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Esen O, Walshe I, Goodall S. Energy intake, hydration status, and sleep of world-class male archers during competition. J Int Soc Sports Nutr 2024; 21:2345358. [PMID: 38708971 DOI: 10.1080/15502783.2024.2345358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/12/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Nutritional intake and sleep, play an important role for recovery and performance in elite sport but little work has been undertaken in archery. The present study aimed to assess energy intake (EI), hydration status, and sleep parameters in world-class male archers over the course of a four-day competition. METHODS Results, Conclusions Six male, elite-standard archers participated in the study and measurements of hydration status, EI, competition load, and sleep were recorded throughout each day of competition. RESULTS Daily energy, carbohydrate, and protein intake ranged between 2,563 and 3,986 kcal, 4 and 7.1 g/kg BM, 2.2 and 3.6 g/kg BM per day, respectively. Thus, archers practiced elements of periodized nutrition such that energy and carbohydrate intake was greater on the high-volume competition days (i.e. days 1 and 3; more numbers of arrows, longer duration, and walking distance) in comparison to low-volume days (days 2 and 4) over the tournament (all p > 0.01). Additionally, urine specific gravity was higher after waking, compared to pre- and post-competition, and before bed (all p < 0.05). This indicates that archers were euhydrated pre- and post-competition and before bedtime, while they were slightly hypohydrated after waking up. Sleep data show that disturbances were kept to a minimum. CONCLUSIONS Collectively, archers appear capable of periodizing their nutritional intake according to daily physical loading during a tournament whilst, staying euhydrated and maintaining sleep quality. In part, such data can help to explain why these archers experience a sustained level of success.
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Affiliation(s)
- Ozcan Esen
- Northumbria University, Department of Sport, Exercise & Rehabilitation, Faculty of Health and Life Sciences, Newcastle upon Tyne, UK
| | - Ian Walshe
- Northumbria University, Department of Sport, Exercise & Rehabilitation, Faculty of Health and Life Sciences, Newcastle upon Tyne, UK
| | - Stuart Goodall
- Northumbria University, Department of Sport, Exercise & Rehabilitation, Faculty of Health and Life Sciences, Newcastle upon Tyne, UK
- North-West University Potchefstroom, Physical Activity, Sport and Recreation Research Focus Area, Faculty of Health Sciences, South Africa
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Winegar R. Enhancing sleep quality for adult patients: Interventions and insights. Nurse Pract 2024; 49:22-30. [PMID: 38915146 DOI: 10.1097/01.npr.0000000000000203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
ABSTRACT Sleep is critical to a person's physiological and psychological functioning. Approximately 30% to 40% of the general population experiences insomnia, and among patients with mental health conditions, the prevalence of insomnia and other sleep disturbances rises to about 70%. Insomnia is associated with many adverse health issues, including lower immunity, weight gain, elevated BP, and increased mortality, and it is often undiagnosed and either untreated or self-treated. Providers can work together with patients to enact measures-such as implementation of enhanced sleep hygiene, engagement in cognitive behavioral therapy, and treatment of any underlying causes-that can markedly improve patient sleep quality. This article provides an overview of evidence-based best practices and whole-person strategies that NPs can adopt to address poor sleep quality in adult patients, and it serves as a primer for primary care NPs on common presentations of several sleep disorders.
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Affiliation(s)
- Rhonda Winegar
- Rhonda Winegar is an assistant professor at the University of Texas at Arlington College of Nursing and Health Innovation in Arlington, Tex
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Winegar R. Promoting healthy sleep among older adults. Geriatr Nurs 2024; 58:298-303. [PMID: 38850995 DOI: 10.1016/j.gerinurse.2024.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/10/2024]
Abstract
As people age, their sleep patterns and needs naturally change in response to developmental and health-related factors. However, attaining sufficient restorative sleep remains crucial for overall well-being in older adults. This manuscript provides an overview of common sleep alterations that tend to emerge with advancing age, such as shifts in circadian rhythms, decreases in deeper sleep stages, fragmented sleep architecture and an association between comorbidities and sleep disruption. Practical recommendations that target environmental, behavioral and lifestyle modifications may optimize sleep initiation, maintenance, and duration for the older population. By enhancing understanding of the sleep changes that occur in the aged population, geriatric nurses are better able to provide respectful, patient-centered care to older adults that are experiencing sleep difficulties.
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Affiliation(s)
- Rhonda Winegar
- Graduate Faculty, University of Texas at Arlington, Rhonda Winegar, 5904 Abilene Trail, Austin, Texas, 78749, USA.
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4
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Murphy CJ, Saavedra JM, Ólafsson D, Kristófersdóttir KH, Arnardóttir ES, Kristjánsdóttir H. The training times of athletes could play a role in clinical sleep problems due to their associations with sleep difficulty scores. Sleep Health 2024:S2352-7218(24)00031-7. [PMID: 38834377 DOI: 10.1016/j.sleh.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 02/19/2024] [Accepted: 02/26/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVES Sleep is a key component of athletic recovery, yet training times could influence the sleep of athletes. The aim of the current study was to compare sleep difficulties in athletes across different training time groups (early morning, daytime, late evening, early morning plus late evening) and to investigate whether training time can predict sleep difficulties. METHODS Athletes from various sports who performed at a national-level (n = 273) answered the Athlete Sleep Screening Questionnaire (ASSQ) along with several other questionnaires related to demographics, exercise training, and mental health. From the ASSQ, a Sleep Difficulty Score (SDS) was calculated. Transformed SDS (tSDS) was compared across different training time categories using multiple one-way ANOVAs. A stepwise regression was then used to predict tSDS from various sleep-related factors. RESULTS SDSs ranged from none (31%), mild (38%), moderate (22%), and severe (9%). However, the one-way ANOVAs revealed training earlier or later vs. training daytime shifted the tSDS in a negative direction, a trend toward increased sleep difficulty. In particular, athletes training in the late evening (>20:00 or >21:00) had a significantly higher tSDS when compared to daytime training (p = .03 and p < .01, respectively). The regression model (p < .001) explained 27% of variance in the tSDS using depression score, age, training time, and chronotype score. CONCLUSION Among a heterogeneous sample of national-level athletes, 31% displayed moderate to severe SDSs regardless of their training time. However, when athletes trained outside daytime hours there was a tendency for the prevalence of sleep difficulties to increase.
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Affiliation(s)
- Conor J Murphy
- Physical Activity, Physical Education, Sport and Health Research Centre (PAPESH), Sports Science Department, School of Social Sciences, Reykjavik University, Reykjavik, Iceland; Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Reykjavik, Iceland.
| | - Jose M Saavedra
- Physical Activity, Physical Education, Sport and Health Research Centre (PAPESH), Sports Science Department, School of Social Sciences, Reykjavik University, Reykjavik, Iceland; Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Reykjavik, Iceland
| | - Daði Ólafsson
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | | | - Erna Sif Arnardóttir
- Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Reykjavik, Iceland
| | - Hafrún Kristjánsdóttir
- Physical Activity, Physical Education, Sport and Health Research Centre (PAPESH), Sports Science Department, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
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Thomas CL, Carr K, Yang F, Fleisher S, Um P, Clemens B, McNutt R, Balkin T, Collen JF. From trenches to technology: a narrative review of sleep medicine in the military. J Clin Sleep Med 2024; 20:973-981. [PMID: 38420974 PMCID: PMC11145036 DOI: 10.5664/jcsm.11088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
Diagnoses of military-relevant sleep disorders have increased substantially since the terrorist attacks of September 11, 2001. The cause of this increase appears to be complicated and multifactorial, with military and civilian populations clearly differing with respect to both the nature and distribution of sleep disorders diagnoses. In part, these differences may be attributable to the fact that a majority of service members are chronically sleep-restricted-an unavoidable consequence of continuous and sustained military operations that "set the stage" for development of specific sleep disorders. The purpose of this narrative review is to describe the military relevance of several common sleep disorders, assess the extent to which these disorders currently constitute a burden on the military health care system, and suggest strategies to alleviate that burden. The military health care system does not have enough sleep medicine providers to address the immediate and long-term consequences of sleep disorders in military personnel. Digital technologies and education packages can be leveraged to improve access to care. CITATION Thomas CL, Carr K, Yang F, et al. From trenches to technology: a narrative review of sleep medicine in the military. J Clin Sleep Med. 2024;20(6):973-981.
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Affiliation(s)
- Connie L. Thomas
- Walter Reed Army Institute of Research, Silver Spring, Maryland
- Walter Reed National Military Medical Center, Bethesda, Maryland
- Uniformed Services University, Bethesda, Maryland
| | - Kyle Carr
- Uniformed Services University, Bethesda, Maryland
| | - Felix Yang
- Uniformed Services University, Bethesda, Maryland
| | | | - Paul Um
- Uniformed Services University, Bethesda, Maryland
| | | | - Ryan McNutt
- Womack Army Medical Center, Fort Liberty, North Carolina
| | - Thomas Balkin
- Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Jacob F. Collen
- Walter Reed National Military Medical Center, Bethesda, Maryland
- Uniformed Services University, Bethesda, Maryland
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Barreira J, Brito J, Costa JA, Figueiredo P. Sleep duration is associated with overnight changes in perceived fatigue in elite women soccer players. SCI MED FOOTBALL 2024; 8:145-152. [PMID: 36587830 DOI: 10.1080/24733938.2022.2163511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 01/03/2023]
Abstract
The current study aimed to describe sleep habits and analyze the associations between sleep indices, changes in perceived fatigue (Δ Fatigue) and external training load measures in women soccer players during a 7-day training camp. Sixteen elite women soccer players (age: 25.4 ± 3.6 years; mean ± SD) from the Portuguese Women's National Team participated in the study. Sleep indices (sleep duration and efficiency) were measured using a wrist-worn accelerometer. External training loads measures were measured using GPS devices. Players also reported perceived fatigue using a Likert scale (1 - very, very low to 7 - very, very high) before and immediately after sleep. Players' within-subject coefficient of variation for sleep duration was 5.6%, and 4.6% for sleep efficiency. Individually, 8 players (50%) slept less than 7 h per night throughout the training camp, and the same number of athletes had a sleep efficiency lower than 85%. Similar values (p<0.05) were measured for sleep duration and efficiency between training and match days. A moderate negative within-subjects correlation was found between Δ Fatigue and sleep duration (adjusted for pre-sleep fatigue) [r = -0.32; 95% Confidence Interval (-0.51 - -0.08); p = 0.04]. These findings reinforce the importance of sleep in the recovery process of elite women soccer players, showing that more sleep may help to attenuate fatigue.
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Affiliation(s)
- João Barreira
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, ISMAI, Maia, Portugal
| | - João Brito
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal
| | - Júlio A Costa
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal
| | - Pedro Figueiredo
- Physical Education Department, College of Education, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Vila Real, Portugal
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Javaloyes A, Mateo-March M, Peña-González I, Moya-Ramón M. Assessing sleep quality in elite and junior cyclists. Front Sports Act Living 2024; 6:1369435. [PMID: 38752212 PMCID: PMC11095108 DOI: 10.3389/fspor.2024.1369435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/10/2024] [Indexed: 05/18/2024] Open
Abstract
In the pursuit of optimal recovery, the significance of sleep cannot be overstated for elite cyclists, including high-level cyclists within the junior category. This study aims to assess the sleep quality of elite athletes of different categories and disciplines, including junior. The sleep quality of 112 high-level cyclists (males n = 80; females n = 32) participating in endurance and sprint disciplines was evaluated using the Pittsburgh Sleep Quality Index (PSQI). A noteworthy 41% of both elite and junior cyclists displayed poor sleep quality. No significant differences were observed between elite and junior cyclists in terms of sleep quality, but there was a medium effect size, indicating greater sleep efficiency in junior cyclists [0.36 (0.16, 0.53)]. Gender differences were found, with females exhibiting worse PSQI scores (males = 4.00 [2.25]; females 5.00 [3.00]; p = 0.035). Endurance cyclists spent more time in bed compared to cyclists from sprinting disciplines (8:30 [1.00] and 8:00 [1:03], respectively; p = 0.019). These findings reveal poor sleep habits, even among individuals classified as good sleepers by the PSQI, emphasizing the importance of preventing sleep disorders in cyclists. This study provides valuable insights into athlete sleep quality, encompassing various categories, genders, and cycling disciplines. In conclusion, elite cyclists demonstrate suboptimal sleep quality, suggesting the potential for interventions utilizing the PSQI. These findings advocate for the incorporation of sleep quality assessments into routine evaluations for athletes.
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Affiliation(s)
- Alejandro Javaloyes
- Department of Sport Science, Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain
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Washif JA, Hettinga FJ, Ammar A, van Rensburg DCJ, Materne O, Trabelsi K, Romdhani M, Farooq A, Pyne DB, Chamari K. Supporting athletes during a challenging situation: recommendations from a global insight of COVID-19 home-based training experience. BMC Sports Sci Med Rehabil 2024; 16:83. [PMID: 38622683 PMCID: PMC11017558 DOI: 10.1186/s13102-024-00869-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 03/24/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND For athletes, overcoming obstacles in challenging situations like pandemic home training is crucial. Strategies and approaches in this context are not well-documented. Our study aims to investigate such a scenario from a performance standpoint, based on a major global crisis: the COVID-19 pandemic and lockdown. METHODS This cross-sectional study surveyed athletes without disabilities using online questionnaires (35 languages) from May to July 2020. Questions included aspects of alternative routines, training monitoring, recovery, sleep patterns, injury occurrence/prevention based on structured answers, and an open-ended question on lockdown training experiences. RESULTS Of the 11,762 athletes from 142 countries, 63% were male, including at World-Class, International, National, State and Recreational levels. During lockdown, 25% athletes used innovative or modern ways to maintain or improve fitness e.g., virtual reality and tracking devices (favoring World-Class level, 30%). Many athletes, regardless of gender (43%) watched video competitions to improve/maintain their mental skills and performance [World-Class (47%) and International (51%)]. Contact frequency between athletes and their coaches was mainly at least once a week (36%), more among higher-level (World-Class/International) than lower-level athletes (27 vs. 16%). Higher-level athletes (≥ 54%) monitored training load and were assisted by their coaches (21%). During lockdown, stretching (67%) was considered one of the primary means of recovery, especially for higher-level athletes (> 70%). Compared to pre-lockdown, about two-thirds of athletes reported "normal" or "improved" sleep quality and quantity, suggesting a low sleep quality pre-lockdown. On average, 40% utilized injury prevention exercises (at least) once a week [World-Class (51%) and International (39%)]. Most injury occurrences during lockdown involved the knee (18%), ankle (16%), and back (9%). Four key themes emerged regarding lockdown experiences: remote training adaptation (e.g., shifting training focus), training creativity (e.g., using household items), performance enhancement opportunities (e.g., refocusing neglected aspects), and mental and motivation challenges. CONCLUSIONS Both male and female athletes, particularly those of higher levels, displayed some adaptalibity during the COVID-19 lockdown, employing innovative approaches and technology for training. Many athletes implemented load monitoring, recovery, and attentive of injury prevention, while optimizing their sleep quality and quantity. Athletes demonstrated their abilities to navigate challenges, and utilized different coping strategies in response to the lockdown's constraints.
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Affiliation(s)
- Jad Adrian Washif
- Sports Performance Division, Institut Sukan Negara Malaysia (National Sports Institute of Malaysia), Kuala Lumpur, Malaysia.
| | - Florentina J Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg- University Mainz, Mainz, Germany
- Research Laboratory, Molecular Bases of Human Pathology, Faculty of Medicine of Sfax, University of Sfax, LR19ES13, Sfax, Tunisia
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Dina Christa Janse van Rensburg
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Medical Board Member, World Netball, Manchester, UK
| | | | - Khaled Trabelsi
- High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, University of Sfax, LR19JS01, Sfax, Tunisia
| | - Mohamed Romdhani
- Physical Activity, Sport and Health, UR18JS01, National Observatory of Sports, Tunis, Tunisia
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), Faculty of Sport Sciences, UPL, UFR STAPS, Paris Nanterre University, Nanterre, France
| | - Abdulaziz Farooq
- Research Department, Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - David B Pyne
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Karim Chamari
- Higher Institute of Sport and Physical Education, ISSEP Ksar Saïd, Manouba University, Manouba, Tunisia
- Naufar Wellness and Recovery Center, Doha, Qatar
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Kishi A, Millet GY, Desplan M, Lemarchand B, Bouscaren N. Sleep and Ultramarathon: Exploring Patterns, Strategies, and Repercussions of 1,154 Mountain Ultramarathons Finishers. SPORTS MEDICINE - OPEN 2024; 10:34. [PMID: 38589752 PMCID: PMC11001838 DOI: 10.1186/s40798-024-00704-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/24/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Sleep and physical performance are strongly related and mutually influence each other. Athletes, particularly in disciplines like offshore sailing and ultra-endurance sports, often suffer from sleep deprivation due to factors like irregular training times, travel, and the extended duration of events like 100-mile mountain races. Despite growing interest in sleep's role in sports science, few studies have specifically investigated the sleep patterns of ultramarathon runners. This study aimed to investigate sleep patterns and sleep management strategies in ultramarathons, and the repercussions of sleep deprivation during and after races. METHODS This cross-sectional study using e-survey was conducted on 1154 runners from two ultramarathons (a 165 km race with 9,576 m positive elevation; 2018 finish time [23:18:48-66:04:00], and a 111 km race with 6,433 m elevation; [15:34:56 - 41:54:16]). RESULTS The results revealed that 58% of the runners reported implementing sleep management strategies before or during the race. Most runners began the race with some level of sleep debt (-50 min a week before the race). During the races, 77% of runners slept, with the cumulative sleep duration varying based on race duration and the number of nights spent on the race (76 min at 165 km and 27 min at 111 km). Short naps lasting less than 30 min were the most popular strategy. The prevalence of symptoms attributed to sleep deprivation during the race was high (80%), with reported falls and hallucinations. After the race, runners reported recovering a normal state of wakefulness relatively quickly (within two days); 22% believed that sleep deprivation during the race increased the risk of accidents in everyday life. CONCLUSION This study provides valuable insights into sleep patterns and strategies in ultramarathon running and emphasizes the importance of adequate sleep management for performance and post-race recovery.
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Affiliation(s)
- Anthony Kishi
- Unité Fonctionnelle de Médecine du Sport, CHU de la Réunion, Site Hôpital de Saint-Pierre, BP 350, Saint-Pierre, 97448, France
| | - Guillaume Y Millet
- Inter-university Laboratory of Human Movement Biology, Univ Lyon, UJM-Saint-Etienne, Saint-Etienne, 7424, F-42023, EA, France
- Institut Universitaire de France (IUF), Paris, France
| | - Matthieu Desplan
- Be Sports Clinic, Centre Médical Médimarien, Schaerbeek, 1030, Belgique
| | - Bruno Lemarchand
- Unité Fonctionnelle de Médecine du Sport, CHU de la Réunion, Site Hôpital de Saint-Pierre, BP 350, Saint-Pierre, 97448, France
| | - Nicolas Bouscaren
- Inter-university Laboratory of Human Movement Biology, Univ Lyon, UJM-Saint-Etienne, Saint-Etienne, 7424, F-42023, EA, France.
- Service de santé Publique et soutien à la recherche, INSERM CIC 1410, CHU Réunion, Saint Pierre, France.
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Hobgood CD, Jarman AF. Resilience Building Practices for Women Physicians. J Womens Health (Larchmt) 2024; 33:532-541. [PMID: 37843899 PMCID: PMC11238838 DOI: 10.1089/jwh.2022.0502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
Women now make up more than half of the physician workforce, but they are disproportionately plagued by burnout. Medicine is a fast-paced stressful field, the practice of which is associated with significant chronic stress due to systems issues, crowding, electronic medical records, and patient case mix. Hospitals and health care systems are responsible for mitigating system-based burnout-prone conditions, but often their best efforts fail. Physicians, particularly women, must confront their stressors and the daily burden of significant system strain when this occurs. Those who routinely exceed their cumulative stress threshold may experience burnout, career dissatisfaction, and second victim syndrome and, ultimately, may prematurely leave medicine. These conditions affect women in medicine more often than men and may also produce a higher incidence of health issues, including depression, substance use disorder, and suicide. The individual self-care required to maintain health and raise stress thresholds is not widely ingrained in provider practice patterns or behavior. However, the successful long-term practice of high-stress occupations, such as medicine, requires that physicians, especially women physicians, attend to their wellness. In this article, we address one aspect of health, resilience, and review six practices that can create additional stores of personal resilience when proactively integrated into a daily routine.
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Affiliation(s)
- Cherri D Hobgood
- Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Angela F Jarman
- Department of Emergency Medicine, University of California, Davis School of Medicine, California, USA
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11
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Danilkowicz RM, Hurley ET, Hinton ZW, Meyer LE, Cheah JW, Hutyra C, Poehlein E, Green CL, Mather RC. Association between sleep dysfunction and Patient-Reported Outcomes Measurement Information System scores in patients with rotator cuff tears. J ISAKOS 2024; 9:143-147. [PMID: 38104945 DOI: 10.1016/j.jisako.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/03/2023] [Accepted: 12/06/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES The purpose of this study was to utilize Patient-Reported Outcomes Measurement Information System (PROMIS) sleep scores to determine the prevalence of sleep dysfunction and its association with other PROMIS scores in patients with rotator cuff tears (RCT). METHODS Patients were retrospectively identified using the International Classification of Diseases-10 codes for RCT pathology, and PROMIS outcomes were assessed at multiple visits between November 2017 and February 2020. Generalized linear mixed effects models were fitted with PROMIS sleep score as the predictor variable and other PROMIS scores as the response variable. Additionally, models were fit using a clinically significant dichotomization of PROMIS sleep scores to assess differences in average PROMIS scores. RESULTS The study cohort included 481 patients, 201 (41.8 %) of whom had disrupted sleep at first visit. A higher percentage of those with disrupted sleep at first visit were female, nonwhite, and not married compared to those with normal sleep. PROMIS scores at first visit differed by sleep category. Higher PROMIS sleep scores were associated with higher anxiety, depression, fatigue, pain intensity, and pain interference scores and lower physical function, social participation, and upper extremity scores. Relationships were similar when dichotomous PROMIS sleep scores were considered. CONCLUSION There was a high prevalence of sleep dysfunction in patients with RCT. Sleep disturbance is associated with increased anxiety, depression, fatigue, pain intensity, pain interference and decreased physical function, social participation, and upper extremity function in patients with RCTs. LEVEL OF EVIDENCE III Retrospective Cohort Study.
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Affiliation(s)
- Richard M Danilkowicz
- Duke University Hospital, Division of Orthopedic Surgery, Department of Sports Medicine, 311 Trent Drive, Durham, NC 27710, USA
| | - Eoghan T Hurley
- Duke University Hospital, Division of Orthopedic Surgery, Department of Sports Medicine, 311 Trent Drive, Durham, NC 27710, USA.
| | - Zoe W Hinton
- Duke University Hospital, Division of Orthopedic Surgery, Department of Sports Medicine, 311 Trent Drive, Durham, NC 27710, USA
| | - Lucy E Meyer
- Duke University Hospital, Division of Orthopedic Surgery, Department of Sports Medicine, 311 Trent Drive, Durham, NC 27710, USA
| | - Jonathan W Cheah
- Duke University Hospital, Division of Orthopedic Surgery, Department of Sports Medicine, 311 Trent Drive, Durham, NC 27710, USA
| | - Carolyn Hutyra
- Duke University Hospital, Division of Orthopedic Surgery, Department of Sports Medicine, 311 Trent Drive, Durham, NC 27710, USA
| | - Emily Poehlein
- Duke University School of Medicine, Department of Biostatistics and Bioinformatics, 311 Trent Drive, Durham, NC 27710, USA
| | - Cynthia L Green
- Duke University School of Medicine, Department of Biostatistics and Bioinformatics, 311 Trent Drive, Durham, NC 27710, USA
| | - Richard C Mather
- Duke University Hospital, Division of Orthopedic Surgery, Department of Sports Medicine, 311 Trent Drive, Durham, NC 27710, USA
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Parent AA, Guadagni V, Rawling JM, Poulin MJ. Performance Evaluation of a New Sport Watch in Sleep Tracking: A Comparison against Overnight Polysomnography in Young Adults. SENSORS (BASEL, SWITZERLAND) 2024; 24:2218. [PMID: 38610432 PMCID: PMC11014025 DOI: 10.3390/s24072218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/23/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024]
Abstract
Introduction: This study aimed to validate the ability of a prototype sport watch (Polar Electro Oy, FI) to recognize wake and sleep states in two trials with and without an interval training session (IT) 6 h prior to bedtime. Methods: Thirty-six participants completed this study. Participants performed a maximal aerobic test and three polysomnography (PSG) assessments. The first night served as a device familiarization night and to screen for sleep apnea. The second and third in-home PSG assessments were counterbalanced with/without IT. Accuracy and agreement in detecting sleep stages were calculated between PSG and the prototype. Results: Accuracy for the different sleep stages (REM, N1 and N2, N3, and awake) as a true positive for the nights without exercise was 84 ± 5%, 64 ± 6%, 81 ± 6%, and 91 ± 6%, respectively, and for the nights with exercise was 83 ± 7%, 63 ± 8%, 80 ± 7%, and 92 ± 6%, respectively. The agreement for the sleep night without exercise was 60.1 ± 8.1%, k = 0.39 ± 0.1, and with exercise was 59.2 ± 9.8%, k = 0.36 ± 0.1. No significant differences were observed between nights or between the sexes. Conclusion: The prototype showed better or similar accuracy and agreement to wrist-worn consumer products on the market for the detection of sleep stages with healthy adults. However, further investigations will need to be conducted with other populations.
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Affiliation(s)
- Andrée-Anne Parent
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.-A.P.); (V.G.)
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Veronica Guadagni
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.-A.P.); (V.G.)
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Jean M. Rawling
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Marc J. Poulin
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.-A.P.); (V.G.)
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- O’Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
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Mekoulou Ndongo J, Bika Lele EC, Malam Moussa Ahmet H, Guessogo WR, Wiliam MB, Guyot J, Rozand V, Ahmadou, Ayina Ayina CN, Kojom Foko LP, Barth N, Bongue B, Ba A, Samb A, Roche F, Mandengue SH, Assomo-Ndemba PB. Poor quality of sleep and musculoskeletal pains among highly trained and elite athletes in Senegal. BMC Sports Sci Med Rehabil 2024; 16:54. [PMID: 38389100 PMCID: PMC10882835 DOI: 10.1186/s13102-023-00705-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/21/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND Previous studies reported that poor sleep quality (PSQ) was associated with musculoskeletal pains (MSP) and poor physical performance in athletes. OBJECTIVE The current study aimed at determining PSQ and its associations with MSP in some sub-Saharan athletes. METHODS A cross sectional study was conducted among 205 highly trained and 115 elite athletes (aged: 25 ± 2 years, Body mass index: 22.8 ± 0.9 kg/m2) in Dakar, Senegal, during a competitive season in a variety of sport disciplines including athletics, basketball, football, rugby, wrestling, tennis. Quality of sleep and MSP were assessed using the French version Pittsburgh Sleep Quality Index (PSQI) and French version of Nordic questionnaire respectively. Pain on body joints during a week was defined as seven-day MSP (MSP-7d) and PSQ for a PSQI > 5. RESULTS 27.8% (95%CI: 23.2-32.9) of the overall sample suffered PSQ, with 33.7% (95%CI: 24.7-44.0) in basketball and 24.7% (95%CI: 16.9-34.6) in football. According to athletic status and gender, PSQ was more prevalent among highly trained (66.3; 95%CI: 55.9-75.3) and men (69.7%; 95%CI: 59.5-78.7). Among athletes with PSQ 43.8% (95%CI: 33.9-54.2) suffered MSP-7d, with 36.6%; highly trained (95%CI: 23.7-42.9) and 28.1% female. Considering body region, hips/thigh (14.6%; 95% CI: 8.74-23.4) and upper back (13.5%; 95%CI: 7.88 -21, 1) were more affected. Basketball players were more affected from MSP (MSP-7d = 38.5%; 95%CI: 24. 9-54.1) on high on wrists/hands (MSP-7d = 44.4%; 95%CI: 18.9 -73.3; P = 0.04). Based on athletic status, MSP-7d were higher on highly trained necks (100%; 95%CI: 56.1-100; p = 0.04). PSQ was associated with basketball (OR: 3.062, 95%CI: 1.130-8.300, p = 0.02) compared to Athletic. PSQ and MSP-7d were associated on Wrist/hands (OR: 3.352, 95%CI: 1.235-9.099, p = 0.01), and at the upper back (OR: 5.820, 95%CI: 2.096-16.161, p = 0.0007). CONCLUSION These results indicate that PSQ is considerable among Senegalese athletes and is associated with MSP during a week. Hence, we recommend to look for strategies optimizing good quality of sleep in order to reduce pains, to improve health.
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Affiliation(s)
- Jerson Mekoulou Ndongo
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Elysée Claude Bika Lele
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | | | | | - Mbang Biang Wiliam
- National Institute of Youth and Sports Yaoundé, University of Yaounde I, Yaounde, Cameroon
| | - Jessica Guyot
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, Université Jean Monnet, Saint-Étienne, 42023, France
| | - Vianey Rozand
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Inter-universitaire de Biologie de la Motricité, F-42023, Saint-Étienne, France
| | - Ahmadou
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Clarisse Noel Ayina Ayina
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Loick Pradel Kojom Foko
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Nathalie Barth
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Inter-universitaire de Biologie de la Motricité, F-42023, Saint-Étienne, France
| | - Bienvenu Bongue
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, Université Jean Monnet, Saint-Étienne, 42023, France
- Support and Education Technical Centre of Health Examination Centres (CETAF), Saint-Etienne, France
| | - Abdoulaye Ba
- Faculty of Medicine, Pharmacy and Dentistry, University of Cheikh Anta Diop, Dakar, Sénégal
| | - Abdoulaye Samb
- Faculty of Medicine, Pharmacy and Dentistry, University of Cheikh Anta Diop, Dakar, Sénégal
| | - Fréderic Roche
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, Université Jean Monnet, Saint-Étienne, 42023, France
| | - Samuel Honoré Mandengue
- Physical Activities and Sport Physiology & Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
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14
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Ghattassi K, Farjallah MA, Graja A, Romdhani M, Boudhina N, Guimard A, Driss T, Souissi N, Chtourou H, Hammouda O. Nocturnal Melatonin Ingestion Improves Soccer Players' Short-Term Maximal Performances on the Following Day. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024:1-8. [PMID: 38329497 DOI: 10.1080/02701367.2024.2303457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 01/04/2024] [Indexed: 02/09/2024]
Abstract
Purpose: Exogenous melatonin has been proven to have beneficial effects on sleep. A good sleep quality promotes recovery and improves physical performance. In this sense, the present study aimed to explore the potential effect of nocturnal melatonin ingestion on psycho-cognitive and short-term maximal performances, in the following morning. Method: Twelve professional soccer players (22.9 ± 1.3 years, 1.80 ± 0.05 m, and 72.0 ± 8.8 kg) volunteered to perform two separate testing sessions after either nocturnal melatonin or placebo ingestion. The next morning, participants performed the following psycho-cognitive and physical tests: Hooper's index, reaction time, vigilance, handgrip strength (HG), squat jump (SJ), modified agility T-test (MAT) and Wingate anaerobic test (WanT). Rating of perceived exertion (RPE) and blood lactate [La] were recorded, respectively, immediately and 3 min after the WanT. Blood glucose [GL] was measured before and 3 min after WanT. Results: Compared with placebo, melatonin improved subjective sleep quality, short-term maximal performances (HG and SJ), reaction-time, as well as peak and mean WanT powers and decreased fatigue index and RPE scores. However, [La] and [GL] were not affected by melatonin ingestion. Conclusion: Nocturnal melatonin intake before sleep has beneficial effects on cognitive and physical performances the following day.
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Affiliation(s)
| | | | | | | | | | - Alexandre Guimard
- Université Sorbonne Paris Nord
- Université d'Orléans CIAMS
- Université Paris-Saclay CIAMS
- SAPRéM, Université d'Orléans
| | | | | | | | - Omar Hammouda
- Faculty of Medicine, University of Sfax
- Paris Nanterre University
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15
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Pradhan S, Parganiha A, Agashe CD, Pati AK. Circadian rhythm in sportspersons and athletic performance: A mini review. Chronobiol Int 2024; 41:137-181. [PMID: 38247325 DOI: 10.1080/07420528.2024.2305663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024]
Abstract
Circadian rhythms in the physiological and behavioral processes of humans play a crucial role in the quality of living and also in the magnitude of success and failure in various endeavors including competitive sports. The rhythmic activities of the body and performance in sportspersons do have a massive impact on their every cutthroat competition. It is essential to schedule sports activities and training of players according to their circadian typology and time of peak performance for improved performance and achievement. In this review, the focus is on circadian rhythms and diurnal variations in peak athletic performance in sportspersons. Accuracy and temporal variability in peak performance in an individual could be attributed to various factors, namely chronotype, time of the day, body temperature, jetlag, hormones, and prior light exposure. Circadian rhythm of mood, alertness, T-core, and ultimately athletic performance is not only affected by sleep but also by circadian variations in hormones, such as cortisol, testosterone, and melatonin. There are, however, a few reports that are not consistent with the conclusions drawn in this review. Nevertheless, circadian rhythm and performance among sportspersons and athletes are important areas of research. This review might be useful to the managers and policymakers associated with competitive sports and athletic events.
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Affiliation(s)
- Sraddha Pradhan
- School of Studies in Life Science, Pt. Ravishankar Shukla University, Raipur, India
| | - Arti Parganiha
- School of Studies in Life Science, Pt. Ravishankar Shukla University, Raipur, India
- Center for Translational Chronobiology, Pt. Ravishankar Shukla University, Raipur, India
| | - C D Agashe
- School of Studies in Physical Education, Pt. Ravishankar Shukla University, Raipur, India
| | - Atanu Kumar Pati
- School of Studies in Life Science, Pt. Ravishankar Shukla University, Raipur, India
- Center for Translational Chronobiology, Pt. Ravishankar Shukla University, Raipur, India
- School of Comparative Indic Studies and Tribal Sciences, Kalinga Institute of Social Sciences - Deemed to be a University, Bhubaneswar, India
- Odisha State Higher Education Council, Government of Odisha, Bhubaneswar, India
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16
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Wang H, Dai Y, Li X, Yu L. Associations of Training and Academic Stress with Sleep in Dual-Career Collegiate Badminton Athletes: A Preliminary Study. Nat Sci Sleep 2024; 16:43-52. [PMID: 38283369 PMCID: PMC10822114 DOI: 10.2147/nss.s432475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/18/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction Poor sleep negatively impacts cognitive and physical functioning and affects athletic and academic achievement. "Dual-career" athletes emphasize the pursuit of academic excellence along with athletic performance. Purpose The study aimed to assess sleep characteristics and sleep quality in dual-career collegiate badminton athletes. Furthermore, the study explored associations between training and academic stress and sleep, providing a theoretical basis for better training and sleep programs for dual-career athletes. Participants and Methods In this study, 15 dual-career collegiate badminton athletes were recruited, and 12 subjects (male n = 8, female n = 4, mean age 20.3 ± 1.7) completed the questionnaire. Repeated measurements were taken monthly in the spring semester from March to August 2021. The questionnaire assessed sleep quality and daytime sleepiness by the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Score (ESS). Moreover, we collected average training, study time per week, and monthly sports competitions and academic tests to quantify participants' training and academic stress. Results An average of 36.1% of dual-career athletes reported poor sleep and 25.0% had excessive daytime sleepiness. Overall, a significant positive correlation existed between PSQI scores and weekly study hours (r = 0.308, p = 0.009). Significant positive correlations were found between the four stressors and PSQI (August: r = 0.868, p < 0.001; July: r = 0.573, p = 0.026) or ESS scores (March: r = -0.678, p = 0.015; August: r = 0.598, p = 0.040) for specific months. Hierarchical linear modeling (HLM) analysis identified that lower study and training hours predict better sleep quality. Conclusion Dual-career collegiate badminton athletes had a higher prevalence of poor sleep and daytime sleepiness, and daytime sleepiness did not result in better sleep quality; study and training hours had the greatest effect on the sleep quality of dual-career collegiate badminton athletes.
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Affiliation(s)
- Haonan Wang
- Department of Exercise Physiology, School of Sport Science, Beijing Sport University, Beijing, 100084, People’s Republic of China
- Department of Physical Education and Research, Central South University, Changsha, 410083, People’s Republic of China
| | - Yinghong Dai
- Xiangya School of Medicine, Central South University, Changsha, 410008, People’s Republic of China
| | - Xiaotian Li
- Department of Physical Education and Research, Central South University, Changsha, 410083, People’s Republic of China
- School of Sport Training, Wuhan Sports University, Wuhan, Hubei, 430079, People’s Republic of China
| | - Liang Yu
- Department of Exercise Physiology, School of Sport Science, Beijing Sport University, Beijing, 100084, People’s Republic of China
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17
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Drăgoi CM, Nicolae AC, Ungurianu A, Margină DM, Grădinaru D, Dumitrescu IB. Circadian Rhythms, Chrononutrition, Physical Training, and Redox Homeostasis-Molecular Mechanisms in Human Health. Cells 2024; 13:138. [PMID: 38247830 PMCID: PMC10814043 DOI: 10.3390/cells13020138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/05/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
A multitude of physiological processes, human behavioral patterns, and social interactions are intricately governed by the complex interplay between external circumstances and endogenous circadian rhythms. This multidimensional regulatory framework is susceptible to disruptions, and in contemporary society, there is a prevalent occurrence of misalignments between the circadian system and environmental cues, a phenomenon frequently associated with adverse health consequences. The onset of most prevalent current chronic diseases is intimately connected with alterations in human lifestyle practices under various facets, including the following: reduced physical activity, the exposure to artificial light, also acknowledged as light pollution, sedentary behavior coupled with consuming energy-dense nutriments, irregular eating frameworks, disruptions in sleep patterns (inadequate quality and duration), engagement in shift work, and the phenomenon known as social jetlag. The rapid evolution of contemporary life and domestic routines has significantly outpaced the rate of genetic adaptation. Consequently, the underlying circadian rhythms are exposed to multiple shifts, thereby elevating the susceptibility to disease predisposition. This comprehensive review endeavors to synthesize existing empirical evidence that substantiates the conceptual integration of the circadian clock, biochemical molecular homeostasis, oxidative stress, and the stimuli imparted by physical exercise, sleep, and nutrition.
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Affiliation(s)
- Cristina Manuela Drăgoi
- Department of Biochemistry, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania; (C.M.D.); (A.C.N.); (A.U.); (D.M.M.)
| | - Alina Crenguţa Nicolae
- Department of Biochemistry, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania; (C.M.D.); (A.C.N.); (A.U.); (D.M.M.)
| | - Anca Ungurianu
- Department of Biochemistry, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania; (C.M.D.); (A.C.N.); (A.U.); (D.M.M.)
| | - Denisa Marilena Margină
- Department of Biochemistry, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania; (C.M.D.); (A.C.N.); (A.U.); (D.M.M.)
| | - Daniela Grădinaru
- Department of Biochemistry, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania; (C.M.D.); (A.C.N.); (A.U.); (D.M.M.)
| | - Ion-Bogdan Dumitrescu
- Department of Physics and Informatics, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania;
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Chrétien A, D’arripe-Longueville F, Haffner K, Hayotte M, Bernier M, Vuillemin A. Using a socioecological approach to explore healthy lifestyle in elite sport: a qualitative study of French athletes', coaches', and managers' perspectives. Int J Qual Stud Health Well-being 2023; 18:2251235. [PMID: 37674351 PMCID: PMC10599688 DOI: 10.1080/17482631.2023.2251235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/18/2023] [Indexed: 09/08/2023] Open
Abstract
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.
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Affiliation(s)
- Aurélia Chrétien
- Graduate School of Health Science Ecosystems, Université Côté d'Azur, LAMHESS, Nice, France
| | | | - Kevin Haffner
- Faculté des Sciences du Sport et de l’éducation, Université de Bretagne Occidentale, CREAD, Brest, France
| | - Meggy Hayotte
- Graduate School of Health Science Ecosystems, Université Côté d'Azur, LAMHESS, Nice, France
| | - Marjorie Bernier
- Faculté des Sciences du Sport et de l’éducation, Université de Bretagne Occidentale, CREAD, Brest, France
| | - Anne Vuillemin
- Graduate School of Health Science Ecosystems, Université Côté d'Azur, LAMHESS, Nice, France
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Vitale JA, Borghi S, Piacentini MF, Banfi G, La Torre A. To Sleep Dreaming Medals: Sleep Characteristics, Napping Behavior, and Sleep-Hygiene Strategies in Elite Track-and-Field Athletes Facing the Olympic Games of Tokyo 2021. Int J Sports Physiol Perform 2023; 18:1412-1419. [PMID: 37730209 DOI: 10.1123/ijspp.2023-0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/20/2023] [Accepted: 08/11/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE Few data are available on sleep characteristics of elite track-and-field athletes. Our study aimed to assess (1) differences in sleep between sexes and among different track-and-field disciplines, (2) the effect of individualized sleep-hygiene strategies on athletes' sleep parameters, and (3) daytime nap characteristics in track-and-field athletes. METHODS Sleep characteristics of 16 elite Olympic-level track-and-field athletes (male: n = 8; female: n = 8) were assessed during the preseason period, at baseline (T0), and during the in-season period, after the adoption of individualized sleep-hygiene strategies (T1). Sleep parameters were objectively monitored by actigraphy for a minimum of 10 days, for each athlete, at both T0 and T1. A total of 702 nights were analyzed (T0 = 425; T1 = 277). RESULTS Female athletes displayed better sleep efficiency (88.69 [87.69-89.68] vs 91.72 [90.99-92.45]; P = .003, effect size [ES]: 0.44), lower sleep latency (18.99 [15.97-22.00] vs 6.99 [5.65-8.32]; P < .001, ES: 0.65), higher total sleep time (07:03 [06:56-07:11] vs 07:18 [07:10-07:26]; P = .030, ES: 0.26), earlier bedtime (00:24 [00:16-00:32] vs 00:13 [00:04-00:22]; P = .027, ES: 0.18), and lower nap frequency (P < .001) than male athletes. Long-distance runners had earlier bedtime (00:10 [00:03-00:38] vs 00:36 [00:26-00:46]; P < .001, ES: 0.41) and wake-up time (07:41 [07:36-07:46] vs 08:18 [08:07-08:30]; P < .001, ES: 0.61), higher nap frequency, but lower sleep efficiency (88.79 [87.80-89.77] vs 91.67 [90.95-92.38]; P = .013, ES: 0.44), and longer sleep latency (18.89 [15.94-21.84] vs 6.69 [5.33-8.06]; P < .001, ES: 0.67) than athletes of short-term disciplines. Furthermore, sleep-hygiene strategies had a positive impact on athletes' total sleep time (429.2 [423.5-434.8] vs 451.4 [444.2-458.6]; P < .001, ES: 0.37) and sleep latency (14.33 [12.34-16.32] vs 10.67 [8.66-12.68]; P = .017, ES: 0.19). CONCLUSIONS Sleep quality and quantity were suboptimal at baseline in Olympic-level track-and-field athletes. Large differences were observed in sleep characteristics between sexes and among different track-and-field disciplines. Given the positive effect of individualized sleep-hygiene strategies on athlete's sleep, coaches should implement sleep education sessions in the daily routine of top-level athletes.
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Affiliation(s)
| | - Stefano Borghi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | | | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Antonio La Torre
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Power CJ, Fox JL, Elliott-Sale KJ, Bender AM, Dalbo VJ, Scanlan AT. Waking Up to the Issue! Research Inattention and Sex-Related Differences Warrant More Sleep Studies in Female Athletes. Sports Med 2023:10.1007/s40279-023-01963-5. [PMID: 37989830 DOI: 10.1007/s40279-023-01963-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 11/23/2023]
Abstract
Understanding sleep patterns and behaviors of athletes is essential for developing targeted sleep-based interventions for implementation in practice. However, more than double the number of sleep studies have examined male athletes compared with female athletes, making the current understanding of sleep patterns, behaviors, and interventions among athletes disproportionately indicative of men. Consequently, this review demonstrates the need for more female-specific sleep data among athlete populations due to research inattention and sex-related differences. Specifically, this review identifies variations in sleep patterns and behaviors between male and female athletes, as well as physiological and lifestyle factors that potentially affect sleep patterns and behaviors across the lifespan, specifically in female athletes. In this regard, evidence suggests some female athletes experience longer sleep durations and better objective sleep quality, but similar or worse subjective sleep quality compared with male athletes. Additionally, scheduling training in the morning or throughout the day may benefit sleep in some female athletes. Considering sleep disorders, women may be at greater risk for insomnia and restless legs syndrome compared with men, which may be attributed to pregnancy, as well as a higher prevalence of anxiety and depressive symptoms, iron deficiency without anemia, and use of psychotropic medication among women. Finally, the menstrual cycle, menstrual disorders, oral contraceptive use, and the postpartum period have been shown to exert detrimental effects on sleep patterns and behaviors and should theoretically be considered when monitoring and managing sleep in female athletes.
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Affiliation(s)
- Cody J Power
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia.
| | - Jordan L Fox
- Rural Clinical School, The University of Queensland, Rockhampton, QLD, Australia
| | - Kirsty J Elliott-Sale
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Amy M Bender
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Absolute Rest, Austin, TX, USA
| | - Vincent J Dalbo
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia
| | - Aaron T Scanlan
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia
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Maleček J, Omcirk D, Skálová K, Pádecký J, Janikov MT, Obrtel M, Jonáš M, Kolář D, Michalička V, Sýkora K, Vágner M, Přívětivý L, Větrovský T, Bendová Z, Třebický V, Tufano JJ. Effects of 36 hours of sleep deprivation on military-related tasks: Can ammonium inhalants maintain performance? PLoS One 2023; 18:e0293804. [PMID: 37967128 PMCID: PMC10651003 DOI: 10.1371/journal.pone.0293804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/12/2023] [Indexed: 11/17/2023] Open
Abstract
INTRODUCTION A lack of sleep can pose a risk during military operations due to the associated decreases in physical and cognitive performance. However, fast-acting ergogenic aids, such as ammonia inhalants (AI), may temporarily mitigate those adverse effects of total sleep deprivation (TSD). Therefore, the present study aimed to investigate the acute effect of AI on cognitive and physical performance throughout 36 hours of TSD in military personnel. METHODS Eighteen male military cadets (24.1 ± 3.0 y; 79.3 ± 8.3 kg) performed 5 identical testing sessions during 36 hours of TSD (after 0 [0], 12 [-12], 24 [-24], and 36 [-36] hours of TSD), and after 8 [+8] hours of recovery sleep. During each testing session, the following assessments were conducted: Epworth sleepiness scale (ESS), simple reaction time (SRT), shooting accuracy (SA), rifle disassembling and reassembling (DAS), and countermovement jump height (JH). Heart rate (HR) was continuously monitored during the SA task, and a rating of perceived exertion (RPE) was obtained during the JH task. At each time point, tests were performed twice, either with AI or without AI as control (CON), in a counterbalanced order. RESULTS There was faster SRT (1.6%; p < 0.01) without increasing the number of errors, higher JH (1.5%; p < 0.01), lower RPE (9.4%; p < 0.001), and higher HR (5.0%; p < 0.001) after using AI compared to CON regardless of TSD. However, neither SA nor DAS were affected by AI or TSD (p > 0.05). Independent of AI, the SRT was slower (3.2-9.3%; p < 0.001) in the mornings (-24, +8) than in the evening (-12), JH was higher (3.0-4.7%, p < 0.001) in the evenings (-12, -36) than in the mornings (0, -24, +8), and RPE was higher (20.0-40.1%; p < 0.001) in the sleep-deprived morning (-24) than all other timepoints (0, -12, -36, +8). Furthermore, higher ESS (59.5-193.4%; p < 0.001) was reported at -24 and -36 than the rest of the time points (0, -12, and + 8). CONCLUSION Although there were detrimental effects of TSD, the usage of AI did not reduce those adverse effects. However, regardless of TSD, AI did result in a short-term increase in HR, improved SRT without affecting the number of errors, and improved JH while concurrently decreasing the RPE. No changes, yet, were observed in SA and DAS. These results suggest that AI could potentially be useful in some military scenarios, regardless of sleep deprivation.
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Affiliation(s)
- Jan Maleček
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Dan Omcirk
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Kateřina Skálová
- National Institute of Mental Health, Klecany, Czech Republic
- Faculty of Science, Charles University, Prague, Czech Republic
| | - Jan Pádecký
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Martin Tino Janikov
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Michael Obrtel
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Michal Jonáš
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - David Kolář
- National Institute of Mental Health, Klecany, Czech Republic
| | - Vladimír Michalička
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Karel Sýkora
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Michal Vágner
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Lubomír Přívětivý
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Tomáš Větrovský
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Zdeňka Bendová
- National Institute of Mental Health, Klecany, Czech Republic
- Faculty of Science, Charles University, Prague, Czech Republic
| | - Vít Třebický
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - James J. Tufano
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
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Tan C, Lu J, Wang J, An Y, Cao G, Zhao D, Qiu J. Chronotype characteristics of professional athletes in China: a comprehensive descriptive study. J Physiol Anthropol 2023; 42:26. [PMID: 37941071 PMCID: PMC10631192 DOI: 10.1186/s40101-023-00343-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023] Open
Abstract
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.
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Affiliation(s)
- Chenhao Tan
- Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Agency), Shanghai, 200030, China
| | - Jiaojiao Lu
- Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Agency), Shanghai, 200030, China
| | - Jinhao Wang
- Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Agency), Shanghai, 200030, China
| | - Yan An
- Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Agency), Shanghai, 200030, China
| | - Guohuan Cao
- Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Agency), Shanghai, 200030, China
| | - Defeng Zhao
- Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Agency), Shanghai, 200030, China
| | - Jun Qiu
- Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Agency), Shanghai, 200030, China.
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23
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Sim JE, Leota J, Mascaro L, Hoffman D, Facer-Childs ER. Sleep patterns before and after competition: A real-world examination of elite athletes. J Sports Sci 2023; 41:2014-2026. [PMID: 38314742 DOI: 10.1080/02640414.2024.2308960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/12/2024] [Indexed: 02/07/2024]
Abstract
Good sleep before and after competitions is crucial to cognitive, physiological performance and recovery. Yet, elite athletes face a unique set of challenges when acquiring good sleep before and after competitions, and indeed commonly report sleep problems when it matters most. This study examined the sleep of elite athletes before and after competition compared to before and after free days. A total of 1808 unique nights of actigraphy (n = 1495) and sleep diary (n = 1335) data from elite Australian Football League and National Rugby League male athletes (N = 85, M-age = 24.4 ± 3.6) were collected and analysed using multi-level mixed models. On nights before competitions, athletes advanced sleep timings (p < .001, d = 0.63) and increased total sleep time (p < .001, d = 0.65) compared to nights before free days. On nights after competitions, athletes delayed sleep timings (p < .001, d = 1.64), reduced total sleep time (p < .001, d = 1.28), and had significantly worse quality sleep (p < .001, d = 0.71) compared to nights after free days. Sleep was especially worse following night competitions. While elite athletes and organisations may be implementing effective sleep strategies to optimise sleep the night before competitions, strategies to improve sleep after competitions may be lacking. We discuss potential factors contributing to this asymmetry and propose areas for research moving forward.
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Affiliation(s)
- Jian En Sim
- School of Psychological Sciences, Monash University, Melbourne, Australia
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Josh Leota
- School of Psychological Sciences, Monash University, Melbourne, Australia
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Luis Mascaro
- School of Psychological Sciences, Monash University, Melbourne, Australia
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Daniel Hoffman
- School of Psychological Sciences, Monash University, Melbourne, Australia
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Elise R Facer-Childs
- School of Psychological Sciences, Monash University, Melbourne, Australia
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- High Performance Department, St Kilda Football Club, Australian Football League, Melbourne, Australia
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Pasquier F, Pla R, Bosquet L, Sauvet F, Nedelec M. The Impact of Multisession Sleep-Hygiene Strategies on Sleep Parameters in Elite Swimmers. Int J Sports Physiol Perform 2023; 18:1304-1312. [PMID: 37709276 DOI: 10.1123/ijspp.2023-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 07/05/2023] [Accepted: 07/23/2023] [Indexed: 09/16/2023]
Abstract
PURPOSE Short sleep duration and poor sleep quality are common in swimmers. Sleep-hygiene strategies demonstrated beneficial effects on several sleep parameters. The present study assessed the impact of a multisession sleep-hygiene training course on sleep in elite swimmers. METHODS Twenty-eight elite swimmers (17 [2] y) participated. The sleep-hygiene strategy consisted of 3 interventions. Sleep was measured by actigraphy for 7 days before the beginning of the intervention (baseline), after the first collective intervention (postintervention), after the second collective intervention (postintervention 2), and, finally, after the individual intervention (postintervention 3). The Epworth Sleepiness Scale (ESS) was completed concurrently. Swimmers were classified into 2 groups: nonsomnolent (baseline ESS score ≤ 10, n = 13) and somnolent (baseline ESS score ≥ 11, n = 15). RESULTS All swimmers had a total sleep time of <8 hours per night. Sixty percent of swimmers were moderately morning type. Later bedtime, less time in bed, and total sleep time were observed in the somnolent group compared with the nonsomnolent group at baseline. An interaction between training course and group factors was observed for bedtime, with a significant advance in bedtime between baseline, postintervention 2, and postintervention 3 for the somnolent group. CONCLUSIONS The present study confirms the importance of implementing sleep-hygiene strategies, particularly in athletes with an ESS score ≥11. A conjunction of individual and collective measures (eg, earlier bedtime, napping, and delaying morning training session) could favor the total sleep time achieved.
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Affiliation(s)
- Florane Pasquier
- Laboratory of Sport, Expertise and Performance (EA 7370), French National Institute of Sport (INSEP), Paris, France
| | - Robin Pla
- Fédération Française de Natation, Clichy, France
| | - Laurent Bosquet
- Laboratory MOVE-UR20296-University of Poitiers, Poitiers, France
| | - Fabien Sauvet
- Institut de Recherche Biomédicale des Armées (IRBA), Brétigny-sur-Orge, France
- EA7330 VIFASOM, Université de Paris, Hotel Dieu, Paris, France
| | - Mathieu Nedelec
- Laboratory of Sport, Expertise and Performance (EA 7370), French National Institute of Sport (INSEP), Paris, France
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Dai C, Peng Z, Wang L, Song T, Xu L, Xu M, Shao Y. Total sleep deprivation reduces the table tennis anticipation performance of young men: A functional magnetic resonance imaging study. iScience 2023; 26:107973. [PMID: 37822501 PMCID: PMC10562798 DOI: 10.1016/j.isci.2023.107973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/31/2023] [Accepted: 09/15/2023] [Indexed: 10/13/2023] Open
Abstract
This study explored whether and how sleep deprivation (SD) affects sport-related anticipation. Twenty table tennis players and 28 non-athletes completed a table tennis anticipation task before and after 36 h SD. Functional magnetic resonance imaging (fMRI) data were acquired simultaneously. The results showed that, compared with the non-athletes, table tennis players had higher neural efficiency, manifested by their higher anticipation accuracy and lower frontal lobe activation. SD impaired anticipation performance, accompanied by decreased activation of the occipital and temporal lobes. Compensatory activation occurred in the left hippocampus and orbital part of the right inferior frontal gyrus (IFG) after SD in the table tennis player group, but not in the non-athlete group. The decreased accuracy of non-athletes was positively correlated with decreased activation of orbital part of the right IFG. This study's findings improve the understanding of the cognitive neuroscience mechanisms by which SD affects sport-related anticipation.
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Affiliation(s)
- Cimin Dai
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Ziyi Peng
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Letong Wang
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Tao Song
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Lin Xu
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Mengmeng Xu
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Yongcong Shao
- School of Psychology, Beijing Sport University, Beijing 100084, China
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
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26
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Surała O, Malczewska-Lenczowska J, Sitkowski D, Witek K, Słomiński P, Certa M, Madej D. Effect of training load on sleep parameters and biochemical fatigue markers in elite swimmers. Biol Sport 2023; 40:1229-1237. [PMID: 37867745 PMCID: PMC10588581 DOI: 10.5114/biolsport.2023.124843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/02/2022] [Accepted: 01/29/2023] [Indexed: 10/24/2023] Open
Abstract
The effect of strenuous exercise on sleep patterns in swimmers is equivocal. Therefore, the purpose of the study was to describe possible changes in sleep parameters among elite swimmers subjected to different training loads (TL). Methods: Eighteen elite swimmers (8 females) were monitored across two high-volume preparatory 1-wk periods (P1, P2) and a lower-volume tapering 1-wk period (P3) before a major competition. Internal (the session rating of perceived exertion [sRPE]) and external TL (training duration and volume) were measured, along with several sleep indices (e.g., bedtime, get-up time, sleep time, wake after sleep onset [WASO]). Serum measurements of urea, creatine kinase (CK), testosterone and cortisol were taken before and after training sessions at the beginning (Mondays) and end (Fridays) of each micro cycle. Athlete TL decreased significantly in a stepwise manner from P1 to P2 and from P2 to P3. Of all sleep parameters, only significant differences in bedtime and get-up time emerged (P3 > P1 and/or P2). Sleep duration (~6.3 h) or quality (WASO: 41-45 min) were also unaffected by TL. CK levels declined from P1 to P3 (d = -0.8), and from P2 to P3 (d = -0.6). Positive exercise-induced changes in CK were also seen in each training period. The other biomarkers did not show the same temporal or acute patterns. Irrespective of the TL, the monitored swimmers experienced insufficient and fragmented sleep across this study. Neither sleep quality nor quantity were affected by different magnitudes of TL. Among the biochemical markers of fatigue, baseline plasma CK activity best reflected the physiological response to TL.
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Affiliation(s)
- Olga Surała
- Institute of Sport – National Research Institute, Warsaw, Poland
| | | | | | - Konrad Witek
- Institute of Sport – National Research Institute, Warsaw, Poland
| | - Paweł Słomiński
- Józef Piłsudski University of Physical Education, Warsaw, Poland
| | - Maciej Certa
- Józef Piłsudski University of Physical Education, Warsaw, Poland
| | - Dawid Madej
- Warsaw University of Life Sciences – SGGW, Warsaw, Poland
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Grier T, Benedict T, Mahlmann O, Goncalves L, Jones BH. Physical and behavioral characteristics of soldiers acquiring recommended amounts of sleep per night. Sleep Health 2023; 9:626-633. [PMID: 37225611 DOI: 10.1016/j.sleh.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/13/2023] [Accepted: 03/21/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Only one-third of U.S. Army Soldiers meet the recommended sleep guideline of 7 or more hours per night. Soldiers meeting the recommended sleep guideline are more likely to perform better on cognitive and physical tasks. The purpose of this analysis was to compare the physical and behavioral characteristics of Soldiers who met and did not meet the sleep recommendation guideline and determine associations between physical and behavioral characteristics and the acquisition of recommended amounts of sleep per night. METHODS A survey was administered to U.S. Army Soldiers. Adjusted odds ratios and corresponding 95% confidence intervals were calculated to determine associations between achieving the recommended number of hours of sleep per night and age, physical characteristics, health behaviors, physical training, and physical performance. RESULTS A survey was completed by 4229 men and 969 women. Male Soldiers who met the recommended sleep requirement had lower estimated body fat [20.3 ± 4.2% vs. 21.1 ± 4.4%], were less likely to use tobacco [11.5% vs. 16.2%] and exercised more [259 ± 226 vs. 244 ± 224 min/wk] compared with those who did not obtain 7 hours of sleep per night. Female Soldiers who met the recommended sleep requirement had lower estimated body fat [31.4 ± 4% vs. 32.1 ± 4.6%] and exercised more [258 ± 206 vs. 241 ± 216 min/wk] compared with those who did not obtain 7 hours of sleep per night. CONCLUSION Soldiers who choose to adopt healthy lifestyle characteristics may be more likely to meet the recommended sleep duration guideline.
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Affiliation(s)
- Tyson Grier
- US Army Public Health Center, Clinical Public Health and Epidemiology Directorate, Gunpowder, Maryland, USA.
| | - Timothy Benedict
- US Army Public Health Center, Clinical Public Health and Epidemiology Directorate, Gunpowder, Maryland, USA
| | - Olivia Mahlmann
- Armed Forces Health Surveillance Branch, Defense Health Agency, Gunpowder, Maryland, USA
| | - Latoya Goncalves
- US Army Public Health Center, Clinical Public Health and Epidemiology Directorate, Gunpowder, Maryland, USA
| | - Bruce H Jones
- US Army Public Health Center, Clinical Public Health and Epidemiology Directorate, Gunpowder, Maryland, USA
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Nikolaidis PT, Weiss K, Knechtle B, Trakada G. Sleep in marathon and ultramarathon runners: a brief narrative review. Front Neurol 2023; 14:1217788. [PMID: 37822525 PMCID: PMC10563314 DOI: 10.3389/fneur.2023.1217788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/11/2023] [Indexed: 10/13/2023] Open
Abstract
Introduction Sleep is considered a fundamental biological function in humans necessary for recovery from daily physical activities. Considering the increasing popularity of long-distance running and participation in races such as marathons and ultramarathons, the aim of the present study was to review the relationship of such strenuous physical activities with sleep. Methods A search of Scopus was performed on 24/6/2023 using the syntax [ABS (sleep) AND ABS (marathon)] to identify relevant papers, the references of which were hand-searched to find additional sources. Results Optimal sleep has been shown to affect injury prevention and susceptibility to infection positively. In turn, participation in a marathon race may influence nocturnal autonomic modulation and disturb homeostasis. Ultramarathon races may have such a long duration that results in sleep deprivation even for several days, where sleep duration is quite below the physiological range. It seems that for ultramarathons of short duration, continuous running and sleep deprivation are beneficial for performance. In contrast, for races longer than 200 miles, it is necessary to develop sleep strategies to sustain performance. Conclusion In summary, the longer the distance of a running race, the greater the importance of an optimal sleep for race performance as well as the impact of a race on sleep.
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Affiliation(s)
| | - Katja Weiss
- Institute of Primary Care, University of Zurich, Zürich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zürich, Switzerland
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
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Fagher K, Dahlström Ö, Lexell J. Mental health, sleep, and pain in elite Para athletes and the association with injury and illness-A prospective study. PM R 2023; 15:1130-1139. [PMID: 36270015 DOI: 10.1002/pmrj.12917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 08/19/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The interest in the health of Para athletes continues to increase. Still, there are few studies that have evaluated health parameters beyond injury and illness in this athlete population. OBJECTIVE To assess (1) the weekly proportion of elite Para athletes reporting anxiety/depression, low sleep levels (≤7 hours), and pain over 52 weeks; (2) and to explore whether these health parameters are associated with the risk for a sports injury or illness. DESIGN A 52-week prospective study, part of the Sports-related Injury and Illness in Paralympic Sport Study (SRIIPSS). SETTING A total of 107 Swedish elite Para athletes with physical, visual, and intellectual impairment participated. MAIN OUTCOME MEASURES Data on self-reported anxiety/depression, sleep levels, pain, and injuries/illnesses were collected weekly. Comparisons of these parameters preceding an injury/illness were made using Friedman's analysis of variance (ANOVA). RESULTS The proportion of athletes reporting weekly anxiety/depression was 34.1%; 60.9% of athletes reported sleeping ≤7 hours and 49.9% reported pain. In exploratory analyses, there were no significant differences between weeks before an injury for any of the variables. There were significant differences in levels of sleep over the weeks, where sleep levels were significantly higher (>10 hours) 4 weeks prior to an illness (p = .016). CONCLUSION This cohort of elite Para athletes reported relatively high levels of anxiety/depression, low sleep levels, and pain, which is a concern. High sleep levels and the risk for illness might be an indication of overtraining, which commonly leads to persistent fatigue and an increased susceptibility to infections. Monitoring of the health of elite Para athletes is recommended to be able to improve performance and health in this population.
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Affiliation(s)
- Kristina Fagher
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
| | - Örjan Dahlström
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Athletics Research Center, Linköping University, Linköping, Sweden
| | - Jan Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
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Unver S, Yigit S, Tural E, Yigit E, Atan T. Evaluation of a circadian rhythm gene (PER3) VNTR variant in Turkish athletes. NUCLEOSIDES, NUCLEOTIDES & NUCLEIC ACIDS 2023; 43:173-183. [PMID: 37610137 DOI: 10.1080/15257770.2023.2248198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE Circadian rhythmicity has been shown to contribute to the regulation of key physiological and cognitive processes related to performance. The period homolog 3 (PER3) is expressed in a circadian pattern in the suprachiasmatic nucleus. Therefore, in this study, we aimed to evaluate the role of the variable tandem repeat (VNTR) variant of the PER3 gene in athletic performance in the Turkish population. METHODS This study included 223 subjects, which consisted of 123 athletes and 100 sedentary controls. Blood samples were drawn from all subjects. DNA was extracted from whole-blood samples. The PER3 VNTR variant was genotyped using the polymerase chain reaction-restriction method (PCR). The results of the analyses were evaluated for statistical significance. RESULTS The mean ages of athletes and controls were 22 ± 2.814 and 23 ± 3.561, respectively. Endurance athletes in the group were 21.1%, and sprint athletes were 78.9%. There was no statistical significance in terms of PER3 VNTR genotype distribution or allele frequency. In the recessive model, a statistically significant association was observed when the athletes were compared with the controls according to 4/4 + 4/5 versus 5/5 genotype (p = 0.020). CONCLUSION In this case-control study, for the first time in our country, we obtained findings suggesting that the PER3 VNTR variant may affect sports performance in the Turkish population. Results need to be replicated in different ethnic and larger samples.
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Affiliation(s)
- Saban Unver
- Department of Coaching Education, Faculty of Sports Science, University of Ondokuz Mayis, Samsun, Turkey
| | - Serbulent Yigit
- Department of Genetics, Faculty of Veterinary, Ondokuz Mayıs University, Samsun, Turkey
- Department of Medical Biology, Graduate Institute, Ondokuz Mayıs University, Samsun, Turkey
| | - Ercan Tural
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Ondokuz Mayıs University, Samsun, Turkey
| | - Ercument Yigit
- Department of Sports Management, School of Physical Education and Sports, Halic University, Istanbul, Turkey
| | - Tulin Atan
- Department of Coaching Education, Faculty of Sports Science, University of Ondokuz Mayis, Samsun, Turkey
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Marilac Soalheiro L, de Jesus Brandão B, Paiva RVN, Dias Carvalho L, Menezes Paranhos RD, Ribeiro Barbosa PC, Guerrero-Vargas NN, Tamura EK. Familiarity of Brazilian psychologists with basic concepts in sleep science and chronobiology. Chronobiol Int 2023; 40:1072-1083. [PMID: 37661786 DOI: 10.1080/07420528.2023.2250870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023]
Abstract
Desynchronization of circadian rhythms and sleep-wake patterns impacts biochemical, physiological, and behavioral functions, including mental processes. The complex relationship between circadian rhythms and mental health makes it challenging to determine causality between circadian desynchronization and mental disorders. Regarding the fact that psychologists act as the front line for initial mental health care, we aimed to assess the knowledge and use of sleep science and basic chronobiology by professional psychologists in Brazil. Data were collected via an online questionnaire completed by 1384 professional psychologists between October 2018 and May 2019. Our findings revealed that ±80% of psychologists reported that at least half of their patients presented some sleep-related complaints; however, only ±27% routinely inquired about sleep quality even in the absence of patient complaints. Additionally, only ±66% initiated treatments to understand these complaints, potentially influenced by the lack of prior academic exposure to biological rhythms as reported by ±76% of Brazilian psychologists interviewed. Importantly, ±15% did not believe in an association between mental health and biological rhythms, and even a significant ±67% were unfamiliar with the term chronobiology and ±63% were not able to describe any other biological rhythm except for the sleep-wake cycle. These results demonstrate that fundamental concepts in chronobiology and sleep science are unknown to a substantial proportion of Brazilian psychologists. In conclusion, we propose that this subject could be more effectively integrated into psychologists' academic training, potentially promoting benefits through the incorporation of a chronobiological approach in mental health practice.
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Affiliation(s)
| | | | | | - Lázaro Dias Carvalho
- Department of Health Sciences, Universidade Estadual de Santa Cruz, Ilhéus, Brazil
| | | | - Paulo César Ribeiro Barbosa
- Department of Human Sciences and Philosophy, Universidade Estadual de Feira de Santana, Feira de Santana, Brazil
| | - Natali N Guerrero-Vargas
- Department of Anatomy, Faculty of Medicine, Universidad Nacional Autonóma de México, México City, México
| | - Eduardo Koji Tamura
- Department of Health Sciences, Universidade Estadual de Santa Cruz, Ilhéus, Brazil
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Cunha LA, Costa JA, Marques EA, Brito J, Lastella M, Figueiredo P. The Impact of Sleep Interventions on Athletic Performance: A Systematic Review. SPORTS MEDICINE - OPEN 2023; 9:58. [PMID: 37462808 DOI: 10.1186/s40798-023-00599-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 06/18/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Sleep is essential for maximal performance in the athletic population. Despite that, the sport context has many factors that can negatively influence athletes' sleep and subsequent recovery. OBJECTIVES The purpose of this systematic review was to synthesize the most recent literature regarding sleep interventions aimed at improving sleep and subsequent performance in athletes. METHODS The present systematic review was conducted based on the PRISMA guidelines and the PICOS approach. The search was conducted in May 2022 using the electronic database PubMed, SPORTDiscus via EBSCOhost, and Web of Science. Once extracted, studies were included if they met the following criteria: (1) participants were athletes of individual or team sports; (2) implemented an intervention aimed at improving sleep; (3) measured at least one objective performance/recovery outcome; and (4) reported the relationship between sleep and performance. RESULTS The search returned 1584 records. Following the screening, a total of 25 studies met our inclusion criteria. All the included articles were intervention studies published between 2011 and 2021. The included studies implemented various sleep interventions, such as sleep hygiene, naps, sleep extension, light manipulation, cold water immersion, mindfulness, or a combination of two or more strategies. Sleep extension and naps were the most representative and most effective strategies to improve sleep and performance. Mindfulness and light manipulation demonstrated promising results, but more studies are needed to confirm these findings. Sleep hygiene, removing electronic devices at night, and cold water immersion had no effects on sleep and subsequent performance/recovery, but these results are based on a few studies only. CONCLUSION While acknowledging the limited amount of high-quality evidence reviewed, it appears that increasing sleep duration at night or through napping was the most effective interventions to improve physical and/or cognitive performance. Protocol Registration This protocol was registered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on May 11, 2022, with the registration number INPLASY202250069.
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Affiliation(s)
- Lúcio A Cunha
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, Maia, Portugal
| | - Júlio A Costa
- Portugal Football School, Portuguese Football Federation, Cruz Quebrada, Portugal
| | - Elisa A Marques
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, Maia, Portugal
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - João Brito
- Portugal Football School, Portuguese Football Federation, Cruz Quebrada, Portugal
| | - Michele Lastella
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Australia
| | - Pedro Figueiredo
- Physical Education Department, College of Education, United Arab Emirates University, Al Ain, Abu Dhabi, UAE.
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Vila Real, Portugal.
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Gorovoy SB, Campbell RL, Fox RS, Grandner MA. App-Supported Sleep Coaching: Implications for Sleep Duration and Sleep Quality. FRONTIERS IN SLEEP 2023; 2:1156844. [PMID: 37860823 PMCID: PMC10586750 DOI: 10.3389/frsle.2023.1156844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
OBJECTIVES The present study evaluated whether completers of a 12-week app-based, personalized text supported sleep coaching program demonstrated improvements in sleep continuity, sleep duration, and reduced use of sleep aids. METHODS Data were obtained from Sleep Reset, a 12-week consumer product that offers app-based sleep education and monitoring, along with personalized text-based sleep coaching provided by live coaches. 564 completers were included in the study. Pre-post changes for sleep latency (SL), wake after sleep onset (WASO), number of awakenings (NWAK), total sleep time (TST), sleep efficiency (SE%) and use of "sleep aids" were evaluated. To evaluate whether the program produced meaningful results, the proportion of participants who demonstrated reductions in SL, WASO, and NWAK, and increases in TST and SE% were examined. RESULTS Mean SL was reduced by 11 minutes, mean WASO was reduced by 28 minutes, mean SE% increased by 6.6%, and mean TST increased by about 44 minutes. Of those who reported using "sleep aids" during Week 1, 41% no longer used them by week 12. Those with low SE% at baseline demonstrated greater improvements in SL (16.2 vs 5.7mins), WASO (47.3 vs 7.2mins), SE% (11.2% vs 1.6%), and TST (65.3 vs 31.2mins). Those with ≤6 hours of sleep at baseline demonstrated greater improvements in WASO (36.8 vs 22.3mins), SE% (10.1% vs 4.3%), and TST (85.1 vs 25.5mins). CONCLUSIONS Participants that completed the app-based, personalized text supported coaching intervention reported subjective improvements in sleep duration and quality that suggest more beneficial effects particularly in those with lower sleep efficiency or sleep duration at baseline. An effective sleep coaching program that utilizes trained sleep coaches with access to board-certified providers, may provide a valuable resource for subclinical populations.
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Affiliation(s)
- Suzanne B. Gorovoy
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, Tucson
| | - Rebecca L. Campbell
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, Tucson
| | | | - Michael A. Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, Tucson
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Willmer F, Reuter C, Pramsohler S, Faulhaber M, Burkhardt A, Netzer N. The Effects of Napping on Wakefulness and Endurance Performance in Athletes: A Randomized Crossover Study. Life (Basel) 2023; 13:1414. [PMID: 37374196 DOI: 10.3390/life13061414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Athletes often experience poor sleep quality due to stress, altitude exposure, travel across different time zones, and pre-competition nervousness. Coaches use daytime naps to counteract the negative effects of fragmented nighttime sleep. Napping before competitions has also been used to enhance performance in athletes without sleep problems, with mixed results in previous studies, particularly for endurance performance. Thus, we investigated the effects of napping after partial sleep deprivation (PSD) on endurance performance and wakefulness in athletes. Methods: We recruited 12 healthy and trained participants (seven female and five male) for a randomized crossover study design. The participants underwent two test sessions: a five-hour night of sleep without a nap (noNap) and a five-hour night of sleep with a 30-min nap opportunity (Nap30). Participants recorded their sleep-wake rhythm one week before and during the study using the Consensus Sleep Diary-Core and the Morningness-Eveningness Questionnaire to examine their circadian rhythm type. We quantified PSD and the nap with pupillography (pupil unrest index, PUI), a subjective level of sleepiness questionnaire (Karolinska Sleepiness Scale, KSS), and polysomnography. After each night, participants performed a maximal cycling ergometry test to determine time to exhaustion (TTE) and maximal oxygen uptake (VO 2max). Results: Participants had an average sleep duration of 7.2 ± 0.7 h and were identified as moderately morning types (n = 5), neither type (n = 5), and moderately evening types (n = 2). There was a significant difference in both sleepiness parameters between the two conditions, with the PUI (p = 0.015) and KSS (p ≤ 0.01) significantly decreased at 5 h and nap compared with only 5 h of sleep. The PUI (p ≤ 0.01) and KSS (p ≤ 0.01) decreased significantly from before to after the nap. However, there was no significant difference in physical exercise test results between the conditions for TTE (p = 0.367) or VO 2max (p = 0.308). Conclusions: Our results suggest that napping after light PSD does not significantly influence endurance performance. We conclude that aerobic performance is a multidimensional construct, and napping after PSD may not enhance it. However, napping is an effective method to increase wakefulness and vigilance, which can be beneficial for sports competitions.
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Affiliation(s)
- Felix Willmer
- Hermann-Buhl-Institute for Hypoxia and Sleep Medicine Research, 83661 Lenggries, Germany
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Claire Reuter
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Stephan Pramsohler
- Hermann-Buhl-Institute for Hypoxia and Sleep Medicine Research, 83661 Lenggries, Germany
| | - Martin Faulhaber
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Anja Burkhardt
- Hermann-Buhl-Institute for Hypoxia and Sleep Medicine Research, 83661 Lenggries, Germany
| | - Nikolaus Netzer
- Hermann-Buhl-Institute for Hypoxia and Sleep Medicine Research, 83661 Lenggries, Germany
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
- EURAC Research Center, 39100 Bozen, Italy
- Division Sports Medicine and Rehabilitation, Department Medicine, University of Ulm, 89069 Ulm, Germany
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Baize D, Meriaux-Scoffier S, Chrétien A, Hayotte M, Piponnier E, d'Arripe-Longueville F. Sleep Assessment in Competitive Athletes: Development and Validation of French Versions of the Athens Insomnia Scale and the Athlete Sleep Behavior Questionnaire. Sleep Sci 2023; 16:183-196. [PMID: 37425979 PMCID: PMC10325846 DOI: 10.1055/s-0043-1770803] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
Objective The purpose of this study was to develop and validate French versions of two questionnaires assessing competitive athletes' sleep: the Athens Insomnia Scale (AIS-FR) and the Athlete Sleep Behavior Questionnaire (ASBQ-FR). Methods Four complementary studies were carried out, with a total sample of 296 French competitive athletes from different sports and expertise levels. The studies aimed to develop preliminary versions of the AIS-FR and the ASBQ-FR (study 1), and then to examine their respective dimensionality and reliability (study 2), temporal stability (study 3), and concurrent validity (study 4). The dimensionality was established using confirmatory factor analysis. Similar and correlated psychological factor scales were used to examine the concurrent validity (the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the State-Trait Anxiety Inventory and the Positive and Negative Affect Schedule). Results The AIS-FR consists of eight items with two subfactors: nocturnal symptoms and diurnal symptoms, assessed by a uniformized 4-point Likert-type scale. The ASBQ-FR is composed of 15 items with three subfactors, which differs from the original English version: behaviors affecting sleep, behaviors related to anxiety, and sleep disturbances. Due to the Covid context and curfews, three items of the original scale were excluded from the statistical analyses because non-applicable. Both scales presented satisfactory psychometric properties. Discussion The AIS-FR and ASBQ-FR appear to be valid and reliable tools that can be used with competitive athletes for everyday training and research purposes. An ASBQ-FR version that includes the three excluded items should undergo validation testing once pandemic restrictions are eased.
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Affiliation(s)
- Diane Baize
- Sport Sciences department, LAMHESS, Université Côte d'Azur, Nice, France
| | | | - Aurélia Chrétien
- Sport Sciences department, LAMHESS, Université Côte d'Azur, Nice, France
| | - Meggy Hayotte
- Sport Sciences department, LAMHESS, Université Côte d'Azur, Nice, France
| | - Enzo Piponnier
- Sport Sciences department, LAMHESS, Université Côte d'Azur, Nice, France
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Edinborough L, Hill J, Jarvis M, Bruce-Low S, Pedlar CR. A bespoke sleep monitoring and sleep hygiene intervention improves sleep in an U18 professional football player: A case study. J Sports Sci 2023:1-8. [PMID: 37183452 DOI: 10.1080/02640414.2023.2213032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This case study reports on a professional football player (age: 17.6 years) who was referred for sleep monitoring and intervention after reporting excessive night-time awakenings. The player undertook a series of subjective sleep assessments and objective sleep monitoring (activity monitor). Based on the data presented, a sleep hygiene intervention was prescribed. Numerical comparisons were made between pre-intervention (Pre) and post-intervention (Post) values. Objective values were also compared to reference data from a similarly aged professional cohort from the same club (n = 11). Wake episodes per night (Pre: 7.9 ± 3, Post: 4.5 ± 1.9; -43%) and wake after sleep onset (WASO; Pre: 74.3 ± 31.8 mins, Post: 50.0 ± 22.8 mins, -33%) were improved from Pre to Post. Compared to the reference data, mean wake episodes per night (Pre: 7.9 ± 3.0, reference: 4.6 ± 2.6; -42%) and WASO (Pre: 74.3 ± 31.8 mins, reference: 44.3 ± 36.5 mins; -40%) were all lower compared to Pre levels. Whilst causality cannot be proven, we observed multiple sleep metrics improving following an intervention. This provides a potential framework for practitioners looking to provide targeted sleep assessment and intervention.
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Affiliation(s)
- Luke Edinborough
- Faculty of Sport, Allied Health and Performance Sciences, St Mary's University, Twickenham, UK
- Department of Sport Science, Southampton Football Club, Southampton, UK
| | - Jessica Hill
- Faculty of Sport, Allied Health and Performance Sciences, St Mary's University, Twickenham, UK
| | - Mark Jarvis
- Department of Sport Science, Southampton Football Club, Southampton, UK
| | - Stewart Bruce-Low
- School of Health Sport & Bioscience, University of East London, London, UK
| | - Charles R Pedlar
- Faculty of Sport, Allied Health and Performance Sciences, St Mary's University, Twickenham, UK
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, University College London (UCL), London, UK
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Śliż D, Wiecha S, Gąsior JS, Kasiak PS, Ulaszewska K, Lewandowski M, Barylski M, Mamcarz A. Impact of COVID-19 Infection on Cardiorespiratory Fitness, Sleep, and Psychology of Endurance Athletes-CAESAR Study. J Clin Med 2023; 12:jcm12083002. [PMID: 37109342 PMCID: PMC10143025 DOI: 10.3390/jcm12083002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
COVID-19 has a deteriorating impact on health which is especially important for endurance athletes (EAs) who need to maintain continuity of training. The illness affects sleep and psychology, which influence sport performance. The aims of this study were: (1) to assess the consequences of mild COVID-19 on sleep and psychology and (2) to assess the consequences of mild COVID-19 on cardiopulmonary exercise test (CPET) results. A total of 49 EAs (males = 43, 87.76%; females = 6, 12.24%; age = 39.9 ± 7.8 years; height = 178.4 ± 6.8 cm; weight = 76.3 ± 10.4 kg; BMI = 24.0 ± 2.6 kg·m-2) underwent a maximal cycling or running CPET pre- and post-COVID-19 and completed an original survey. Exercise performance deteriorated after COVID-19 (maximal oxygen uptake, VO2max = 47.81 ± 7.81 vs. 44.97 ± 7.00 mL·kg·min-1 pre- and post-infection, respectively; p < 0.001). Waking up at night affected the heart rate (HR) at the respiratory compensation point (RCP) (p = 0.028). Sleep time influenced pulmonary ventilation (p = 0.013), breathing frequency (p = 0.010), and blood lactate concentration (Lac) (p = 0.013) at the RCP. The maximal power/speed (p = 0.046) and HR (p = 0.070) were linked to the quality of sleep. Stress management and relaxation techniques were linked with VO2max (p = 0.046), maximal power/speed (p = 0.033), and maximal Lac (p = 0.045). Cardiorespiratory fitness deteriorated after mild COVID-19 and was correlated with sleep and psychological indices. Medical professionals should encourage EAs to maintain proper mental health and sleep after COVID-19 infection to facilitate recovery.
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Affiliation(s)
- Daniel Śliż
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
- School of Public Health, Postgraduate Medical Education Center, 01-813 Warsaw, Poland
| | - Szczepan Wiecha
- Department of Physical Education and Health, Faculty in Biala Podlaska, Jozef Pilsudski University of Physical Education in Warsaw, 21-500 Biala Podlaska, Poland
| | - Jakub S Gąsior
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Przemysław Seweryn Kasiak
- Students' Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
| | - Katarzyna Ulaszewska
- Students' Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
| | - Marcin Lewandowski
- Department of Pharmacology and Clinical Pharmacology Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, 00-927 Warsaw, Poland
| | - Marcin Barylski
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 90-419 Łódź, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
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Nye NS, Grubic T, Kim M, O'Connor F, Deuster PA. Universal Training Precautions: A Review of Evidence and Recommendations for Prevention of Exercise-Related Injury, Illness, and Death in Warfighters and Athletes. J Athl Train 2023; 58:232-243. [PMID: 35724358 PMCID: PMC10176841 DOI: 10.4085/1062-6050-0400.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Facing pressure to train for victory, warfighters and athletes encounter numerous health risks that are directly related to their regular physical training. The concept of universal training precautions (UTPs) signifies universal processes designed to prevent unnecessary bodily harm, including injury, illness, and death, during physical training programs. Although no formal guidelines exist for collectively implementing a defined set of UTPs to address a broad scope of exercise-related health risks, recommendations and guidelines have been published relating to preventing sudden death during high school sports and collegiate conditioning sessions. A long list of critical topics must be considered as UTPs, including physical fitness factors, transition-period accommodation, hydration, environmental factors and acclimatization, appropriate recovery, use of medications and dietary supplements, and importantly, leadership. In this article, we outline in detail, with corresponding Strength of Recommendation Taxonomy ratings, what should be considered universal recommendations to minimize the risk of warfighters and athletes coming to harm when participating in group physical activities.
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Affiliation(s)
| | - Tyler Grubic
- Aviation Survival Training Center, NAS Patuxent River, MD
| | - Michael Kim
- Sports Medicine Clinic, Fort Belvoir Community Hospital, VA
| | | | - Patricia A. Deuster
- USU/MEM Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Silver Spring, MD
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Chung Y, Wu JL, Huang WC. Effects of prebiotics on intestinal physiology, neuropsychological function, and exercise capacity of mice with sleep deprivation. Food Res Int 2023; 165:112568. [PMID: 36869551 DOI: 10.1016/j.foodres.2023.112568] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/27/2022] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
People suffered from insufficient or disrupted sleep due to night shifts, work pressure, and irregular lifestyles. Sleep deprivation caused by inadequate quantity or quality of sleep has been associated with not only increased risk of metabolic diseases, gut dysbiosis, and emotional disorders but also decreased work and exercise performance. In this study, we used the modified multiple platform method (MMPM) to induce pathological and psychological characteristics of sleep deprivation with C57BL/6J male mice, and investigated whether supplementing a prebiotics mixture of short-chain galactooligosaccharides (scGOS) and long-chain fructooligosaccharides (lcFOS) (9:1 ratio) could improve the impacts of sleep deprivation on intestinal physiology, neuropsychological function, inflammation, circadian rhythm, and exercise capacity. Results showed that sleep deprivation caused intestinal inflammation (increased TNFA and IL1B) and decreased intestinal permeability with a significant decrease in the tight junction genes (OCLN, CLDN1, TJP1, and TJP2) of intestine and brain. The prebiotics significantly increased the content of metabolite short-chain fatty acids (acetate and butyrate) while recovering the expression of indicated tight junction genes. In hypothalamus and hippocampus, clock (BMAL1 and CLOCK) and tight junction (OCLN and TJP2) genes were improved by prebiotics, and corticotropin-releasing hormone receptor genes, CRF1 and CRF2, were also significantly regulated for mitigation of depression and anxiety caused by sleep deprivation. Also, prebiotics brought significant benefits on blood sugar homeostasis and improvement of exercise performance. Functional prebiotics could improve physiological modulation, neuropsychological behaviors, and exercise performance caused by sleep deprivation, possibly through regulation of inflammation and circadian rhythm for health maintenance. However, the microbiota affected by prebiotics and sleep deprivation should warrant further investigation.
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Affiliation(s)
- Yi Chung
- College of Human Development and Health, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan.
| | - Jia-Ling Wu
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan.
| | - Wen-Ching Huang
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan.
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Zorn J, Vollrath S, Matits L, Schönfelder M, Schulz SVW, Jerg A, Steinacker JM, Bizjak DA. Relationship between physical performance and perception of stress and recovery in daily life post COVID-19-An explorative study. PLoS One 2023; 18:e0285845. [PMID: 37186604 PMCID: PMC10184944 DOI: 10.1371/journal.pone.0285845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/02/2023] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION COVID-19 is a multi-systemic disease which can target the lungs and the cardiovascular system and can also affect parts of the brain for prolonged periods of time. Even healthy athletes without comorbidities can be psychologically affected long-term by COVID-19. OBJECTIVE This study aimed to investigate athletes' perceived mental stress and recovery levels in daily life, and their maximal aerobic power, at three different time points, post COVID-19. METHODS In total, 99 athletes (62.6% male), who had been infected by COVID-19, filled out the Recovery Stress Questionnaire for Athletes (REST-Q-Sport) and completed cardiopulmonary exercise testing (endpoint maximal aerobic power output (Pmax)) at the initial screening (t1: 4 months after infection). Follow-up assessments occurred three (t2, n = 37) and seven months after t1 (t3, n = 19). RESULTS Subgroup means from the Recovery category were significantly below the reference value of four at all three time points, except "General Recovery" (3.76 (± 0.96), p = 0.275, d = 0.968) at t3."Overtiredness" (2.34 (± 1.27), p = 0.020, r = 0.224) was significantly above the reference value of two at t1, while all other Stress subgroups were not significantly different from the reference value or were significantly below the maximum threshold of two at t1, t2 and t3. Spearman's ρ revealed a negative association between Pmax and the subcategories of stress (ρ = -0.54 to ρ = -0.11, p < 0.050), and positive correlations between Pmax and "Somatic Recovery" (ρ = 0.43, p < 0.001) and "General Recovery" (ρ = 0.23, p = 0.040) at t1. Pmax (t1: 3.83 (± 0.99), t2: 3.78 (± 1.14), β = 0.06, p < 0.003) increased significantly from t1 to t2. In addition, REST-Q-Sport indicated a decrease in "Sleep" (t2 = 2.35 (± 0.62), t3 = 2.28(± 0.61), β = -0.18, p < 0.023) at t3, when compared to t2. CONCLUSION The perceived recovery seems to be negatively affected in post COVID-19 athletes. Physical performance post COVID-19 correlates with both "Emotional and Somatic Stress" and "Somatic and General Recovery", indicating potential mental and physical benefits of exercise. While it is evident that COVID-19, like other viral infections, may have an influence on physical performance, monitoring stress and recovery perceptions of athletes is critical to facilitate their return-to-sports, while minimizing long-term COVID-19 induced negative effects like the athletic objective and subjective perceived recovery and stress levels.
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Affiliation(s)
- Jule Zorn
- Department of Medicine, Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Shirin Vollrath
- Department of Medicine, Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Lynn Matits
- Department of Medicine, Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
- Division of Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Martin Schönfelder
- Department of Sport and Health Science, Division of Exercise Biology, Technical University Munich, Munich, Germany
| | - Sebastian V W Schulz
- Department of Medicine, Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Achim Jerg
- Department of Medicine, Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Jürgen M Steinacker
- Department of Medicine, Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Daniel A Bizjak
- Department of Medicine, Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
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Taheri M, Irandoust K, Reynoso-Sánchez LF, Muñoz-Helú H, Cruz-Morales KN, Torres-Ramírez R, Mirmoezzi M, Youzbashi L, Mirakhori F, Dergaa I, Vancini RL, Mataruna-Dos-Santos LJ, Korinna Zazueta-Beltrán D, Zouhal H, Morales-Beltrán RA, Soylu Y, Molgado-Sifuentes A, González-Hernández J, Hernández-Cruz G, Bojorquez Castro LB, Kurt C, Trabelsi K, Chtourou H, Seghatoleslami A, López-Camacho MO, Mendoza-Baldenebro RE, Torabi F, Ben Saad H, Washif JA, Strahler J, Guimarães-Mataruna AF, Lebaron TW, Shaabani Ezdini E, Rezaei MS, Moshtagh M, Yagin FH, Gülü M, Esmaeili A, Müller P, Ammar A, Scoditti E, Garbarino S, Puce L, Bragazzi NL, Nobari H. Effects of home confinement on physical activity, nutrition, and sleep quality during the COVID-19 outbreak in amateur and elite athletes. Front Nutr 2023; 10:1143340. [PMID: 37139442 PMCID: PMC10150803 DOI: 10.3389/fnut.2023.1143340] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/09/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Despite the progress in the management of the pandemic caused by COVID-19, it is necessary to continue exploring and explaining how this situation affected the athlete population around the world to improve their circumstances and reduce the negative impact of changes in their lifestyle conditions that were necessitated due to the pandemic. The aim of this study was to analyze the moderating influence of physical activity (PA) and dietary habits on the impact of the COVID-19 pandemic experience on sleep quality in elite and amateur athletes. Materials and methods A total of 1,420 elite (40.1%) and amateur (59.9%) athletes (41% women; 59% men) from 14 different countries participated in a cross-sectional design study. Data were collected using a battery of questionnaires that identified sociodemographic data, sleep quality index, PA levels, dietary habits, and the athletes' perception of their experience during the COVID-19 pandemic. Means and standard deviations were calculated for each variable. The analysis of variances and the correlation between variables were carried out with non-parametric statistics. A simple moderation effect was calculated to analyze the interaction between PA or dietary habits on the perception of the COVID-19 experience effect on sleep quality in elite and amateur athletes. Results The PA level of elite athletes was higher than amateur athletes during COVID-19 (p < 0.001). However, the PA level of both categories of athletes was lower during COVID-19 than pre-COVID-19 (p < 0.01). In addition, amateurs had a higher diet quality than elite athletes during the pandemic (p = 0.014). The perception of the COVID-19 experience as controllable was significantly higher (p = 0.020) among elite athletes. In addition, two moderating effects had significant interactions. For amateur athletes, the PA level moderated the effect of controllable COVID-19 experience on sleep quality [F (3,777) = 3.05; p = 0.028], while for elite athletes, the same effect was moderated by dietary habits [F (3,506) = 4.47, p = 0.004]. Conclusion Elite athletes had different lifestyle behaviors compared to amateurs during the COVID-19 lockdown. Furthermore, the relevance of maintaining high levels of PA for amateurs and good quality dietary habits by elite athletes was noted by the moderating effect that both variables had on the influence of the controllable experience during the COVID-19 pandemic on sleep quality.
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Affiliation(s)
- Morteza Taheri
- Department of Sport Sciences, Imam Khomeini International University, Qazvin, Iran
- Department of Motor Behavior, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
- Morteza Taheri
| | - Kadijeh Irandoust
- Department of Sport Sciences, Imam Khomeini International University, Qazvin, Iran
- Institute of Future Studies, Imam Khomeini International University, Qazvin, Iran
| | | | - Hussein Muñoz-Helú
- Department of Economic-Administrative Sciences, Autonomous University of Occident, Los Mochis, Mexico
| | | | - Raymundo Torres-Ramírez
- Department of Economic-Administrative Sciences, Autonomous University of Occident, Los Mochis, Mexico
| | - Masoud Mirmoezzi
- Faculty of Physical Education and Sport Science, Islamic Azad University, Tehran, Iran
| | - Leila Youzbashi
- Department of sport sciences, Faculty of Humanities, University of Zanjan, Zanjan, Iran
| | - Fatemeh Mirakhori
- Department of Sport Sciences, Imam Khomeini International University, Qazvin, Iran
- Department of Motor Behavior, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
| | - Ismail Dergaa
- Primary Health Care Corporation, Doha, Qatar
- Research Unit Physical Activity, Sport, and Health, (UR18JS01), National Observatory of Sport, Tunis, Tunisia
- High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
| | - Rodrigo Luiz Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | | | | | - Hassane Zouhal
- Univ Rennes, M2S (Laboratoire Mouvement, Sport, Santé) - EA 1274, Rennes, France
- Institute International des Sciences du Sport, Irodouer, France
| | | | - Yusuf Soylu
- Faculty of Sport Sciences, Tokat Gaziosmanpasa University, Tokat, Türkiye
| | | | - Juan González-Hernández
- Department of Personality, Evaluation and Psychological Treatment, University of Granada, Granada, Spain
| | - Germán Hernández-Cruz
- Faculty of Sport Organization, Autonomous University of Nuevo Leon, San Nicolás de los Garza, Mexico
| | | | - Cem Kurt
- Kirkpinar Sport Sciences Faculty, Trakya University, Edirne, Türkiye
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
| | - Hamdi Chtourou
- Research Unit Physical Activity, Sport, and Health, (UR18JS01), National Observatory of Sport, Tunis, Tunisia
- High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
| | | | | | | | - Farnaz Torabi
- Department of Physical Education, Payame Noor University, Tehran, Iran
| | - Helmi Ben Saad
- Faculty of Medicine, Farhat Hached Hospital, Research Laboratory “Heart Failure, LR12SP09”, University of Sousse, Sousse, Tunisia
| | - Jad Adrian Washif
- Sports Performance Division, Institut Sukan Negara Malaysia (National Sports Institute of Malaysia), Kuala Lumpur, Malaysia
| | - Jana Strahler
- Sport Psychology, Institute of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | | | - Tyler W. Lebaron
- Department of Kinesiology and Outdoor Recreation, Southern Utah University, Cedar City, UT, United States
- Molecular Hydrogen Institute, Enoch, UT, United States
- Centre of Experimental Medicine, Institute for Heart Research, Slovak Academy of Sciences, Bratislava, Slovakia
| | | | - Marjan Sadat Rezaei
- Department of Sport Sciences, Imam Khomeini International University, Qazvin, Iran
| | - Mozhgan Moshtagh
- Social Determinants of Health Research Center, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Fatma Hilal Yagin
- Department of Biostatistics, and Medical Informatics, Faculty of Medicine, Inonu University, Malatya, Türkiye
| | - Mehmet Gülü
- Department of Sport Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Türkiye
| | - Atefeh Esmaeili
- Department of Sport Sciences, Imam Khomeini International University, Qazvin, Iran
| | - Patrick Müller
- Division of Cardiology and Angiology, German Center for Neurodegenerative Diseases (DZNE), Univerisity Hospital Magdeburg, Magdeburg, Germany
| | - Achraf Ammar
- High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS (Faculty of Sport Sciences), UPL, Paris Nanterre University, Nanterre, France
| | - Egeria Scoditti
- National Research Council (CNR)-Institute of Clinical Physiology (IFC), Lecce, Italy
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Luca Puce
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Nicola Luigi Bragazzi
- Human Nutrition Unit, Department of Food and Drugs, Medical School, University of Parma, Parma, Italy
- *Correspondence: Nicola Luigi Bragazzi
| | - Hadi Nobari
- Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
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Gavanda S, von Andrian-Werburg C, Wiewelhove T. Assessment of fatigue and recovery in elite cheerleaders prior to and during the ICU World Championships. Front Sports Act Living 2023; 5:1105510. [PMID: 36949892 PMCID: PMC10025303 DOI: 10.3389/fspor.2023.1105510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/24/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction Little is known about the demands of competitive cheerleading. Therefore, the objective of this study was to assess fatigue and recovery during preparation for world championships. Methods Fifteen participants from the German senior "All-Girl" and "Coed" national teams (nine males and six women) were recruited. Data were collected during the final preparation (T1 -T7) and competition days (C1 -C2). Heart rate variability (HRV) and resting heart rate (HR) were measured every morning. Data on training load, recovery, and stress (Short Scale for Recovery and Stress) were surveyed after training. Countermovement jump height (CMJ), sit-and-reach, and exercise-induced muscle damage (EMID) scores were taken in the afternoon. Results There was a practically relevant decrease in CMJ (T2, T6). A trend for HR to increase (T5-C2) and HRV to decrease (T4, T6-C2) was evident. Through training, recovery decreased and recovered as C1 approached (mental performance: T2-T4 p = 0.004; T2-C1 p = 0.029; T3-T4 p = 0.029; emotional balance: T3-T4 p = 0.023; T3-C1 p = 0.014; general recovery status T1-T3 p = 0.008; T3-T4 p = 0.024; T3-C1 p = 0.041), whereas stress increased during the first days and returned to normal before C1 (emotional dysbalance: T2-T4 p = 0.014; T2-C1 p = 0.009; T3-T4 p = 0.023; T3-C1 p = 0.014). EMID scores increased for the upper and lower body between T3, T5-T7 (p ≤ 0.036) and T3, T6-T7 (p ≤ 0.047), respectively. Discussion Pre-competition training led to substantial fatigue, and most markers indicate that athletes do not compete fully recovered. This could possibly be avoided by optimizing the training load or implementing recovery strategies.
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Affiliation(s)
- Simon Gavanda
- Department of Fitness & Health, IST University of Applied Sciences, Düsseldorf, Germany
- Correspondence: Simon Gavanda
| | | | - Thimo Wiewelhove
- Department of Fitness & Health, IST University of Applied Sciences, Düsseldorf, Germany
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Cook JD, Charest J. Sleep and Performance in Professional Athletes. CURRENT SLEEP MEDICINE REPORTS 2023; 9:56-81. [PMID: 36683842 PMCID: PMC9843114 DOI: 10.1007/s40675-022-00243-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 01/19/2023]
Abstract
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.
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Affiliation(s)
- Jesse D. Cook
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI USA
| | - Jonathan Charest
- Faculty of Kinesiology, University of Calgary, Calgary, AB Canada
- Centre for Sleep & Human Performance, 106, 51 Sunpark Drive SE, Calgary, AB T2X 3V4 Canada
- École de Psychologie, Université Laval, Québec, QC Canada
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Fabries P, Gomez-Merino D, Sauvet F, Malgoyre A, Koulmann N, Chennaoui M. Sleep loss effects on physiological and cognitive responses to systemic environmental hypoxia. Front Physiol 2022; 13:1046166. [PMID: 36579023 PMCID: PMC9792101 DOI: 10.3389/fphys.2022.1046166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
In the course of their missions or training, alpinists, but also mountain combat forces and mountain security services, professional miners, aircrew, aircraft and glider pilots and helicopter crews are regularly exposed to altitude without oxygen supplementation. At altitude, humans are exposed to systemic environmental hypoxia induced by the decrease in barometric pressure (<1,013 hPa) which decreases the inspired partial pressure of oxygen (PIO2), while the oxygen fraction is constant (equal to approximately 20.9%). Effects of altitude on humans occur gradually and depend on the duration of exposure and the altitude level. From 1,500 m altitude (response threshold), several adaptive responses offset the effects of hypoxia, involving the respiratory and the cardiovascular systems, and the oxygen transport capacity of the blood. Fatigue and cognitive and sensory disorders are usually observed from 2,500 m (threshold of prolonged hypoxia). Above 3,500 m (the threshold for disorders), the effects are not completely compensated and maladaptive responses occur and individuals develop altitude headache or acute altitude illness [Acute Mountain Sickness (AMS)]. The magnitude of effects varies considerably between different physiological systems and exhibits significant inter-individual variability. In addition to comorbidities, the factors of vulnerability are still little known. They can be constitutive (genetic) or circumstantial (sleep deprivation, fatigue, speed of ascent.). In particular, sleep loss, a condition that is often encountered in real-life settings, could have an impact on the physiological and cognitive responses to hypoxia. In this review, we report the current state of knowledge on the impact of sleep loss on responses to environmental hypoxia in humans, with the aim of identifying possible consequences for AMS risk and cognition, as well as the value of behavioral and non-pharmacological countermeasures.
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Affiliation(s)
- Pierre Fabries
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), UMR, Université Paris-Saclay, IRBA, Evry-Courcouronnes, France,French Military Health Academy—Ecole du Val-de-Grâce, Place Alphonse Laveran, Paris, France,*Correspondence: Pierre Fabries,
| | - Danielle Gomez-Merino
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Vigilance Fatigue Sommeil et Santé Publique (VIFASOM) URP 7330, Université de Paris Cité, Paris, France
| | - Fabien Sauvet
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,French Military Health Academy—Ecole du Val-de-Grâce, Place Alphonse Laveran, Paris, France,Vigilance Fatigue Sommeil et Santé Publique (VIFASOM) URP 7330, Université de Paris Cité, Paris, France
| | - Alexandra Malgoyre
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), UMR, Université Paris-Saclay, IRBA, Evry-Courcouronnes, France
| | - Nathalie Koulmann
- Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), UMR, Université Paris-Saclay, IRBA, Evry-Courcouronnes, France,French Military Health Academy—Ecole du Val-de-Grâce, Place Alphonse Laveran, Paris, France
| | - Mounir Chennaoui
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Vigilance Fatigue Sommeil et Santé Publique (VIFASOM) URP 7330, Université de Paris Cité, Paris, France
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Fietze I, Glos M. Sport und Schlaf. SOMNOLOGIE 2022. [DOI: 10.1007/s11818-022-00392-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Bulmer S, Corrigan SL, Drain JR, Tait JL, Aisbett B, Roberts S, Gastin PB, Main LC. Characterising Psycho-Physiological Responses and Relationships during a Military Field Training Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14767. [PMID: 36429484 PMCID: PMC9690080 DOI: 10.3390/ijerph192214767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Over a 15-day period, that included an eight-day field trial, the aims of this study were to (1) quantify the physical workload, sleep and subjective well-being of soldiers in training; (2a) Explore relationships between workload and well-being, and (2b) sleep and well-being; (3) Explore relationships between workload, sleep, and well-being. METHODS Sixty-two Combat Engineer trainees (59 male, 3 female; age: 25.2 ± 7.2 years) wore an ActiGraph GT9X to monitor daily energy expenditure, physical activity, and sleep. Rating of perceived exertion (RPE), sleep quality, and fatigue were measured daily, subjective well-being was reported days 1, 5, 9, 13 and 15. Multi-level models were used for the analysis. RESULTS Well-being was affected by a combination of variables including workload, subjective sleep quality, sleep duration, and sleep efficiency. RPE and subjective sleep quality were consistently significant parameters within the models of best fit. CONCLUSIONS Perceptions of well-being were lower during the field training when physical workload increased, and sleep decreased. Energy expenditure was comparatively low, while daily sleep duration was consistent with field training literature. Subjective assessments of workload and sleep quality were consistently effective in explaining variations in well-being and represent an efficient approach to monitor training status of personnel.
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Affiliation(s)
- Sean Bulmer
- Deakin University, Centre for Sport Research, School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia
| | - Sean L. Corrigan
- Deakin University, Centre for Sport Research, School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia
| | - Jace R. Drain
- Defence Science and Technology Group, Fisherman’s Bend, Melbourne, VIC 3207, Australia
| | - Jamie L. Tait
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia
| | - Brad Aisbett
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia
| | - Spencer Roberts
- Deakin University, Centre for Sport Research, School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia
| | - Paul B. Gastin
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia
| | - Luana C. Main
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia
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Tallis J, Guimaraes-Ferreira L, Clarke ND. Not Another Caffeine Effect on Sports Performance Study-Nothing New or More to Do? Nutrients 2022; 14:4696. [PMID: 36364958 PMCID: PMC9658326 DOI: 10.3390/nu14214696] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 11/07/2023] Open
Abstract
The performance-enhancing potential of acute caffeine consumption is firmly established with benefits for many aspects of physical performance and cognitive function summarised in a number of meta-analyses. Despite this, there remains near exponential growth in research articles examining the ergogenic effects of caffeine. Many such studies are confirmatory of well-established ideas, and with a wealth of convincing evidence available, the value of further investigation may be questioned. However, several important knowledge gaps remain. As such, the purpose of this review is to summarise key knowledge gaps regarding the current understanding of the performance-enhancing effect of caffeine and justify their value for future investigation. The review will provide a particular focus on ten research priorities that will aid in the translation of caffeine's ergogenic potential to real-world sporting scenarios. The discussion presented here is therefore essential in guiding the design of future work that will aid in progressing the current understanding of the effects of caffeine as a performance enhancer.
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Affiliation(s)
- Jason Tallis
- Research Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry CV1 5FB, UK
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Pradhan S, Miller TJ. Does rest breed rust? An examination of DNP-Rest decisions and performance in the National Basketball Association regular and post-season. Front Sports Act Living 2022; 4:977692. [PMID: 36329855 PMCID: PMC9622780 DOI: 10.3389/fspor.2022.977692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
Within the National Basketball Association (NBA), players and teams maintain that having healthy players sit out some games during the regular season may help them be more productive during the post-season. This decision to not play in order to rest the player, aptly noted as a DNP-Rest decision on injury reports, is in line with team and player goals, and fits with a growing body of evidence in support of the power of rest for health and performance. However, these practices conflict with some goals of the league, which has a vested interest in having the top talent play to attract broadcasters, advertisers, live spectators, and thus, enhance viewership. The current study is among the first to test the theory that strategically resting healthy players during the regular season results in better performance, as indicated by Player Efficiency Rating (PER) and Win Shares, during the post-season. Utilizing data from the 2016–17 through the 2020–21 NBA seasons, there was not sufficient evidence to suggest that resting more games during the regular season results in better performance in the post-season. Findings from a nested case-control study of 184 players (92 cases; 92 controls) also showed no differences in the change in performance from regular to post-season between cases of players who received rest during the regular season and matched controls. Although the restorative effects of rest might be considerable in the short term, the current study provides additional evidence to suggest that the impact may not carry over into the post-season.
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Affiliation(s)
- Sean Pradhan
- School of Business, Menlo College, Atherton, CA, United States,Center for Sports Management, Menlo College, Atherton, CA, United States,*Correspondence: Sean Pradhan
| | - Travis J. Miller
- Department of Psychology, Menlo College, Atherton, CA, United States
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Arentson-Lantz EJ, Deer RR, Kokonda M, Wen CL, Pecha TA, Carreon SA, Ngyen TM, Volpi E, Nowakowski S. Improvements in sleep quality and fatigue are associated with improvements in functional recovery following hospitalization in older adults. FRONTIERS IN SLEEP 2022; 1:1011930. [PMID: 37251511 PMCID: PMC10217784 DOI: 10.3389/frsle.2022.1011930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Study objectives Poor sleep quality, a frequent problem in older adults, has been shown to be associated with reduced physical function and wellbeing. However, little is known about the relationship between sleep quality and the recovery of physical function following hospitalization. Thus, we conducted this study to examine the association between sleep quality and functional recovery after an acute hospitalization in community dwelling older adults. Methods Older adult patients (N = 23, mean age = 74 ± 9 years) were recruited during an acute hospitalization (average length of stay 3.9 days) with a cardiovascular (56%), pulmonary (22%), or metabolic (13%) admission diagnosis. Objective physical function was measured using the Short Physical Performance Battery (SPPB) and self-reported function was assessed with Katz Index of Independence in Activities of Daily Living (ADL) and Lawton Instrumental Activities of Daily Living Scale (IADL). Sleep quality was measured using Pittsburgh Sleep Quality Index (PSQI) global score and Iowa Fatigue Score (IFS). Testing was performed prior to discharge (baseline) and 4-weeks post-discharge (follow-up). Results Regression models showed PSQI Subjective Sleep Quality change scores from baseline to 4-week follow-up predicted a change in ADL (β = -0.22); PSQI Use of Sleep Medications change scores predicted a change in SPPB Total (β = 1.62) and SPPB Chair Stand (β = 0.63); IFS change scores predicted SPPB Total (β = -0.16) and SPPB Chair Stand performance (β = -0.07) change scores. Conclusions For older adults, changes in sleep medication use, daytime dysfunction, and fatigue were associated with improvements in functional recovery (including physical performance and independence) from acute hospitalization to 4-week follow-up. These results suggest that interventions focused on improving sleep quality, daytime consequences, and fatigue might help enhance physical functioning following hospitalization. Clinical trial registration ClinicalTrials.gov, identifier: NCT02203656.
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Affiliation(s)
- Emily J. Arentson-Lantz
- Department of Nutrition, Metabolism, and Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, United States
| | - Rachel R. Deer
- Department of Nutrition, Metabolism, and Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, United States
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States
| | - Manasa Kokonda
- Center for Innovation in Quality, Effectiveness, and Safety, Michael DeBakey VA Medical Center, Houston, TX, United States
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Chelsey L. Wen
- School of Public Health, University of Texas Health Science Center, Houston, TX, United States
| | - Thomas A. Pecha
- School of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Samantha A. Carreon
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Trung M. Ngyen
- School of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Elena Volpi
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States
| | - Sara Nowakowski
- Department of Nutrition, Metabolism, and Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, United States
- Center for Innovation in Quality, Effectiveness, and Safety, Michael DeBakey VA Medical Center, Houston, TX, United States
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States
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Feingold CL, Smiley A. Healthy Sleep Every Day Keeps the Doctor Away. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10740. [PMID: 36078455 PMCID: PMC9518120 DOI: 10.3390/ijerph191710740] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
When one considers the big picture of their health, sufficient sleep may often go overlooked as a keystone element in this picture. Insufficient sleep in either quality or duration is a growing problem for our modern society. It is essential to look at what this means for our health because insufficient sleep increases our risks of innumerable lifechanging diseases. Beyond increasing the risk of developing these diseases, it also makes the symptoms and pathogenesis of many diseases worse. Additionally, consistent quality sleep can not only improve our physical health but has also been shown to improve mental health and overall quality of life. Substandard sleep health could be a root cause for numerous issues individuals may be facing in their lives. It is essential that physicians take the time to learn about how to educate their patients on sleep health and try to work with them on an individual level to help motivate lifestyle changes. Facilitating access to sleep education for their patients is one way in which physicians can help provide patients with the tools to improve their sleep health. Throughout this paper, we will review the mechanisms behind the relationship between insufficient sleep health and chronic disease and what the science says about how inadequate sleep health negatively impacts the overall health and the quality of our lives. We will also explain the lifechanging effects of sufficient sleep and how we can help patients get there.
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