Effect of time of day and partial sleep deprivation on the reaction time and the attentional capacities of the handball goalkeeper

Behavioral interventions and behavior change techniques used to improve sleep outcomes in athlete populations: A scoping review

BACKGROUND

Athletes display a high prevalence of undesired sleep characteristics that may affect both performance and wellbeing.

OBJECTIVES

This scoping review aimed to identify and map the existing evidence of behavioral sleep interventions and their effects on sleep outcomes in athletes, and retrospectively code the behavior change techniques (BCTs) implemented using the Behavior Change Technique Taxonomy (BCTTv1).

METHODS

Conducted following the JBI methodology for scoping reviews, four online databases were used to identify prospective interventions with at least one behavioral component in competitive athletes, and reporting a sleep outcome pre- and post-intervention.

RESULTS

Thirty-three studies met the inclusion criteria, encompassing 892 participants with a median age of 23. Five intervention categories were identified (education, mind-body practices, direct, multi-component, and other), with each demonstrating mixed efficacy but the potential to improve sleep outcomes. The BCTs varied in type and frequency between each category, with only 18 unique BCTs identified across all studies.

CONCLUSIONS

The varied efficacy of previous studies at improving sleep outcomes may be attributed to the lack of behavior change theory applied during intervention development. Designing interventions following a targeted specification of the behavioral problem, and the integration of corresponding BCTs should be considered in future research.

Impact of one night of sleep restriction on sleepiness and cognitive function: A systematic review and meta-analysis

Detrimental consequences of chronic sleep restriction on cognitive function are well established in the literature. However, effects of a single night of sleep restriction remain equivocal. Therefore, we synthesized data from 44 studies to investigate effects of sleep restriction to 2-6 h sleep opportunity on sleepiness and cognition in this meta-analysis. We investigated subjective sleepiness, sustained attention, choice reaction time, cognitive throughput, working memory, and inhibitory control. Results revealed a significant increase in subjective sleepiness following one night of sleep restriction (Standardized Mean Difference (SMD) = 0.986, p < 0.001), while subjective sleepiness was not associated with sleep duration during sleep restriction (β = -0.214, p = 0.039, significance level 0.01). Sustained attention, assessed via common 10-min tasks, was impaired, as demonstrated through increased reaction times (SMD = 0.512, p < 0.001) and attentional lapses (SMD = 0.489, p < 0.001). However, the degree of impaired attention was not associated with sleep duration (ps > 0.090). We did not find significant effects on choice reaction time, cognitive throughput, working memory, or inhibitory control. Overall, results suggest that a single night of restricted sleep can increase subjective sleepiness and impair sustained attention, a cognitive function crucial for everyday tasks such as driving.

The effect of last meal "Suhoor" timing on diurnal variations in cognitive performance during Ramadan fasting among female athletes

The present study aimed to investigate the effect of the timing of the last meal, "Suhoor", on diurnal variation in cognitive performance during Ramadan intermittent fasting (RIF). In a randomized order, 26 adolescent female athletes (aged 15.9 ± 0.9 y) were tested in three sessions at 7:00 a.m., 12:00 p.m., and 5:00 p.m. across four different conditions: the 10 days preceding Ramadan (PR); the final 12 days of Ramadan (RO): two different conditions: Early Suhoor (SEarly), and Late Suhoor (SLate); and, ultimately, the 10 days immediately after Ramadan (AR) with an in-between recovery period of ≥24 h. During each test session, the oral temperature (OT), simple reaction time test (SRT), choice reaction time test (CRT), attention test (ATT), and mental rotation test (MRT) were evaluated. The Pittsburgh Sleep Quality Index (PSQI) and daily diary intake were assessed across the three periods. Compared to PR, the sleep parameters assessed by the PSQI were significantly lower during the RO and AR periods. However, neither total dietary intake nor OT showed any changes due to RIF. Compared to PR, the afternoon performances of SRT, CRT, ATT, and MRT significantly declined under both the SEarly and SLate conditions. Notably, midday performance decreased only during SLate, while morning performance remained unaffected in both conditions. Additionally, compared to SEarly, these performances were better during SLate in the afternoon and at midday. In summary, nutrient intake timing had a significant effect on the diurnal fluctuations in cognitive functions during Ramadan fasting, particularly around noon and in the afternoon. Our results illustrate the benefits of a late last meal (Suhoor) in preserving optimal morning cognitive abilities and preventing any impairment during the fasted state at midday or in the afternoon, which could affect overall athletic performance.

The effects of sleep deprivation and extreme exertion on cognitive performance at the world-record breaking Suffolk Back Yard Ultra-marathon

Using a prospective observational design, this study investigated the hypothesis that competing in the Suffolk Back Yard Ultra-marathon, would result in impaired cognitive performance and examined whether pre-race sleep patterns could mitigate this. Fifteen runners (1 female) volunteered to undertake this study and eleven males were included in the final analysis. Before the race and after withdrawal participants completed the following cognitive performance tasks: 2 Choice Reaction Time (2CRT), Stroop, and the Tower Puzzle. Pre-race sleep strategies were subjectively recorded with a 7-day sleep diary. Following race withdrawal, reaction time increased (Δ 77±68 ms; p = 0.004) in the 2CRT and executive function was impaired in the Stroop task (Interference score Δ -4.3±5.6 a.u.; p = 0.028). Decision making was not affected in the Tower Puzzle task. There was a significant correlation between the pre-race 7-day average sleep scores and both 2CRT Δ throughput (r = 0.61; p = 0.045) and 2CRT Δ RT (r = -0.64; p = 0.034). This study supports the hypothesis that running an ultra-marathon, which includes at least one night of sleep deprivation, impairs cognitive performance and provides novel evidence suggesting good sleep quality, in the week prior to an ultra-marathon, could minimise these effects.

Diurnal variation in variables related to cognitive performance: a systematic review

PURPOSE

The aim of this review was to assess current evidence regarding changes in cognitive function according to time-of-day (TOD) and assess the key components of research design related to manuscripts of chronobiological nature.

METHODS

An English-language literature search revealed 523 articles through primary database searches, and 1868 via organization searches/citation searching. The inclusion criteria were met by eleven articles which were included in the review. The inclusion criteria set were healthy adult males, a minimum of two timepoints including morning and evening, cognitive measures of performance, and peer-reviewed academic paper.

RESULTS

It was established that cognitive performance varies with TOD and the degree of difference is highly dependent on the type of cognitive task with differences ranging from 9.0 to 34.2% for reaction time, 7.3% for alertness, and 7.8 to 40.3% for attention. The type of cognitive function was a determining factor as to whether the performance was better in the morning, evening, or afternoon.

CONCLUSION

Although some studies did not establish TOD differences, reaction time and levels of accuracy were highest in the evening. This implies that cognitive processes are complex, and existing research is contradictory. Some studies or cognitive variables did not show any measurable TOD effects, which may be due to differences in methodology, subjects involved, testing protocols, and confounding factors. No studies met all requirements related to chronobiological research, highlighting the issues around methodology. Therefore, future research must use a rigorous, approach, minimizing confounding factors that are specific to examinations of TOD.

The relationship between sleep, perfectionistic strivings, perfectionistic concerns, and academic and sports performance in young athletes

Perfectionism is associated with sleep as well as with academic and sports performance. Given the importance of sleep for performance and the sleep changes that occur during adolescence, the present study aimed to explore the relationship between sleep, two dimensions of perfectionism (perfectionistic strivings and perfectionistic concerns), with academic and sports performance in young athletes. The occurrence of perfectionistic strivings was identified as a tendency to set high personal standards for oneself, while the occurrence of perfectionistic concerns was identified as a tendency to feel pressure to be perfect and have concerns about imperfections. A total of 32 athletes aged 13 to 16 years old participated in this study. Perfectionism, sleep, and course grades were measured at the end of the school year. Sleep was measured by actigraphy, and sports performance improvement was obtained by comparing individual performance at the beginning and the end of the school year. The moderating effect of both dimensions of perfectionism on the relationships between sleep and academic and sports performance improvement was measured. First, results showed no significant relationship between sleep and academic/sports performance. Further analyses revealed that perfectionistic strivings moderated the relationship between certain aspects of sleep with academic and sports performance improvement. Delayed and suboptimal sleep habits were associated with lower academic and sports performance improvement when low levels of perfectionistic strivings were present. Results with perfectionistic concerns showed that this dimension did not moderate the relationship between sleep and academic and sports performance improvement. This study supports the notion that high levels of perfectionistic strivings in young athletes may mitigate the adverse effects of poor sleep habits in young athletes.

The Impact of Multisession Sleep-Hygiene Strategies on Sleep Parameters in Elite Swimmers

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.

Circadian preference and physical and cognitive performance in adolescence: A scoping review

Adolescence is a crucial period of development which coincides with changes in circadian rhythmicity. This may augment the impact of circadian preference on performance in this group. We aimed to scope the literature available on chronotypes and their effect on physical and mental aspects of performance in adolescents. Studies were identified by systematically searching bibliographical databases and grey literature. The Morningness-Eveningness Questionnaire was the most frequently reported tool for circadian preference assessment. Academic achievement was the most prevailing outcome, with evidence suggesting that morning type adolescents tend to outperform evening types, yet the results vary depending on multiple factors. Performance in tests of intelligence and executive functions was generally better at optimal times of the day (synchrony effect). Physical performance was examined in 8 studies, with very heterogeneous outcomes. Although the associations between circadian preference and performance in adolescents are evident in some areas, there are many factors that may be involved in the relationship and require further investigation. This review highlights the assessment of physical performance in relation to chronotypes, the multidimensional assessment of circadian preference, and the need for longitudinal studies as priorities for further research.Protocol: OSF Registration - Public registration, DOI: 10.17605/OSF.IO/UCA3Z.

Diurnal Variation of Specific Tests' Performance and Related Psychological Aspects in Young Judo Athletes

Purpose: This study investigated the effects of time-of-day on judo athletes' performances and the associated psychological variables and perceived exertion following judo-specific tests. Methods: Twelve male judo athletes (age: 16 ± 1 years) performed in a randomized and counterbalanced order the special judo fitness test (SJFT), the judo physical fitness test (JPFT), the dynamic and isometric judogi chin-up tests in the morning (8:00 a.m), midday (12:00 p.m), and afternoon (5:00 p.m). Oral temperature and psychological variables [profile of mood state (POMS), Hooper questionnaire, total quality of recovery (TQR)] were assessed before and after the tests, and ratings of perceived exertion (RPE) and the physical activity enjoyment scale (PACES) were assessed only after the tests. Results: RPE score was higher in the morning compared to the afternoon after the JPFT (d = 0.38, p = .045). PACES after JPFT was higher in the morning compared to midday (d = 0.85, p < .001). The isometric and dynamic performances during chin-up tests were higher in the afternoon compared to the morning (d = 0.38, p = .048 and 0.047, respectively). Also, oral temperature was higher in the afternoon compared to the morning (d = 0.41, p = .050) and the midday (p = .047) for dynamic test, while TQR, well-being indices, and POMS did not differ according to time-of-day (p > .05). Conclusions: These results suggest that dynamic and isometric judo chin-up tests are time-of-day dependent with higher performance recorded in the afternoon than in the morning. However, performances in the JPFT and SJFT were not time-of-day dependent.

The Impact of Sleep Interventions on Athletic Performance: A Systematic Review

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.

Sleep and Sport Performance

SUMMARY

Elite athletes and coaches believe sleep is the most important recovery strategy and widely consider it critical to optimal performance. Despite this perceived importance, there are numerous circumstances that can reduce sleep quantity and quality in athletic populations. Because of the effects of sleep loss on various physical, neurophysiological, and cognitive parameters, such perturbations can have consequences for performance and recovery outcomes. Although peer-reviewed literature examining the interaction between sleep, performance, and recovery in athletes is increasing, understanding of these issues remains equivocal. Perhaps most pertinently, the effect of sleep on sport performance does not align with a one-size-fits-all approach and rather depends on numerous factors such as type of sport, scheduling, time of the season, and the intraindividual requirements for sleep. The relationship between brain plasticity and memory, which in turn can influence learning processes and long-term memory consolidation, suggests that sleep may play an important role in learning new skills and tactics for both elite and developing athletes. The aim of this special issue review was to analyze the evidence of sleep loss on sport performance and recovery, with a specific focus on elite athletes. An assessment of these sleep-compromising situations that elite athletes may face during a typical season and practical considerations for alleviating these issues is also provided to further the understanding for medical professionals, scientists, and applied sporting practitioners alike.

The Impact of Kiwifruit Consumption on the Sleep and Recovery of Elite Athletes

BACKGROUND

Poor sleep and resultant under-recovery can negatively impact training adaptations, increase the risk of injury and reduce subsequent performance. Due to the 'food first' approach adopted by many athletes, there is scope for investigation of 'functional food' based interventions (i.e., kiwifruit contains melatonin which plays a role in circadian rhythm regulation) designed to promote athlete recovery and/or enhance sleep quality and quantity.

METHODS

Following the baseline assessment (Week 1) all subjects began the intervention (Weeks 2-5). During the 4-week intervention, participants were asked to consume 2 medium-sized green kiwifruit (Actinidia Deliciosa) an hour before bed. Participants completed a questionnaire battery at baseline and post-intervention, and a daily sleep dairy for the duration of the study.

RESULTS

The results demonstrated a positive impact of kiwifruit consumption on key aspects of sleep and recovery in elite athletes. From baseline to post-intervention, there were clinically significant improvements in sleep quality (i.e., improved PSQI global scores and sleep quality component scores) and improvements in recovery stress balance (reduced general stress and sports stress scales). Moreover, the intervention improved sleep as evidenced by significant increases in total sleep time and sleep efficiency % and significant reductions in number of awakenings and wake after sleep onset.

CONCLUSION

The findings broadly suggested that kiwifruit does impact positively on sleep and recovery in elite athletes.

Sleep Patterns Fluctuate Following Training and Games across the Season in a Semi-Professional, Female Basketball Team

Quantifying athlete sleep patterns may inform development of optimal training schedules and sleep strategies, considering the competitive challenges faced across the season. Therefore, this study comprehensively quantified the sleep patterns of a female basketball team and examined variations in sleep between nights. Seven semi-professional, female basketball players had their sleep monitored using wrist-worn activity monitors and perceptual ratings during a 13-week in-season. Sleep variables were compared between different nights (control nights, training nights, training nights before games, nights before games, non-congested game nights, and congested game nights), using generalized linear mixed models, as well as Cohen's d and odds ratios as effect sizes. Players experienced less sleep on training nights before games compared to control nights, training nights, nights before games, and congested game nights (p < 0.05, d = 0.43-0.69). Players also exhibited later sleep onset times on non-congested game nights compared to control nights (p = 0.01, d = 0.68), and earlier sleep offset times following training nights before games compared to all other nights (p < 0.01, d = 0.74-0.79). Moreover, the odds of players attaining better perceived sleep quality was 88% lower on congested game nights than on nights before games (p < 0.001). While players in this study attained an adequate sleep duration (7.3 ± 0.3 h) and efficiency (85 ± 2%) on average across the in-season, they were susceptible to poor sleep on training nights before games and following games. Although limited to a team-based case series design, these findings suggest basketball coaches may need to reconsider scheduling team-based, on-court training sessions on nights prior to games and consider implementing suitable psychological and recovery strategies around games to optimize player sleep.

A Multiday Professional Padel Tournament Impairs Sleep, Mental Toughness, and Reaction Time: A World Padel Tour Field Study

This study aimed to assess, for the first time, how self-reported sleep, mental toughness, and reaction time are impacted by a professional padel tournament. In addition, we evaluated whether sex, age, and/or ranking play a role in this possible effect of a tournament on these variables. Twenty-three professional players (15 men, Mage = 24 ± 6 years; eight women, Mage = 21 ± 5 years) were evaluated on two occasions: (a) baseline, in a noncompetitive week and (b) postmeasure, the morning after an individual was eliminated from the tournament. The Pittsburgh Sleep Quality Index, the Mental Toughness Questionnaire, and the psychomotor vigilance task were used to evaluate the dependent variables. Wilcoxon tests or paired samples t tests were employed to assess the effect of participating in the tournament. To test correlations between variables, Pearson correlation coefficients (quantitative variables) or chi-square distributions (qualitative variables) were employed. Results showed that self-reported sleep (p < .01), mental toughness (p = .01), and reaction time (p = .04) were significantly impaired by the tournament. Exploring moderating variables, results showed that mental toughness did not correlate with sleep impairments (p > .05). In contrast, a nearly significant correlation between sleep impairments and higher reaction times was found (p = .066). No significant effects of age, sex, and ranking were observed. In conclusion, participating in a padel competition impairs the self-reported sleep, mental toughness, and reaction time of professional padel players. A trend toward a significant correlation between the competition-related impairment in sleep and reaction time was observed, whereas age, ranking, and sex were not found to be moderators of any of these impairments.

Schlaf und Wettkämpfe bei jungen AthletInnen

Hintergrund

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

Ziel der Arbeit

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

Material und Methode

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

Ergebnisse

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

Diskussion

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

The Impact of Dietary Factors on the Sleep of Athletically Trained Populations: A Systematic Review

Many athletic populations report poor sleep, especially during intensive training and competition periods. Recently, diet has been shown to significantly affect sleep in general populations; however, little is known about the effect diet has on the sleep of athletically trained populations. With sleep critical for optimal recovery and sports performance, this systematic review aimed to evaluate the evidence demonstrating that dietary factors influence the sleep of athletically trained populations. Four electronic databases were searched from inception to May 2022, with primary research articles included if they contained a dietary factor(s), an outcome measure of sleep or sleepiness, and participants could be identified as ‘athletically trained’. Thirty-five studies were included, with 21 studies assessed as positive quality, 13 as neutral, and one as negative. Sleep or sleepiness was measured objectively in 46% of studies (n = 16). The review showed that evening (≥5 p.m.) caffeine intakes >2 mg·kg−1 body mass decreased sleep duration and sleep efficiency, and increased sleep latency and wake after sleep onset. Evening consumption of high glycaemic index carbohydrates and protein high in tryptophan may reduce sleep latency. Although promising, more research is required before the impact of probiotics, cherry juice, and beetroot juice on the sleep of athletes can be resolved. Athletic populations experiencing sleep difficulties should be screened for caffeine use and trial dietary strategies (e.g., evening consumption of high GI carbohydrates) to improve sleep.

Sleep and the Young Athlete

CONTEXT

Sleep plays a vital role in cognitive and physical performance. Teenage athletes (ages 13-19 years) are considered especially at risk for disordered sleep and associated negative cognitive, physical, and psychosomatic effects. However, there is a paucity of evidence-based recommendations to promote sleep quality and quantity in athletes who fall within this age range. We performed a review of the literature to reveal evidence-based findings and recommendations to help sports instructors, athletic trainers, physical therapists, physicians, and other team members caring for young athletes provide guidance on sleep optimization for peak sports performance and injury risk reduction.

METHODS

PubMed, Scopus, and Cochrane CENTRAL were searched on May 11, 2016, and then again on September 1, 2020, for relevant articles published to date.

STUDY DESIGN

Narrative review.

LEVEL OF EVIDENCE

Level 4.

RESULTS

Few studies exist on the effects disordered sleep may have on teenage athletes. By optimizing sleep patterns in young athletes during training and competitions, physical and mental performance, and overall well-being, may be optimized. Adequate sleep has been shown to improve the performance of athletes, although further studies are needed.

CONCLUSION

Twenty-five percent of total sleep time should be deep sleep, with a recommended sleep time of 8 to 9 hours for most young athletes. Screen and television use during athletes' bedtime should be minimized to improve sleep quality and quantity. For young athletes who travel, jet lag can be minimized by allowing 1 day per time zone crossed for adjustment, limiting caffeine intake, planning meals and onboard sleeping to coincide with destination schedules, timing arrivals in the morning whenever possible, and using noise-canceling headphones and eyeshades.

STRENGTH-OF-RECOMMENDATION TAXONOMY (SORT)

B.

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

Sleep health is an important consideration for athletic performance. Athletes are at high risk of insufficient sleep duration, poor sleep quality, daytime sleepiness and fatigue, suboptimal sleep schedules, irregular sleep schedules, and sleep and circadian disorders. These issues likely have an impact on athletic performance via several domains. Sleep loss and/or poor sleep quality can impair muscular strength, speed, and other aspects of physical performance. Sleep issues can also increase risk of concussions and other injuries and impair recovery after injury. Cognitive performance is also impacted in several domains, including vigilance, learning and memory, decision making, and creativity.

Acute Sleep Deprivation Impairs Motor Inhibition in Table Tennis Athletes: An ERP Study

Excellent response inhibition is the basis for outstanding competitive athletic performance, and sleep may be an important factor affecting athletes’ response inhibition. This study investigates the effect of sleep deprivation on athletes’ response inhibition, and its differentiating effect on non-athlete controls’ performance, with the aim of helping athletes effectively improve their response inhibition ability through sleep pattern manipulation. Behavioral and event-related potential (ERP) data were collected from 36 participants (16 table tennis athletes and 20 general college students) after 36 h of sleep deprivation using ERP techniques and a stop-signal task. Sleep deprivation’s different effects on response inhibition in the two groups were explored through repeated-measures ANOVA. Behavioral data showed that in a baseline state, stop-signal response time was significantly faster in table tennis athletes than in non-athlete controls, and appeared significantly longer after sleep deprivation in both groups. ERP results showed that at baseline state, N2, ERN, and P3 amplitudes were lower in table tennis athletes than in non-athlete controls, and corresponding significant decreases were observed in non-athlete controls after 36 h of sleep deprivation. Table tennis athletes showed a decrease in P3 amplitude and no significant difference in N2 and ERN amplitudes, after 36 h of sleep deprivation compared to the baseline state. Compared to non-athlete controls, table tennis athletes had better response inhibition, and the adverse effects of sleep deprivation on response inhibition occurred mainly in the later top-down motor inhibition process rather than in earlier automated conflict detection and monitoring.

Sleep Restriction in Elite Soccer Players: Effects on Explosive Power, Wellbeing, and Cognitive Function

Purpose: To investigate the cognitive, physical, and perceptual effects of sleep restriction (SR) in soccer players following a night match. Methods: In a crossover design, nine male soccer players from the English Premier League 2 (age, 21 ± 5 years; height, 1.80 ± 0.75 m; body mass, 74.2 ± 6.8 kg) recorded their sleep quality and quantity with sleep logs and a subjective survey after two night matches (19:00); one where sleep duration was not altered (CON) and one where sleep was restricted by a later bed-time (SR). Countermovement jump height (CMJ), subjective wellbeing (1-5 likert scale for mood, stress, fatigue, sleep, and soreness), and cognitive function were measured at baseline and the morning following the match (+12 h; M + 1). Results: Bed-time was later in SR than CON (02:36 ± 0.17 vs. 22:43 ± 29; P = .0001; ηp² = 0.999) and sleep duration was shorter in SR than CON (5.37 ± 0.16 vs. 8.59 h ± 0.36; P = .0001; ηp² = 0.926). CMJ decreased by ~8% after the match in both SR and CON (P = .0001; ηp² = 0.915) but there were no differences between the conditions (P > .05; ηp² = 0.041-0.139). Wellbeing was rated worse after both matches (P = .0001; ηp² = 0.949) but there were no differences between the trials (P > .05; ηp² = 0.172-257). SR did not influence cognitive function (P > .05; interaction effects, ηp² = 0.172-257). Conclusion: SR following a nighttime soccer match does not impair CMJ performance, subjective wellbeing, or cognitive function the following morning.

Sleep Duration Correlates With Performance in Ultra-Endurance Triathlon

The relationship between sleep duration, sleep quality, and race completion time during each stage of a 3-day ultra-endurance triathlon (stage 1: 10-km swim, 146-km cycle; stage 2: 276-km cycle; and stage 3: 84.4-km run) was investigated. Seventeen triathletes partook in sleep analysis throughout the ultra-endurance multiday triathlon using an actigraphy wristband. The participants wore the band to record objective sleep outcomes for approximately 4 days (1-2 d prerace, 3 race days, and 1 d postrace), except while racing. The total sleep time (TST; prerace: 414.1 [95.3] min, prestage 1: 392.2 [138.3] min, prestage 2: 355.6 [62.5] min, and prestage 3: 299.7 [107.0] min) significantly decreased over time (P < .05). Significant Pearson moment-product correlations were found between TST and subsequent race-day performance for race stage 1 (r = -.577; P = .019) and stage 3 (r = -.546; P = .035), with further analysis revealing that TST explained 33% and 30% of the variation in performance for stages 1 and 3, respectively. During a 3-day ultra-endurance triathlon, the TST was reduced and had a significant negative correlation to exercise performance, indicating that sleep loss was associated with slower performances. Sleep onset latency, wake episodes, and sleep efficiency did not significantly change over the course of this investigation, which may stem from the close proximity of exercise to sleep.

The Sleep and Recovery Practices of Athletes

BACKGROUND

Athletes maintain a balance between stress and recovery and adopt recovery modalities that manage fatigue and enhance recovery and performance. Optimal TST is subject to individual variance. However, 7-9 h sleep is recommended for adults, while elite athletes may require more quality sleep than non-athletes.

METHODS

A total of 338 (elite n = 115, 74 males and 41 females, aged 23.44 ± 4.91 years; and sub-elite n = 223, 129 males and 94 females aged 25.71 ± 6.27) athletes were recruited from a variety of team and individual sports to complete a battery of previously validated and reliable widely used questionnaires assessing sleep, recovery and nutritional practices.

RESULTS

Poor sleep was reported by both the elite and sub-elite athlete groups (i.e., global PSQI score ≥5-elite 64% [n = 74]; sub-elite 65% [n = 146]) and there was a significant difference in sport-specific recovery practices (3.22 ± 0.90 vs. 2.91 ± 0.90; p < 0.001). Relatively high levels of fatigue (2.52 ± 1.32), stress (1.7 ± 1.31) and pain (50%, n = 169) were reported in both groups. A range of supplements were used regularly by athletes in both groups; indeed, whey (elite n = 22 and sub-elite n = 48) was the most commonly used recovery supplement in both groups. Higher alcohol consumption was observed in the sub-elite athletes (12%, n = 26) and they tended to consume more units of alcohol per drinking bout.

CONCLUSION

There is a need for athletes to receive individualised support and education regarding their sleep and recovery practices.

Quantifying Cognitive Impairment After Sleep Deprivation at Different Times of Day: A Proof of Concept Using Ultra-Short Smartphone-Based Tests

Cognitive functioning is known to be impaired following sleep deprivation and to fluctuate depending on the time of day. However, most methods of assessing cognitive performance remain impractical for environments outside of the lab. This study investigated whether 2-min smartphone-based versions of commonly used cognitive tests could be used to assess the effects of sleep deprivation and time of day on diverse cognitive functions. After three nights of normal sleep, participants (N = 182) were randomised to either one night of sleep deprivation or a fourth night of normal sleep. Using the Karolinska WakeApp (KWA), participants completed a battery of 2-min cognitive tests, including measures of attention, arithmetic ability, episodic memory, working memory, and a Stroop test for cognitive conflict and behavioural adjustment. A baseline measurement was completed at 22:30 h, followed by three measurements the following day at approximately 08:00 h, 12:30 h, and 16:30 h. Sleep deprivation led to performance impairments in attention, arithmetic ability, episodic memory, and working memory. No effect of sleep deprivation was observed in the Stroop test. There were variations in attention and arithmetic test performance across different times of day. The effect of sleep deprivation on all cognitive tests was also found to vary at different times of day. In conclusion, this study shows that the KWA's 2-min cognitive tests can be used to detect cognitive impairments following sleep deprivation, and fluctuations in cognitive performance relating to time of day. The results demonstrate the potential of using brief smartphone-based tasks to measure a variety of cognitive abilities within sleep and fatigue research.

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

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

The Impact of Self-Reported Sleep Quantity on Perceived Decision-Making in Sports Officials During a Competitive Season

Objectives: While sleep research in athletes is extensive, no research has investigated sleep in sports officials during a competitive season. This study explored the (a) self-reported quantity and quality of sleep obtained by sports officials according to the time of competition (day or evening) and (b) impact of reduced sleep on perceived decision-making ability. Design: Sports officials (n = 371) from various sporting codes completed an online questionnaire that evaluated self-reported sleep quantity and quality on habitual nights, before competition, and after competition, as well as perceived decision-making constructs. Results: With sleep restriction defined as less than 7 h of sleep, mixed-effects logistic regression revealed that the estimated probability of reporting reduced sleep quantity increased (p< .05) on habitual nights (0.58), before competition (0.48), and after competition (0.56). The estimated probability of reporting poor sleep quality was 0.01-0.04 across all nights. When considering time of competition (day or evening), reduced sleep quantity was experienced after evening competition (odds ratio [OR] = 3.33, p < .05), while poorer sleep quality (p< .05) was experienced following day (OR = 2.1) and evening (OR = 12.46) competition compared to habitual nights. Furthermore, the impact of reduced sleep on perceived decision-making constructs was negative, with the estimated probability of reporting impaired perceived decision-making between 0.13 and 0.21. Conclusion: Overall, sports officials are vulnerable to reduced quantity and quality of sleep before and after competition, with impaired perceived decision-making ability following nights of less than average sleep.

Partial sleep deprivation affects endurance performance and psychophysiological responses during 12-minute self-paced running exercise

PURPOSE

This study aimed to investigate the effects of partial sleep deprivation (PSD) on physical performance and psychophysiological responses during 12-minute self-paced running exercise.

METHODS

Twenty runners (20.8±1.1 years, 70.6±4.9 kg, 175.1±3.9 cm) performed, in a randomized order, two running self-paced field exercises after a normal sleep night (CONT, bedtime from 22:30 h to 06:30 h) and one night of PSD (bedtime from 00:30 h to 04:30 h). Core temperature and motivation were recorded before exercise. Speed, covered distance, heart rate (HR), rating of perceived exertion (RPE) and respiratory parameters (i.e., minute ventilation (VE), oxygen uptake (VO₂) and carbon dioxide production (VCO₂)) were assessed during exercise. Blood lactate concentration [La] was assessed 2 min after exercise. Simple reaction time (SRT), mood and barrage test (BT) were assessed before and after exercise.

RESULTS

Higher RPE (p=0.01, d=0.90) and lower physical performance (i.e., p=0.001, d=0.59 for running speed and p=0.01, d=0.7 and Δ (%)=-6% for covered distance), following PSD, were obtained compared to CONT. Similarly, PSD attenuated core temperature (p=0.01, d=0.84), HR (p=0.006, ɳp²=0.45), VE (p=0.001, ɳp²=0.73), VO₂ (p=0.001, ɳp²=0.96), BT (p<0.0005, ɳp²=0.86), SRT (p=0.0009, ɳp²=0.44) and mood (p<0.0005). However, VCO₂, [La] and motivation score were not affected by sleep conditions.

CONCLUSION

The decrease of running performance and the increase of physical discomfort after PSD could be the origin of the lower cardio-respiratory responses to the 12-minute self-paced exercise. Effective strategies should be introduced to overcome the deterioration of physical performance and physiological responses after PSD.

Associations Between Sleep Patterns and Performance Development Among Norwegian Chess Players

An inherent part of elite-level chess are high emotional and cognitive stress loads related to performance development. Sleep is a crucial recovery strategy, previously implicated in athletic performance. The main purpose of the current study was to investigate the associations between performance development and objectively measured sleep in a sample of 14 Norwegian chess players over a period of 120 consecutive days. Seven of the chess players in the current sample had negative development in their International Chess Federation (FIDE) ranking score in the period of sleep monitoring, while 7 had positive development. The sleep patterns of the chess players with positive performance development were different from the players with negative development - with higher amounts of deep sleep, less rapid eye movement (REM) sleep and lower respiration rate in the positive performance development group compared to the negative performance development group. The findings are discussed in terms of existing knowledge on the importance of sleep stage distribution and sleep durations for athlete functioning, and in light of applied implications and possible future research.

A Thirty-Five-Minute Nap Improves Performance and Attention in the 5-m Shuttle Run Test during and Outside Ramadan Observance

Ramadan observance is characterized by several changes in behaviors, such as food and sleep, which could affect physical and cognitive performance. The aim of the present study was to investigate the effects of a 35-min nap (N35) opportunity on physical performance during the 5-m shuttle run test (5mSRT); attention; feelings; mood states; and perceptual measures of stress, fatigue, and muscle soreness during Ramadan observance. Fourteen physically active men (22 ± 3 years, 177 ± 4 cm, 76 ± 5 kg) were tested after a no-nap condition (N0), N35 15 days before Ramadan (BR), the last 10 days of Ramadan (DR), and 20 days after Ramadan (AR). Measures included the digit cancellation test (attention estimation), the profile of mood state (POMS), and the Hooper questionnaires. After a 5-min standard warm-up, participants performed the 5mSRT (6 × 30 s with 35 s in between; best distance (BD), total distance (TD), and fatigue index (FI) were recorded), along with the rating of perceived exertion (RPE) after each test repetition. After the 5mSRT test, participants responded to the feeling scale (FS). The results showed that TD and FI during the 5mSRT were not affected by Ramadan observance. However, BD was significantly lower than DR compared to AR after N0 (∆ = -4.3 ± 1.3%; p < 0.01) and N35 (∆ = -2.6 ± 1.0%; p < 0.05). After N0, attention decreased significantly at DR in comparison with BR (p < 0.05) and AR (p < 0.001). BD and TD improved after N35 compared to N0 at BR (∆ = +4.4 ± 2.1%, p < 0.05 for BD and ∆ = +4.8 ± 1.6%, p < 0.01 for TD), DR (∆ = +7.1 ± 2.2%, p < 0.05 for BD and ∆ = +5.1 ± 1.6%, p < 0.01 for TD), and AR (∆ = +5.5 ± 1.5%, p < 0.01 for BD and ∆ = +5.2 ± 1.2%, p < 0.001 for TD). A significant increase in attention was observed after N35 in comparison with N0 at DR (p < 0.01) and AR (p < 0.01). However, no changes were found for the perception of mood states, stress, sleep, muscle soreness, and the FI during the 5mSRT. Also, N35 was better than N0 for RPE at DR (p < 0.05), feelings at AR (p < 0.05), and fatigue estimation at AR (p < 0.01). A 35-min nap opportunity may have beneficial effects on physical and cognitive performances before, during, and after Ramadan.

Effect of Angle of View and Partial Sleep Deprivation on Distance Perception

The present study aimed to investigate the effects of intensive effort on egocentric distance perception according to different angles of view after sleep deprivation at the beginning (SDB) or at the end (SDE) of the night and after a normal sleep night (NNS). Ten male students soccer players (age 22.8 ± 1.3 years; body mass 72.0 ± 10.4 kg; body height 180.0 ± 3.0 cm) performed a repeated cycling (RS) exercise (10 × 6 s maximal cycling with 24 s in between) after SDB, SDE, and NNS. They were asked to estimate three distances (i.e. 15, 25, and 35 m) before and after RS from different angles of view [i.e. in front (0°) and in side (45° left and 45° right)]. For 35 m, distance estimation was better during NNS compared to SDB and SDE for the front and the two side angles either before or after RS (p < 0.05). Concerning 25 m, distance estimation was better after compared to before RS for the front angle during the NNS session (p < 0.05). For 15 m, distance estimation was better during NNS than SDB and SDE for the front and both side angles after RS (p < 0.05). We concluded that partial sleep deprivation negatively affected the estimation of the egocentric distance for the three angles of view either at rest or after RS exercise.

The effect of night-time exercise on sleep architecture among well-trained male endurance runners

The aim of the present study was to investigate the effects of night-time (21:00 hours) high-intensity, intermittent exercise on sleep architecture among well-trained athletes in a laboratory setting. In a randomized, counterbalanced order, 11 well-trained male runners completed a simulated trail-running exercise (TRAIL) on a motorized treadmill and a resting condition (REST; no exercise during the day). After each condition, nocturnal autonomic nervous system activity and core body temperature (CBT) were measured and sleep was analysed using polysomnography and actigraphy. Markers of muscle damage (maximal voluntary contraction [MVC], plasma creatine kinase concentration [CK] and perceived muscle soreness) were recorded before and immediately (POST), 24 hr (H24) and 48 hr (H48) after exercise. TRAIL induced a high level of fatigue and mild exercise-induced muscle damage, as determined by a reduction in MVC (-9.4%, p < .01, d = -1.36) and increases in [CK] (+176.0%, p < .01, d = 1.49) and perceived muscle soreness (+4.5 UA, p < .01, d = 2.17) compared with REST at H24. A trend for increased non-rapid eye movement (+4.2%; p = .10; d = 0.86) and reduced rapid eye movement (-4.4%; p = .07; d = -0.87) during sleep was observed for TRAIL compared with the REST condition. Moreover, compared with REST, TRAIL significantly increased CBT and nocturnal HR during the first part of the night. In conclusion, sleep architecture was modified after night-time, high-intensity exercise among well-trained runners.

Effect of sleep efficiency on salivary metabolite profile and cognitive function during exercise in volleyball athletes

PURPOSE

Sleep duration is known to affect physiological and circadian metabolites and human homeostasis. However, little is known about the relationship between sleep quality and metabolite and cognitive function during exercise. Therefore, the aim of the present study was to investigate the impact of sleep quality on metabolite level and cognitive function in female volleyball athletes.

METHODS

Twelve female volleyball athletes participated in this study. Sleep efficiency was measured for 1 week using NemuriSCAN (Paramount Bed Co. Ltd., Japan) as an index of sleep quality. The subjects were divided into better (n = 6) and lesser (n = 6) sleep quality groups by the median value of sleep efficiency. Saliva samples were collected using a Salimetric oral swab cotton and salivary metabolites were analysed using capillary electrophoresis and time-of-flight mass spectrometry. The subjects performed Stroop tasks (simple and difficult tasks) at rest and during aerobic exercise in recumbent cycle ergometer at light and heavy intensity.

RESULTS

Increased sleep efficiency was found in the better sleep quality group, whereas total sleep time was similar. There were differences in urea cycle and Krebs cycle metabolites between the two groups; their levels were correlated with sleep efficiency. The difficult-task response time during heavy exercise was faster in the better sleep quality group.

CONCLUSION

We demonstrated that sleep efficiency was associated with urea cycle and Krebs cycle metabolite levels and response time during heavy exercise in volleyball athletes. These results suggested that sleep quality may affect amino acid and energy metabolism and cognitive function during heavy exercise.

Observing Ramadan and sleep-wake patterns in athletes: a systematic review, meta-analysis and meta-regression

Objective

To evaluate the effect of observing Ramadan on athletes’ sleep patterns.

Design

Systematic review and meta-analysis.

Data sources

The entire content of PubMed/MEDLINE and Web of Science.

Eligibility criteria for selecting studies

Single-group, prepost and cross-over design studies conducted in athletes aged ≥18 years, training at least twice a week and published in English before 12 July 2018 were included. Studies assessing sleep quantity, quality, daytime sleepiness and/or daily naps based on objective or subjective methods were deemed eligible.

Study appraisal

The methodological quality was assessed using ‘QualSyst’.

Results

Of 13 selected articles, 7 were of strong quality, 3 were moderate and 3 were weak. 11 studies evaluated total sleep time (TST); this decreased during Ramadan in 4 studies, increased in 1 and remained unchanged in 6. Pooled TST findings indicated a moderate effect size (− 0.97, SE=0.37, 95% CI −1.69 to −0.25, t=−2.64, p=0.01) with significant heterogeneity but no publication bias. Meta-regressions showed no effects of study year, age, sample size, type of sport or competition level, but there were effects of country (with France and Tunisia being the most affected countries and Turkey the least affected, Q=32.14, p<0.0001) and study design (Q=7.74, p=0.02). Four studies measured self-reported sleep quality and it decreased in three studies. One study of sleep architecture reported more frequent waking and more light sleep during Ramadan. Daily nap duration was increased in two studies, but daytime sleepiness remained unchanged in four studies.

Conclusion

When athletes continue to train at least two times/week while observing Ramadan, TST is decreased compared with athletes’ baseline levels.

Evening electronic device use and sleep patterns in athletes

The present study aimed to investigate pre-sleep behaviours (including evening electronic device use) and sleep quantity in well-trained athletes. Seventy well-trained athletes (44 females, 26 males) aged 21 ± 4 y from a range of team and individual sports were asked to complete an online sleep diary for 7 days. The sleep diary included questions about pre-sleep behaviours (e.g. napping, caffeine intake), electronic device use in the 2 h prior to bedtime (e.g. type of device and duration of use) and sleep (e.g. time in bed, sleep onset latency). On average, athletes spent 8:20 ± 1:21 h in bed each night. Associations between age, time in bed and sleepiness suggested that younger athletes spent more time in bed (B = -0.05, p = 0.001) but felt sleepier (r = -0.32, p < 0.01) than older athletes. On average, athletes mostly used electronic devices for 0-30 min prior to sleep. The use of multiple devices in the evening was associated with more perceived difficulty in falling asleep (B = 0.22, p = 0.03), but no associations existed with other sleep variables. In summary, younger athletes may require later start times or improved sleep quality to resolve excessive sleepiness.

The psychomotor vigilance test: a comparison of different test durations in elite athletes

The 10-min Psychomotor Vigilance Test (PVT-10) is regarded as the gold-standard for assessing vigilant attention following sleep loss; however, other studies have investigated whether shorter versions of the test elicit similar results to the PVT-10. The present study compared the PVT-10 with 3-min (PVT-3) and 5-min (PVT-5) versions of the test in elite female basketball players. Athletes performed all three tests in the morning and evening for seven consecutive days. Response speed (mean reciprocal reaction time; mean 1/RT), number of errors and number of lapses were determined for each test and time point. The PVT-3 elicited significantly faster response speeds than the other two tests (p < 0.01), while the PVT-5 and PVT-10 were not different. The PVT-10 resulted in more lapses than the PVT-5, followed by the PVT-3, with all tests being significantly different to each other (p < 0.01). In conclusion, while the PVT-5 and PVT-10 were generally similar for response speed, the PVT-3 did not produce results comparable with the PVT-10 for response speed, lapses or errors, and should therefore not be used interchangeably. Further research is required to determine whether the shorter tests are a suitable replacement for the PVT-10 in professional basketball players.

The neurocognitive consequences of sleep restriction: A meta-analytic review

The current meta-analytic review evaluated the effects of experimentally manipulated sleep restriction on neurocognitive functioning. Random-effects models were employed to estimate the overall effect size and the differential effect size across cognitive domains. Age, time of day, age-adjusted sleep deficit, cumulative days of restricted sleep, sleep latency, subjective sleepiness, and biological sex were examined as potential moderators of the effect. Based on a sample of 61 studies, from 71 different populations, findings revealed a significant negative effect of sleep restriction on cognitive processing across cognitive domains (g=-0.383, p<0.001). This effect held for executive functioning (g=-0.324, p<0.001), sustained attention (g=-0.409, p<0.001), and long-term memory (g=-0.192, p=0.002). There was insufficient evidence to detect an effect within the domains of attention, multitask, impulsive decision-making or intelligence. Age group, time of day, cumulative days of restricted sleep, sleep latency, subjective sleepiness, and biological sex were all significant moderators of the overall effect. In conclusion, the current meta-analysis is the first comprehensive review to provide evidence that short-term sleep restriction significantly impairs waking neurocognitive functioning.

Sleep and athletic performance: the effects of sleep loss on exercise performance, and physiological and cognitive responses to exercise

Although its true function remains unclear, sleep is considered critical to human physiological and cognitive function. Equally, since sleep loss is a common occurrence prior to competition in athletes, this could significantly impact upon their athletic performance. Much of the previous research has reported that exercise performance is negatively affected following sleep loss; however, conflicting findings mean that the extent, influence, and mechanisms of sleep loss affecting exercise performance remain uncertain. For instance, research indicates some maximal physical efforts and gross motor performances can be maintained. In comparison, the few published studies investigating the effect of sleep loss on performance in athletes report a reduction in sport-specific performance. The effects of sleep loss on physiological responses to exercise also remain equivocal; however, it appears a reduction in sleep quality and quantity could result in an autonomic nervous system imbalance, simulating symptoms of the overtraining syndrome. Additionally, increases in pro-inflammatory cytokines following sleep loss could promote immune system dysfunction. Of further concern, numerous studies investigating the effects of sleep loss on cognitive function report slower and less accurate cognitive performance. Based on this context, this review aims to evaluate the importance and prevalence of sleep in athletes and summarises the effects of sleep loss (restriction and deprivation) on exercise performance, and physiological and cognitive responses to exercise. Given the equivocal understanding of sleep and athletic performance outcomes, further research and consideration is required to obtain a greater knowledge of the interaction between sleep and performance.