Sleep Dysfunction and Mood in Collegiate Soccer Athletes

The Effect of Sleep on the Health and Dietary Behaviours of GAA Athletes

Decreased sleep quality and duration is associated with an array of negative health outcomes. Evidence suggests athletes are susceptible to sleep inadequacies that may in turn affect their health and dietary behaviours. This study aimed to explore the sleep profile of both male and female Gaelic games players, at an elite and sub-elite level and compare how poor sleep relates to subjective health complaints and food cravings. One hundred and seventy Gaelic games players completed the Pittsburgh Sleep Quality Index (PSQI), Subjective Health Complaints Inventory (SHC) and Food Cravings Questionnaire-Trait-Reduced (FCQ-T-r). Participants were categorised into two groups: poor sleepers (PSQI ≥ 5) and good sleepers (PSQI < 5). Outcome measures of health and food cravings were analysed across the groups, Mann-Whitney U tests were used to assess differences, and Spearman's rank-order correlations were used to determine relationships between variables. Sixty-seven % of athletes were categorised as poor sleepers. There were no significant differences in PSQI scores across genders (p = 0.088) or playing level (p = 0.072). Poor sleepers experienced significantly increased SHC (p < 0.001) and female athletes had significantly more SHC compared to males (p < 0.001). Female athletes experienced more food cravings than males (p = 0.013). However, there were no significant differences in food cravings between good and poor sleepers (p = 0.104). The findings suggest a high prevalence of poor sleepers amongst GAA athletes. Furthermore, a significant relationship exists between poor sleep and health complaints with females at a higher risk of worsened health complaints and higher food cravings. Sleep screening and education interventions to enhance sleep in GAA athletes are advocated.

Depression, anxiety and stress among female student-athletes: a systematic review and meta-analysis

OBJECTIVE

To identify, quantify and analyse determinants of depression, anxiety and stress symptoms among female student-athletes.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Five online databases (PubMed, CINAHL, PsychInfo, SportDiscus and Web of Science) searched from inception through 14 September 2023. Hand-searches and contacting authors for eligible studies.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Articles were included if they were published in English, included female student-athletes competing at National Collegiate Athletic Association institutions, and measured symptom-level depression, anxiety and/or stress.

RESULTS AND SUMMARY

We screened 2415 articles; 52 studies (N=13 849) were included in the systematic review with 13 studies qualifying for meta-analysis. Seventeen determinants were identified including injury (eg, concussions), health (eg, sleep hygiene) and social factors (eg, social support). As data specific to female student-athletes was delineated from studies that included other populations, we observed 16 studies (30.7%) reported that identifying as female was a meaningful determinant of depression, anxiety and stress in athletes. Results of the meta-analysis (k=13, N=5004) suggested a small but significant association (r=0.15, 95% CI 0.05 to 0.24, p=0.004) between other determinants and depression, anxiety, and stress among female student-athletes.

CONCLUSION

Coaches, trainers and clinicians are key contributors in supporting female student-athlete mental health, with responsibilities for integrating mental skill training, sleep hygiene education and regular assessments. Comprehensive mental health and tailored education programmes considering determinants such as injury, health and social factors specific to female student-athletes are needed to enhance mental health equity in sport.

PROSPERO REGISTRATION NUMBER

CRD42022362163.

Associations of Training and Academic Stress with Sleep in Dual-Career Collegiate Badminton Athletes: A Preliminary Study

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.

Sleep restriction between consecutive days of exercise impairs sprint and endurance cycling performance

The study aim was to determine the effect of sleep restriction (3 h) between consecutive days of exercise on sprint and endurance cycling performance, wellness, and mood. A total of 10 well-trained males performed 2 consecutive-day trials separated by a normal night sleep (control [CONT]; mean [SD] sleep duration 3.0 [0.2] h) or sleep restriction (RES; mean [SD] sleep duration 3.0 [0.2] h). Experimental trials included a 90-min fixed-paced cycling bout and the respective sleep conditions on Day 1, followed by two 6-s peak power (6-s PP) tests, a 4- and 20-min time trial (TT) on Day 2. Profile of Mood States (POMS) and wellness questionnaires were recorded on Day 1 and Day 2. Blood lactate and glucose, heart rate (HR), and rating of perceived exertion were recorded throughout Day 2. Power output (PO) was significantly reduced for RES in the 6-s PP trial (mean [SD] 1159 [127] W for RES versus 1250 [186] W for CONT; p = 0.04) and mean PO during the 20-min TT (mean [SD] 237 [59] W for RES versus 255 [58] W for CONT; p = 0.03). There were no differences for HR, lactate and glucose, or POMS between CONT and RES in all experimental trials (p = 0.05-0.89). Participants reported a reduction in overall wellness prior to exercise on Day 2 following RES (mean [SD] 14.5 [1.6] au) compared to CONT (mean [SD] 16 [3.0] au; p = 0.034). Sleep restriction and the associated reductions in wellness, reduce cycling performance during consecutive days of exercise in a range of cycling tests that are relevant to both track and road cyclists.

Daytime Napping Benefits Passing Performance and Scanning Activity in Elite Soccer Players

The present study explored the effect of a daytime napping opportunity on scanning activity, which is an essential component of successful soccer performance. Fourteen male elite collegiate soccer players performed the Trail Making Test (TMT), which was used to assess complex visual attention. In addition, a soccer passing test, modified with reference to the Loughborough Soccer Passing Test, was used to evaluate passing performance as well as scanning activity. A cross-over design was applied to examine nap and no-nap interventions. Participants (N = 14, mean age: 21.6 SD = 0.5 years, height: 1.73 ± 0.06 m, body mass: 67.1 ± 4.5 kg) were randomly allocated to a midday nap (40 minutes) or no-nap group. Subjective sleepiness was measured using the Karolinska Sleepiness Scale, and perceptive fatigue was evaluated by the visual analog scale. There were no significant differences in subjective measurements or TMT between the nap and no-nap groups. However, the performance time for the passing test and scanning activity was significantly shorter (p < 0.001) and scanning activity was significantly more frequent in the nap condition than in the no-nap condition (p < 0.00005). These results suggest that daytime napping is beneficial for soccer-related cognitive function, represented by visuospatial processing and decision-making, and particularly as a potential countermeasure to mental fatigue. Considering that inadequate sleep and residual fatigue are commonly observed in elite soccer, this finding may have practical implications for the preparation of players.

Monitoring mood state to improve performance in soccer players: A brief review

Introduction

Psychological aspects of sport are key in maintaining athlete motivation and make a difference in competitive outcomes. Adjustments to training may be necessary according to athletes' emotional state. Therefore, it is important to assess and quantify mood states throughout the season in team sports, including among soccer players. The Profile of Mood States (POMS) is a widely used questionnaire that assesses emotional states characterized by positive or negative feelings and can be administered repeatedly to assess changes in mood state. This review aims to assess and summarize the current literature on mood state variation in soccer players with a specific focus on training loads, training modalities, and competitive performance.

Methods

A literature search was systematically conducted and resulted in 156 records. After removing duplicates, items with irrelevant titles and abstracts were screened out, and full texts were then screened for relevance and compared with inclusion and exclusion criteria. The remaining 37 articles were included in the final qualitative synthesis.

Results

POMS scores were related to variability in training load, intensity of the training period, modality of training exercises, competitive performance and time of day in soccer players. Common recommendations include monitoring the mood state of soccer players during training sessions, matches, and throughout training periods to detect early signs of psychological disturbance and aid in optimizing high-level training performance.

Conclusion

The POMS allows for monitoring of players' psychological state, providing coaches with data to aid in adjusting acute program variables according to players' psychological states and improve performance. Results offer practical support for the use of a simple POMS measurement as part of an overall program to monitor the players' psychological states. Results also highlight how training choices (i.e., load and exercise modality) and competitive performance are related to mood states (i.e., tension, anger, confusion, depression, fatigue, and vigor).

Dimensions of sleep characteristics and predictors of sleep quality among heart failure patients: A STROBE compliant cross-sectional study in Jordan

Awareness of poor sleep quality and sleep disturbances, as some of the factors that affect negatively quality of life for patients with the different classes of heart failure (HF) would enable health care providers to offer more comprehensive care. The purposes of this study were to describe sleep quality and predictors of disturbances in sleep in heart failure patients in Jordan. An explanatory cross- sectional design was employed to examine sleep quality, dimensions of sleep characteristics, types of disturbances in sleep within the different classes of HF in Jordan. Data were collected from 2 cardiac clinics and 2 medical clinics at 3 hospitals in Jordan. The most common types of disturbances in sleep in all classes of HF were waking up for urination, waking in the middle of the night or early morning, waking up due to cough and snoring, and difficulty to fall asleep within the 30 minutes. However, waking up due to feeling cold or hot were rarely reported in all classes of patients with HF. Regression analysis revealed that significant correlations were found between sleep quality and gender, disease duration, number of medications currently taken and ejection fraction (P < .05). Our findings indicated that sleep quality and disturbances in sleep were worsening with the increase of the New York heart association functional classification sheet class. Moreover, sleep quality had a significant association with gender, disease duration, ejection fraction, and the number of medications currently taken.

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 Mental Health Issues in Current and Former Athletes: A Mini Review

Sleep and mental health are important aspects of human health that work concurrently. However, sleep and mental health disorders are often overlooked and undiagnosed in sport due to the negative stigma associated with them. Evidence suggests that athletes are disproportionately affected by mental health issues and sleep problems. Internal and external pressures contribute to psychological distress. Variable competition times, travel and stress are detrimental to sleep quality. Retirement from sport can deteriorate sleep and psychological wellbeing, particularly for those who retired involuntarily and identify strongly with their athletic role. When untreated, these issues can manifest into a range of clinical disorders. This is concerning, not only for compromised athletic performance, but for general health and wellbeing beyond sport. Previous research has focussed on sleep and health independently among currently competing, or former, athletes. To date, no research has comprehensively assessed and compared sleep complaints and mental health issues between these two cohorts. Moreover, research has failed to obtain data across a variety of different competition levels, sports, and genders, leaving the current scope of the literature narrow. Comorbid conditions (e.g., concussion history, obesity), ex-college athletes, and mental health has been the focus of existing literature post-retirement. Future research would benefit from employing both quantitative and qualitative methodologies to comprehensively assess the prevalence and severity of sleep and mental health disorders across current and retired athletes. Research outcomes would inform education strategies, safeguarding athletes from these issues by reducing negative stigmas associated with help-seeking in sport and ultimately increase self-guided treatment.

Prevalence and Risk Factors of Poor Sleep Quality in Collegiate Athletes during COVID-19 Pandemic: A Cross-Sectional Study

The COVID-19 pandemic has changed our lifestyle, sleep and physical activity habits. This study evaluated the prevalence of poor sleep quality, its disrupters, and the impact of the pandemic in collegiate athletes. We performed a cross-sectional study of collegiate athletes (N = 339, median age: 20 (IQR,19−21) years old, 48.5% female, 47% individual sports) who received a web-based questionnaire in April 2021. This survey included subject characteristics, chronotype, sleep disrupters, the changes due to the pandemic and sleep quality (Pittsburg Sleep Quality Index [PSQI]). A multivariate linear regression was performed to assess the relationship between sleep quality, gender, chronotype, sleep disrupters and the changes to training volume or sleep. Results showed a disrupted sleep quality in 63.7%. One in five students had a total sleep time under 6.5 h per night. Poor sleep quality was significantly correlated with nocturnal concerns related to the pandemic, evening chronotype, female gender, third year of study, caffeine consumption and lack of sleep routine (all p < 0.05). To conclude, poor sleep quality is common in collegiate athletes. Sleep disrupters remain prevalent in the lifestyle habits of this population and may have been exacerbated by changes related to the COVID-19 pandemic. Sleep hygiene should become a major aspect of sports education during the return to post-covid normality.

Decreased Sleep and Subjective Well-Being as Independent Predictors of Injury in Female Collegiate Volleyball Players

Background:

The relationship among sleep duration, subjective well-being, and injury risk in athletes is poorly defined.

Purpose:

To evaluate the independent effects of sleep duration, sleep quality, and subjective well-being on in-season injuries in collegiate female volleyball athletes.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

During a 9-month competitive season, 17 female National Collegiate Athletic Association (NCAA) Division I volleyball players reported mood, fatigue, stress, soreness, sleep duration (hours), and sleep quality every morning. Well-being measures were recorded from 0 (worst) to 5 (best), and all time-loss injuries were recorded by the team athletic trainer. Separate mixed-effects logistic regression models were used to evaluate the effects of sleep and subjective well-being on in-season injury. Each well-being variable was also included in a separate mixed-effects logistic regression model with sleep duration as a covariate.

Results:

A total of 54 injuries were recorded during the study period. Compared with days without an injury, mood, fatigue, stress, soreness, sleep quality, and sleep duration were significantly worse the day before an injury occurred. In the separate prediction models, in-season injury was significantly predicted by fatigue (odds ratio [OR], 0.56 [95% CI, 0.36-0.86]; P = .008), mood (OR, 0.52 [95% CI, 0.35-0.78]; P = .002), stress (OR, 0.63 [95% CI, 0.42-0.94]; P = .023), soreness (OR, 0.54 [95% CI, 0.38-0.79]; P = .001), sleep quality (OR, 0.49 [95% CI, 0.34-0.7]; P < .001), and sleep duration (OR, 0.69 [95% CI, 0.55-0.87]; P = .001). In the multivariable models, sleep duration remained a significant independent predictor in each of the subsequent multivariable models (OR, 0.72-0.74; P < .05 for all), as did mood (OR, 0.55 [95% CI, 0.36-0.83); P = .005) and soreness (OR, 0.57 [95% CI, 0.39-0.83]; P = .003), while fatigue (OR, 0.65 [95% CI, 0.42-1]; P = .054) and stress (OR, 0.68 [95% CI, 0.45-1]; P = .061) no longer reached statistical significance.

Conclusion:

Increased sleep duration, mood, and decreased soreness were independently associated with a reduced risk of in-season injury in this cohort of female NCAA volleyball players.

Sport Specialization and Quality of Life among Middle- and High-School Long-Distance Runners of Different Injury Status: A Retrospective Study

Running-related injuries are prevalent in adolescent long-distance runners. The aim of our retrospective study was to compare differences in sport specialization, running habits,quality of life, and sleep habits among middle-and high-school long-distance runners of different injury statuses. Middle- and high-school long-distance runners across the United States were recruited via cross-country coaches and athletic directors between January and May 2020. Participants completed an online survey with questions related to demographics, sport specialization, running habits, quality of life, sleep, and self-reported injury history. Overall, 306 participants completed the survey (male = 107, female = 176, unspecified = 23; age = 15.7 ± 1.1 years). Of the participants, 178 (58.2%) reported no history of injury, 101 (33.0%) reported a previous injury, and 27 (8.8%) reported a current injury. Middle- and high-school runners with a current injury reported significantly lower overall health (p= .01) and average distance per run (p = .05) than uninjured runners. No significant differences were found among injury status and sport specialization level, quality of life, sleep habits, or running volume (p> .05). Runners with a self-reported previous or current injury do not appear to be classified as high-specialized runners more frequently than uninjured runners.

Sex differences in sleep and influence of the menstrual cycle on women's sleep in junior endurance athletes

Previous research shows that female athletes sleep better according to objective parameters but report worse subjective sleep quality than male athletes. However, existing sleep studies did not investigate variations in sleep and sleep stages over longer periods and have, so far, not elucidated the role of the menstrual cycle in female athletes' sleep. To address these methodological shortcomings, we investigated sex differences in sleep and sleep stages over 61 continuous days in 37 men and 19 women and examined the role of the menstrual cycle and its phases in 15 women. Sleep was measured by a non-contact radar, and menstrual bleeding was self-reported. Associations were investigated with multilevel modeling. Overall, women tended to report poorer subjective sleep quality (p = .057), but objective measurements showed that women obtained longer sleep duration (p < .001), more light (p = .013) and rapid eye movement sleep (REM; hours (h): p < .001, %: p = .007), shorter REM latency (p < .001), and higher sleep efficiency (p = .003) than men. R2 values showed that sleep duration, REM and REM latency were especially affected by sex. Among women, we found longer time in bed (p = .027) and deep sleep (h: p = .036), and shorter light sleep (%: p = .021) during menstrual bleeding vs. non-bleeding days; less light sleep (h: p = .040), deep sleep (%: p = .013) and shorter REM latency (p = .011) during the menstrual than pre-menstrual phase; and lower sleep efficiency (p = .042) and more deep sleep (%: p = .026) during the follicular than luteal phase. These findings indicate that the menstrual cycle may impact the need for physiological recovery, as evidenced by the sleep stage variations. Altogether, the observed sex differences in subjective and objective sleep parameters may be related to the female athletes' menstrual cycle. The paper provides unique data of sex differences in sleep stages and novel insights into the role of the menstrual cycle in sleep among female athletes.

The Prevalence of Mental Health Conditions Among High School and Collegiate Student-Athletes: A Systematic Review

The physical impacts of overtraining, sport specification, and burnout are well documented in the literature; however, the state of the student-athlete’s (SA’s) mental health is something that needs to be investigated more comprehensively. Literature on SA mental health has gained prevalence within the last 5 years. The combination of pressure from sport and academics, as well as the stigmatization of clinical mental health treatment, can have a significant effect on the SA’s psyche. This review explores the prevalence of mental health conditions (MHCs) in high school and collegiate SAs. This includes signs and symptoms of mental health diagnoses to include substance- and alcohol-related addictive disorders and risk factors of such. A systematic review of the CINAHL, ERIC, SPORTDiscus, APA PsycINFO, and Rehabilitation & Sports Medicine resource databases was conducted. The initial search yielded 855 results. Following double screening, 22 studies were included, all of which were deemed medium to high quality. The findings indicate an alarming presence of MHCs ranging from risk factors of alcohol use and major depressive disorders among SAs. There was a high prevalence of mental health issues among SAs who are Black, Indigenous, people of color (BIPOC), and Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ). In most cases, participation in competitive athletics (varsity) did not contribute to additional MHCs for SAs. Sport psychologists should play a role in mental health programming within athletic departments. Athletic departments should develop proactive, targeted strategies to address MHCs for SAs.