

E-sports: What mental health professionals from low & middle-income countries must know

'E-sports' refers to organized videogames. As the number of online gamers and interest in esports continue to rise in low and middle-income countries, mental health professionals need to be aware of their possible psychological and clinical implications. Only a small fraction of esports players present with gaming addiction, but a relatively larger proportion with subtle impairment impacting domains such as self-esteem, performance-related issues, family conflict, sleep-related issues or physical health. An adequate knowledge of esports, its concept, origins, genre and current status should equip mental health professionals in developing a good rapport with these young clients and correctly evaluate them. This review provides an overview of esports and how it pertains to mental health professionals.

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.

Examining the Indirect Effect of Online Gaming on Depression via Sleep Inequality and Anxiety-A Serial and Parallel Mediation Analysis

Stress-related disorders are highly prevalent among first-year college students. Gaming disorder (GD) is an emerging disorder linked to physical and psychological consequences. We aimed to investigate the mechanism linking GD with anxiety, depression, and sleep disorders among first-year undergraduate students. Four hundred fifty-seven participants were recruited, and the survey included the Internet Gaming Disorder Scale Short-Form (IGDS9-SF), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Pittsburgh Sleep Quality Index (PSQI). Our results showed that female students scored significantly higher than males in anxiety and depression. Furthermore, we found that depression is positively and strongly correlated to anxiety, and both are moderately associated with sleep quality. Gaming is positively related to depression, anxiety, and sleep quality. Interestingly, the health sciences tracks showed lower sleep quality than undergraduates from other tracks. There was a 64% variance in depression explained by many predictors, including anxiety, sleep quality, gaming, painkiller use, and gender. In addition, the mediation models showed that the association between gaming and depression is mediated indirectly by sleep quality, and sleep quality may be mediated directly by anxiety. The first year in college occurs at a critical developmental and professional stage, and our results highlight the need to establish support programs and conduct mental health educational workshops.

A review article of the cardiovascular sequalae in esport athletes: a cause for concern?

The esports industry has grown exponentially and is expected to flourish rapidly in the coming years. Awareness about the cardiovascular sequalae in elite esport athletes has gained considerable momentum. Evidence supporting systematic screening in esport athletes is however lacking. In this narrative review, we discuss potential negative health effects on the cardiovascular system in esports enthusiasts. The pathophysiological mechanisms discussed in this narrative review may put esport athletes at an increased risk of cardiovascular events. Although large studies in esport athletes to substantiate these claims are inexistent, case reports or case-controlled studies have been included to support our hypotheses. Sleep deprivation, psychological stress, altered arterial stiffness, hypertension, and heart rate variability are some of these proposed mechanisms. The available data is unfortunately extrapolated from small cohorts. Nevertheless, the risk of sudden cardiac death is an important health concern which should be addressed appropriately. This review will raise awareness about the possible negative impact on the cardiovascular system in esport athletes.

Associations Between Esports Participation and Health: A Scoping Review

Esports are a contemporary phenomenon, with millions of people involved. Still, scientific literature on the topic is scarce. Anecdotal reports, mostly based on what is known from videogames practice, have associated esports with unhealthy lifestyles and health-related problems. The present scoping review aimed to provide an overview of findings from studies regarding the health and well-being in adult esports players, while identifying the most studied topics in the field and those still lacking scientific research.The search was conducted in MEDLINE, Scopus, Web of Science, B-on, and ESCBO databases. Studies regarding health consequences of esports practice conducted with adult esports players were included. No exclusion criteria concerning age, sex, esports modality, or esports level were applied, but articles related to other forms of video gaming or gambling were excluded. The search was limited to peer-reviewed articles. Opinion and review articles were excluded.There were 1416 articles retrieved from which 33 met the inclusion criteria. Lifestyle habits, sleep, exercise and physical health (including musculoskeletal health), physiological demands, and mental health were the main topics of investigation. Several gaps in the literature were identified, namely studies on cardiovascular, respiratory, or metabolic health, or consuming-related risks. Also, the lack of homogeneous methodologies and definitions used in esports-related studies was identified.Esports practice has been associated with different health-related symptoms, but more studies using more robust methodologies and appropriate research design are needed. Topics such as cardiovascular health or the use of performance-enhancing drugs are lacking.

Influence of esports on Sleep and Stress

Abstract. Recreative sleep and a low stress level are important health- and performance-enhancing factors in daily life. The present investigation examines the influence of esports on sleep and stress. In a counterbalanced within-subjects design, 44 participants (37 males, 7 females, 25.2 ± 4.6 years old) completed both a gaming and a nongaming session on two consecutive evenings. We assessed individual sleep duration and individual stress parameters via a Garmin® smartwatch in addition to a short subjective scale. The results show that, in the gaming condition, total sleep time was significantly lower than in the nongaming condition ( p = .003). The participants’ stress level was significantly increased after gaming compared to nongaming ( p = .005). Future research should not only examine the long-term effects of esports on health longitudinally, but also establish suitable sleep interventions and stress coping strategies.

Evaluation of a Brief Sleep Intervention Designed to Improve the Sleep, Mood, and Cognitive Performance of Esports Athletes

This study evaluated a brief sleep intervention designed to improve the sleep, mood, and cognitive performance of professional electronic sports (esports) athletes from three major esports regions (i.e., Asia, North America, and Oceania). Fifty-six esports athletes from South Korea (N = 34), the United States (N = 7), and Australia (N = 15) completed the study. Participants completed an initial 2-week pre-intervention phase to establish a baseline, followed by a 2-week intervention phase that involved a group sleep education class, 1:1 session with a trained clinical psychologist, and daily biofeedback. A wrist activity monitor and daily sleep diary were used to monitor sleep during both phases, while at pre- and post-intervention, participants completed a battery of sleep and mood questionnaires and underwent cognitive performance testing. Sleep knowledge increased from pre- to post-intervention (d = 0.83 [95% CI −1.21, −0.43], p =< 0.001), while there were modest improvements in sleep diary estimates (i.e., sleep onset latency (Mdiff = −2.9 min, p = 0.02), sleep onset time (Mdiff = −12 min, p = 0.03), and sleep efficiency (Mdiff = 1.1%, p = 0.004)) and wrist activity monitor estimates (i.e., sleep onset time (Mdiff = −18 min, p = 0.01)). Insomnia severity scores decreased significantly (d = 0.47 [95% CI 0.08, 0.84], p = 0.001), while sleepiness scores increased but not meaningfully (d = 0.23 [95% CI −0.61, 0.14], p = 0.025). However, there was no significant change in mood (i.e., depression and anxiety) or cognitive performance scores (i.e., mean reaction time or lapses). Sleep interventions for esports athletes require further investigation. Future research should examine whether a stepped-care model, whereby increasing therapeutic input is provided as needed, can optimize sleep, mood, and cognitive performance outcomes.

Symptoms of Nomophobia, Psychological Aspects, Insomnia and Physical Activity: A Cross-Sectional Study of ESports Players in Saudi Arabia

(1) Background: ESports is a new trend of sports, which has gained considerable popularity worldwide. There is a scarcity of evidence that focuses on the lifestyle of ESports players (eSP) particularly on symptoms of nomophobia, level of anxiety, sleep quality, food consumption and physical activity. (2) Objective: to determine the prevalence and relationship between symptoms of nomophobia, psychological aspects, insomnia and physical activity of eSP in Saudi Arabia. (3) Methods: A cross-sectional study was conducted between March and April 2021 using a convenient self-selection adult sample. A total of 893 (216 eSP vs. 677 non-eSP (NeSP)) participants aged over 18 years were included. All participants answered a seven-part validated questionnaire that included: (i) sociodemographic questions; (ii) a symptoms of nomophobia questionnaire; (iii) general anxiety disorder questions, (iv) an insomnia severity index, (v) an Internet addiction scale, (vi) the Yale food addiction scale 2.0 short form and (vii) an international physical activity questionnaire. (4) Results: Among the entire population, the prevalence of moderate to severe nomophobia, anxiety, insomnia, Internet addiction and low physical activity were 29.8%, 13.9%, 63.3%, 27% and 2.8%, respectively. The eSP and NeSP differed significantly in nomophobia scale, anxiety and insomnia values. Compared to NeSP, eSP had a higher level of severe nomophobia p = 0.003, a severe level of anxiety p = 0.025 and symptoms of insomnia p = 0.018. Except for food addiction and physical activity, a positive correlation was identified between symptoms of nomophobia, anxiety and insomnia among eSP. (5) Conclusion: This study reported high prevalence of nomophobia, anxiety and insomnia among eSP compared to NeSP.

Can Nutrients and Dietary Supplements Potentially Improve Cognitive Performance Also in Esports?

Factors influencing brain function and cognitive performance can be critical to athletic performance of esports athletes. This review aims to discuss the potential beneficial effects of micronutrients, i.e., vitamins, minerals and biologically active substances on cognitive functions of e-athletes. Minerals (iodine, zinc, iron, magnesium) and vitamins (B vitamins, vitamins E, D, and C) are significant factors that positively influence cognitive functions. Prevention of deficiencies of the listed ingredients and regular examinations can support cognitive processes. The beneficial effects of caffeine, creatine, and probiotics have been documented so far. There are many plant products, herbal extracts, or phytonutrients that have been shown to affect precognitive activity, but more research is needed. Beetroot juice and nootropics can also be essential nutrients for cognitive performance. For the sake of players’ eyesight, it would be useful to use lutein, which, in addition to improving vision and protecting against eye diseases, can also affect cognitive functions. In supporting the physical and mental abilities of e-athletes the base is a well-balanced diet with adequate hydration. There is a lack of sufficient evidence that has investigated the relationship between dietary effects and improved performance in esports. Therefore, there is a need for randomized controlled trials involving esports players.

Sleep Characteristics in Esport Players and Associations With Game Performance: Residual Dynamic Structural Equation Modeling

The current study aimed to examine sleep characteristics of esport players and the stipulated effects of game performance on consecutive sleep characteristics using residual dynamic structural equation modeling (RDSEM). A sample of 27 Counterstrike players with a mean age of 18½ years participated in the current study. Sleep was detected over a period of 56 days with a Somnofy sleep monitor that utilizes an impulse radio ultra-wideband puls radar and Dopler technology, and weekly game performance was reported by the players. The results showed that esport players' sleep characteristics were in the lower levels of recommended guidelines and that sleep onset started later and sleep offset ended later in the morning compared with athletes from other traditional sports. The esport players displayed stable patterns in sleep onset, sleep offset, time in bed, sleep efficiency and non-REM respiration rates per minute (NREM RPM). On the between-person level, esport players with better game performance spent more time sleeping (r = 0.55) and scored lower on NREM RPM (r = -0.44). Unstandardized within-person cross-lagged paths showed that better game performance predicted subsequent earlier sleep offset. The within-level standardized estimates of the cross-lagged paths revealed that participants with better game performance spent subsequently more time in deep sleep (0.20), less time in light sleep (-0.14), less time in bed (-0.16), and displayed lower NREM RPM (-0.21), earlier sleep offset (-0.21), and onset (-0.09). The findings of better game performance being related to better sleep are discussed in terms of existing knowledge on how stress responses elicitated by poor performance might impact on non-REM respiration rates and sleep.

Identifying electronic-sport athletes' sleep-wake cycle characteristics

Organized electronic-sport competitions (e-Sport) is related to several health problems, including sleep disorders. The objective of this study was to evaluate the characteristics of the sleep-wake cycle of League of Legends (LoL) athletes during their pre-training, training, pre-competition, and competition routines. Twenty male elite LoL players completed the questionnaires related to sleep pattern (Pittsburgh Sleep Quality Index), sleepiness (Epworth Sleepiness Scale), and chronotype (Morningness-Eveningness Questionnaire), and they wore an actigraph for 7 days. Pre-training and pre-competition assessments were carried out by questionnaires (n = 20) and training and competition assessments by actigraph (n = 16). The chronotype that most Eathletes presented was a moderately evening type. They presented a poor sleep quality and were borderline for excessive daytime sleepiness. Sleep onset and offset times were significantly prolonged during the competition condition (t = 2.11, p < .05; t = 2.51, p < .05). Correlations showed a relationship between PSQI and Sleepiness in the pre-training and pre-competition conditions (r = 0.50, p = .02) and chronotype with sleep onset (r = 0.61, p = .01), total sleep time (r = 0.55, p = .02), and time awake (r = 0.49, p = .04) in the competition condition. Linear regression analysis indicated associations between the PSQI and sleepiness (25%; p = .02) during pre-training and pre-competition. During the competition there were associations between chronotype and sleep onset (37%; p = .01), chronotype and time awake (24%; p = .04), and chronotype and TST (30%; p = .02). In general, the findings support the conclusion that LoL athletes presented an altered sleep pattern during their training routines.

Could tDCS Be a Potential Performance-Enhancing Tool for Acute Neurocognitive Modulation in eSports? A Perspective Review

Competitive sports involve physical and cognitive skills. In traditional sports, there is a greater dependence on the development and performance of both motor and cognitive skills, unlike electronic sports (eSports), which depend much more on neurocognitive skills for success. However, little is known about neurocognitive functions and effective strategies designed to develop and optimize neurocognitive performance in eSports athletes. One such strategy is transcranial direct current stimulation (tDCS), characterized as a weak electric current applied on the scalp to induce prolonged changes in cortical excitability. Therefore, our objective is to propose anodal (a)-tDCS as a performance-enhancing tool for neurocognitive functions in eSports. In this manuscript, we discussed the neurocognitive processes that underlie exceptionally skilled performances in eSports and how tDCS could be used for acute modulation of these processes in eSports. Based on the results from tDCS studies in healthy people, professional athletes, and video game players, it seems that tDCS is applied over the left dorsolateral prefrontal cortex (DLPFC) as a potential performance-enhancing tool for neurocognition in eSports.

Sleep Characteristics and Mood of Professional Esports Athletes: A Multi-National Study

Esports is becoming increasingly professionalized, yet research on performance management is remarkably lacking. The present study aimed to investigate the sleep and mood of professional esports athletes. Participants were 17 professional esports athletes from South Korea (N = 8), Australia (N = 4), and the United States (N = 5) who played first person shooter games (mean age 20 ± 3.5 years, 100% male). All participants wore a wrist-activity monitor for 7–14 days and completed subjective sleep and mood questionnaires. Participants had a median total sleep time of 6.8 h and a sleep efficiency of 86.4% per night. All participants had significantly delayed sleep patterns (median sleep onset 3:43 a.m. and wake time 11:24 a.m.). Participants had a median sleep onset latency of 20.4 min and prolonged wake after sleep onset of 47.9 min. Korean players had significantly higher depression scores compared to the other groups (p < 0.01) and trained longer per day than the Australian or United States teams (13.4 vs. 4.8 vs. 6.1 h, respectively). Depression scores were strongly correlated with number of awakenings, wake after sleep onset, and daily training time (p < 0.05). As the first pilot sleep study in the esports field, this study indicates that esports athletes show delayed sleep patterns and have prolonged wake after sleep onset. These sleep patterns may be associated with mood (depression) and training time. Sleep interventions designed specifically for esports athletes appear warranted.