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

Prevalence of anxiety and depression in former elite athletes: a systematic review and meta-analysis

Objectives

To summarise the evidence regarding the prevalence of anxiety and depression in former elite athletes compared with the general population.

Design

Systematic review and meta-analysis.CRD42022347359.

Data sources

Five electronic databases (Web of Science, PubMed, MEDLINE, Scopus and SPORTDiscus) were searched from 1970 to 2023.

Eligibility criteria

Studies were included in the meta-analysis if they: (1) were written in English; (2) included male or female elite athletes that had been retired ≥1 year; (3) included a control group or population reference values; (4) reported the time-point prevalence of anxiety and/or depression; and (5) were of a retrospective, longitudinal or prospective, methodological design. A modified version of the Downs and Black tool was used to determine risk of bias.

Results

37 unique studies including 24 732 former athletes (2% female) were included in the meta-analysis. The time-point prevalence of anxiety (prevalence ratio (PR): 2.08 (95% CI 1.57 to 2.60)) and depression (PR: 2.58 (95% CI 2.04 to 3.12)) in former athletes was over twice that of the general population. Subgroup analyses revealed former American football players and jockeys had the highest time-point prevalence of both anxiety and depression (PR: 2.24-2.88), whereas the time-point prevalence of depression and anxiety was not significantly different to the general population for former rugby players (PR: 1.13-1.30).

Conclusion

Our meta-analyses demonstrated the time-point prevalence of anxiety and depression in former elite athletes could be over twice that of the general population, with sport-specific differences evident.

PROSPERO registration number

CRD42022347359.

Athletic retirement: factors contributing to sleep and mental health problems

Introduction

The aim of this investigation was to determine which factors were associated with symptoms of sleep and mental health disorders in former athletes.

Methods

Former athletes (N = 173, 50% women) who retired from any competition level within the last 20 years participated in an online survey. The survey consisted of the Athlete Sleep Screening Questionnaire (ASSQ), Personal Wellbeing Index-Adult (PWI-A), Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), and Generalised Anxiety Disorder Assessment (GAD-7).

Results

Binary logistic regressions revealed that both age (OR = 0.95 [95% CI:0.92, 0.99], p = 0.007) and gender (OR = 2.28 [95% CI:1.09, 4.79], p = 0.029) were associated with anxiety, with women and younger ex-athletes presenting greater risk of anxiety symptoms. Higher body mass was associated with an increased risk for sleep difficulty (OR = 1.13 [95% CI:1.03, 1.23], p = 0.008), sleep disordered breathing (OR = 1.20 [95% CI:1.10, 1.30], p < 0.001), and compromised wellbeing (OR = 0.89 [95% CI:0.83, 0.96], p = 0.001). Athletes who subjectively placed a lower priority on sport while competing presented greater risk of sleep disordered breathing (OR = 2.00[95% CI:1.05, 3.80], p = 0.035). No associations between recency retirement and any outcome measures were observed.

Discussion

Findings suggest potential predictive factors for difficulty transitioning out of sport. Future longitudinal research should consider the interplay between sport re-engagement and the incidence and chronicity of sleep and mental health disorders.

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.