Sleep, health, and well-being in elite athletes from different sports, before, during, and after international competition

Resilience profiles of elite athletes and their associations with health-related behaviors, well-being, and performance: a latent profile analysis

Resilience is an important factor in the performances of elite athletes as it helps them overcome the adversity they face on a daily basis. It is a dynamic process with resilience qualities evolving throughout athletes' sporting careers. Recent research has established links between resilience, sports performance, lifestyle, and health-related factors. However, no study has yet focused on the resilience profiles of athletes (i.e., sub-groups of individuals with similar levels of different resilience qualities). The aims of this study were to: (a) explore the resilience profiles of elite athletes, (b) determine the characteristics of these resilience profiles (i.e., health-related behaviors, well-being, perceived social support), and (c) determine the correlates of these profiles at intrapersonal and interpersonal levels. Latent profile analysis was performed on 307 French elite athletes. Results revealed "high resilience" and "moderate resilience" profiles. Athletes with "high resilience" profiles were more likely to be men, exhibit better health-related behaviors, and have higher levels of psychological well-being and perceived performance. High levels of conscientiousness, extraversion, the dimensions of the coach-athlete relationship and the motivational climate were also related to the "high resilience" profile. This study is the first to explore the resilience profiles of elite athletes. The results suggest that a high level of resilience is related to the adoption of health-related behaviors favorable to elite sport. Based on these findings, health promotion programs targeting the concept of resilience should be developed in elite sport centers for athletes, coaches, and parents.

Sleep Patterns During Pre-Competition Training Phase: A Comparison Between Male and Female Collegiate Swimmers

Purpose

While there is a rising focus on sleep issues among athletes, a notable gap exists in the comparative analysis of sleep patterns between male and female athletes. This study aims to evaluate the sleep patterns of collegiate swimmers during a specific period (pre-competition training phase) based on the National Sleep Foundation's recommendations and compares sleep differences between males and females.

Patients and Methods

15 swimmers (6 males and 9 females) completed the Athlete Sleep Screening Questionnaire (ASSQ) and wore actigraphy devices for 8 consecutive nights to record objective sleep patterns including bedtime, wake time, sleep onset latency, total sleep time, wake after sleep onset, and sleep efficiency.

Results

The total sleep time of collegiate male (5.0±0.4 h, 4.6 to 5.4h) and female (6.0±0.7 h, 5.5 to 6.5h) swimmers was less than 7 hours per night, and male swimmers' sleep efficiency (76.7±8.9%, 67.4 to 86.0%) was lower than the 85% standard. Male swimmers had less objectively measured sleep duration (p=0.006, d=1.66, large effect), lower sleep efficiency (p=0.013, d=1.51, large effect), and longer wake after sleep onset (p=0.096, d=0.94, moderate effect). Female swimmers had higher sleep difficulty scores (p=0.06, d=1.08, moderate effect), and there was a significant difference in the distribution of sleep difficulty scores between male and female swimmers (p=0.033, V=0.045, small effect).

Conclusion

Collegiate swimmers exhibited poor sleep patterns during pre-competition preparation, and the sleep fragmentation of male swimmers was more pronounced. There were sex differences in both subjective and objective measured sleep patterns, with male swimmers having less sleep and low efficiency, while female swimmers experienced more significant sleep disturbances.

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

Purpose

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

Methods

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

Results

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

Conclusion

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

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

The current study investigated if physical loads peak on game days and if Bio-Electro-Magnetic-Energy-Regulation (BEMER) therapy is affecting sleep duration and sleep quality on nights related to game nights among elite players in Norwegian women's elite football. The sample included 21 female football players from an elite top series club with a mean age of ~24 years (± 2.8). Sleep was measured every day over a period of 273 consecutive days with a Somnofy sleep monitor based on ultra-wideband (IR-UWB) pulse radar and Doppler technology. The current study was conducted as a quasi-experiment, where each player was their own control based on a control period that lasted for 3 months, and an experimental period that lasted for 5 months. Accordantly, the time each player spent with BEMER therapy was used as a control variable. Multivariate analyses of variance using FFMANOVA and univariate ANOVA with False Discovery Rate adjusted p-values show that physical performance (total distance, distance per minute, sprint meters >22.5 kmh, accelerations and decelerations) significantly peak on game day compared with ordinary training days and days related to game days. The results also show that sleep quantity and quality are significantly reduced on game night, which indicate disturbed sleep caused by the peak in physical load. Most sleep variables significantly increased in the experiment period, where BEMER therapy was used, compared to the control period before the introduction of BEMER therapy. Further, the analyses show that players who spent BEMER therapy >440 h had the most positive effects on their sleep, and that these effects were significantly compared to the players who used BEMER therapy <440 h. The findings are discussed based on the function of sleep and the different sleep stages have on recovery.

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

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

Current state and the support system of athlete wellbeing in Japan: The perspectives of the university student-athletes

The optimization of athletes' wellbeing has been increasingly considered essential both in the academic and practical fields of high-performance sports. Various organizations, such as the International Olympic Committee, have highlighted its importance, particularly mental health. Moreover, the increased attention to athlete wellbeing in sport policy debates at the national level has led to the development and implementation of a support system for athletes' mental wellbeing in some countries. Nevertheless, the literature is limited to understanding the case of Japan. Interestingly, only 0.8% of the literature is available on "athlete" and "wellbeing" in Japanese compared to English journals up to 2019. Therefore, the purpose of this study was to identify (a) the current state of wellbeing of Japanese university student-athletes, (b) the level of knowledge about athlete wellbeing, and (c) the athletes' perception of the availability of wellbeing support in the national sports federations, (d) the athlete experience of support services, and develop the types of national support athletes expect and need from the government and national sports federations in the future. As a pilot study, a total of 100 Japanese university student-athletes (43 male, 57 female) from 17 Olympic and seven Paralympic sports completed an online survey. Consequently, the state of their wellbeing was self-perceived as good in all dimensions (i.e., physical, mental, educational, organizational, social, and financial). Moreover, the results showed low recognition of the term "athlete wellbeing" and a lack of knowledge of the availability and accessibility of appropriate support services. The results also showed that Japanese university student-athletes rarely seek help from experts, while 45% indicated "no one" to talk to. Interestingly, however, most athletes considered each dimension of wellbeing important in relation to their performance development. Based on the results, it is necessary to develop an education program, guidelines, and detection systems and improve information accessibility. Given that this pilot study's validity, reliability, and feasibility were verified, further studies should focus more on the wellbeing of Japanese elite athletes in high-performance sports (i.e., Olympic and Paralympic athletes).

Sleep Quality and Sleep Behaviors in Varsity Athletes: A Pilot Study

Sleep hygiene practices may hinder university athletes from obtaining quality sleep to support health and performance. We sought to provide a comprehensive evaluation of sleep quality and behaviors in varsity athletes using validated sleep questionnaires: the Athlete Sleep Screening Questionnaire (ASSQ) and the Athlete Sleep Behavior Questionnaire (ASBQ). Sixty-four (n = 64) athletes participated (54% female; 71% Caucasian). The mean age was 20.3 ± 1.7 years and the mean BMI was 23.3 ± 3.3. Fifty-one percent met the threshold for adequate sleep (7+ h) and 54% reported being somewhat/very satisfied with sleep quality. Global scores for ASSQ Sleep Difficulty and ASBQ sleep behaviors were significantly correlated (r = 0.31; p = 0.014) and not significantly different across age, academic year, or residence. According to the ASSQ, 11% and 24% were classified as having severe or moderate sleep problems, respectively. The ASBQ categorized 62% as having “poor” sleep behaviors. Notable sleep-influencing factors included a high frequency of emotional/cognitive processing of sport-performance issues (46.9%), frequent use of light-emitting devices before bed (90%), training after 7 pm (65%), and the use of sleep medication (19%). Half of the university athletes did not meet the thresholds for adequate sleep, and some may require a referral for clinical sleep issues. The majority of these athletes' sleep behaviors do not promote adequate sleep. The ASSQ shows utility to assess gradations in clinical sleep difficulty; the ASBQ could be used in concert with the ASSQ to discern “cognitive and physiological arousal” targets for use in educational workshops designed to promote optimal sleep hygiene in university athletes.

Validierung des Fragebogens zum Schlafverhalten von Sportlerinnen und Sportlern (FSVS)

Zusammenfassung. Der Athlete Sleep Behavior Questionnaire ist ein englischsprachiger Fragebogen zur Erhebung des individuellen Schlafverhaltens von Sportler_innen. Ziel dieser Studie war die Übersetzung des Athlete Sleep Behavior Questionnaire ins Deutsche sowie die wissenschaftliche Validierung dieser deutschen 18-Item-Version, dem Fragebogen zum Schlafverhalten von Sportlerinnen und Sportlern (FSVS). Die Validierungsstichprobe umfasste 450 Teilnehmende. Mittels eines dichotomen Items zur regelmäßigen Wettkampfteilnahme (ja/nein) wurde in Wettkampfsportler_innen ( n = 209) und Kontrollgruppe ( n = 241) unterteilt. Cronbach-α des FSVS-Gesamtwerts ergab .66. Die Pearson-Produkt-Moment-Korrelationsanalysen ergaben moderate Korrelationen zwischen FSVS-Gesamtwert, der Epworth-Sleepiness-Scale ( r = .33) und dem Pittsburgh-Sleep-Quality-Index ( r = .30). Es wurden signifikante Gruppenunterschiede für den FSVS-Gesamtwert gefunden, t‍(448) = 4.47, p < .001, d = 0.42, bei deskriptiv höheren Werten der Gruppe der Wettkampfsportler_innen. In einer separaten Stichprobe, die 13 Ruderer_innen der deutschen Junioren-Nationalmannschaft umfasste, wurden die Fragebogenwerte anschließend mit objektiven Schlafparametern korreliert. Dabei ließ sich eine hohe Korrelation zwischen FSVS-Gesamtwert und Einschlaflatenz ( rs = .68, p = .011) erkennen. Zusammenfassend ist der FSVS ein schnelles und valides Werkzeug, um dysfunktionale Schlafverhaltensweisen bei Wettkampfsportler_innen zu identifizieren. In Anlehnung an die Originalversion wird die Ableitung von Interventionen anhand einzelner Items empfohlen.

Sleep Quality and Training Intensity in Soccer Players: Exploring Weekly Variations and Relationships

The aim of this study was twofold: it (i) analyzed the weekly variations of sleep quality and training intensity of youth soccer players and (ii) analyzed the relationships between sleep quality and training intensity. This study followed an observational design. Twenty men youth players (age: 18.81 ± 0.41 years) were monitored daily over two weeks for sleep quality and training intensity. Sleep quality was measured daily using the 15-item consensus sleep diary. The training intensity was measured daily using the CR-10 Borg’s scale as a measure of rate of perceived exertion (RPE); a heart rate (HR) sensor was used to measure minimum, average and peak; a global positioning system (GPS) was used for measuring the total distance covered and distances covered at different speed thresholds. Repeated measures ANOVA was used to analyze the weekly variations of sleep quality and training intensity. The Pearson correlation test was executed to analyze the relationships between sleep quality and training intensity. Repeated measures ANOVA revealed significant within-week variations in sleep duration (hours) (p = 0.043), quality of sleep (p = 0.035), RPE (p = 0.007), session-RPE (p = 0.011), HRminimum (p = 0.027), HRpeak (p = 0.005), total distance (p < 0.001), pace (p < 0.002), distance covered at 3.00–6.99 km/h (p < 0.001), distance covered at 7.00–10.99 km/h (p < 0.001), distance covered at 11.00–14.99 km/h (p < 0.001), distance covered at 15.00–18.99 km/h (p < 0.001) and distance covered at >19.00 km/h (p < 0.001). Significant small correlations were found between sleep duration before training and session-RPE (r = 0.252), total distance (r = 0.205), distance covered at 3.00–6.99 km/h (r = 0.209) and distance covered at 7.00–10.99 km/h (r = 0.265). Significant small correlations were found between session-RPE and sleep duration after (r = 0.233), total distance and quality of sleep after (r = 0.198), distance at 3.00–6.99 km/h and quality of sleep after training (r = 0.220), distance covered at >19.00 km/h and quality of sleep after training (r = 0.286), session duration and rested feeling after training (r = 0.227), total distance and rested feeling after training (r = 0.202), distance covered at 11.00–14.99 km/h and rested feeling after training (r = 0.222) and distance covered at >19.00 km/h and rested feeling after training (r = 0.214). In conclusion, sleep duration was longer in the training sessions during the middle of the week; the training intensity was also greater (485.8 ± 56.8 A.U.). Moreover, sleep outcomes after training were slightly correlated with both physiological and locomotor demands.

Effects of sleep self-monitoring via app on subjective sleep markers in student athletes

As sleep problems are highly prevalent among university students and competitive athletes, and the application of commercial sleep technologies may be either useful or harmful, this study investigated the effects of a 2-week sleep self-monitoring on the sleep of physically active university students (n = 98, 21 ± 1.7 years). Two intervention groups used a free sleep app (Sleep Score; SleepScore Labs™, Carlsbad, CA, USA: n = 20 or Sleep Cycle; Sleep Cycle AB, Gothenburg, Sweden: n = 24) while answering online sleep diaries. They used the app analysis function in week 1 and the 'smart alarm' additionally in week 2. As controls, one group answered the online sleep diary without intervention (n = 21) and another the pre-post questionnaires only (n = 33). Facets of subjective sleep behaviour and the role of bedtime procrastination were analysed. Multilevel models did not show significant interactions, indicating intervention effects equal for both app groups. Sleep Cycle users showed trends toward negative changes in sleep behaviour, while the online sleep diary group showed more, tendentially positive, developments. Bedtime procrastination was a significant predictor of several variables of sleep behaviour and quality. The results indicate neither benefits nor negative effects of app-based sleep self-tracking. Thus, student athletes do not seem to be as susceptible to non-validated sleep technologies as expected. However, bedtime procrastination was correlated with poor sleep quality and should be addressed in sleep intervention programmes.

International survey of training load monitoring practices in competitive swimming: How, what and why not?

OBJECTIVE

The purpose of this study is to identify the training load (TL) monitoring practices employed in real-world competitive swimming environments. The study explores data collection, analysis and barriers to TL monitoring.

DESIGN

Cross-sectional.

SETTING

Online survey platform.

PARTICIPANTS

Thirty-one responders working in competitive swimming programmes.

MAIN OUTCOME MEASURES

Methods of data collection, analysis, level of effectiveness and barriers associated with TL monitoring.

RESULTS

84% of responders acknowledged using TL monitoring, with 81% of responders using a combination of both internal and external TL, in line with current consensus statements. Swim volume (mileage) (96%) and session rate of perceived exertion (sRPE) (92%) were the most frequently used, with athlete lifestyle/wellness monitoring also featuring prominently. Thematic analysis highlighted that "stakeholder engagement", "resource constraints" or "functionality and usability of the systems" were shared barriers to TL monitoring amongst responders.

CONCLUSIONS

Findings show there is a research-practice gap. Future approaches to TL monitoring in competitive swimming should focus on selecting methods that allow the same TL monitoring system to be used across the whole programme, (pool-based training, dryland training and competition). Barriers associated with athlete adherence and coach/National Governing Body engagement should be addressed before a TL system implementation.

Variations in Elite Female Soccer Players' Sleep, and Associations With Perceived Fatigue and Soccer Games

The current study investigated the associations between female perceived fatigue of elite soccer players and their sleep, and the associations between the sleep of players and soccer games. The sample included 29 female elite soccer players from the Norwegian national soccer team with a mean age of ~26 years. Perceived fatigue and sleep were monitored over a period of 124 consecutive days. In this period, 12.8 ± 3.9 soccer games per player took place. Sleep was monitored with an unobtrusive impulse radio ultra-wideband Doppler radar (Somnofy). Perceived fatigue was based on a self-report mobile phone application that detected daily experienced fatigue. Multilevel analyses of day-to-day associations showed that, first, increased perceived fatigue was associated with increased time in bed (3.6 ± 1.8 min, p = 0.037) and deep sleep (1.2 ± 0.6 min, p = 0.007). Increased rapid eye movement (REM) sleep was associated with subsequently decreased perceived fatigue (−0.21 ± 0.08 arbitrary units [AU], p = 0.008), and increased respiration rate in non-REM sleep was associated with subsequently increased fatigue (0.27 ± 0.09 AU, p = 0.002). Second, game night was associated with reduced time in bed (−1.0 h ± 8.4 min, p = <0.001), total sleep time (−55.2 ± 6.6 min, p = <0.001), time in sleep stages (light: −27.0 ± 5.4 min, p = <0.001; deep: −3.6 ± 1.2 min, p = 0.001; REM: −21.0 ± 3.0 min, p = <0.001), longer sleep-onset latency (3.0 ± 1.2 min, p = 0.013), and increased respiration rate in non-REM sleep (0.32 ± 0.08 respirations per min, p = <0.001), compared to the night before the game. The present findings show that deep and REM sleep and respiration rate in non-REM sleep are the key indicators of perceived fatigue in female elite soccer players. Moreover, sleep is disrupted during game night, likely due to the high physical and mental loads experienced during soccer games. Sleep normalizes during the first and second night after soccer games, likely preventing further negative performance-related consequences.