Sleep Data, Physical Performance, and Injuries in Preparation for Professional Mixed Martial Arts

Sleep Behaviors and Nutritional Knowledge in Amateur and Professional Combat Sport Athletes

ABSTRACT

Dunican, IC, Galpin, A, Turner, M, and Reale, R. Sleep behaviors and nutritional knowledge in amateur and professional combat sport athletes. J Strength Cond Res XX(X): 000-000, 2024-Combat sports is a term applied to various competitive contact sports involving 2 competitors engaging in a bout or contest under a specific ruleset. Little is known about combat sports athletes' sleep and nutritional knowledge. This study aimed to assess (a) sleep behaviors, (b) alcohol and shiftwork disorders, and (c) the nutritional knowledge of combat sports athletes. Subjects completed various demographic questions and estimations of their weight management practices and validated surveys, including the Athlete Sleep Behavior Questionnaire, Shiftwork Disorder (SWD) Screening Questionnaire, Alcohol Use Disorders Identification Test, and the Abridged Nutrition for Sports Knowledge Questionnaire. A total of 844 combat sports athletes completed the survey, 79% male, height of 177 ± 10 (cm), and body mass of 79 ± 15 (kg). Subjects were categorized into their specific combat sport type (e.g., boxing or Brazilian jiu-jitsu [BJJ]) and by their level (professional or amateur). Sleep quality was average for all combat sport types and risk prevalence of shiftwork disorder at 11%. Mann-Whitney U tests revealed that amateurs, compared with professional strikers (p = 0.046, CLES = 0.80), boxers (p = 0.01, CLES = 0.78), and BJJ (p = 0.046, CLES = 0.61) athletes, consumed significantly more alcohol. A Friedman test showed significant (p < 0.001, W = 0.51) differences in weight between time points, with most combat sports athletes reducing weight for competition. An overall nutritional knowledge average of 55% was reported. This study highlights a critical gap in the knowledge and practices of combat sports athletes in relation to sleep behaviors and disorders, alcohol consumption, and nutritional knowledge, emphasizing the need for targeted educational interventions.

Performance of a multisensor smart ring to evaluate sleep: in-lab and home-based evaluation of generalized and personalized algorithms

STUDY OBJECTIVES

Wearable sleep technology has rapidly expanded across the consumer market due to advances in technology and increased interest in personalized sleep assessment to improve health and mental performance. We tested the performance of a novel device, the Happy Ring, alongside other commercial wearables (Actiwatch 2, Fitbit Charge 4, Whoop 3.0, Oura Ring V2), against in-lab polysomnography (PSG) and at-home electroencephalography (EEG)-derived sleep monitoring device, the Dreem 2 Headband.

METHODS

Thirty-six healthy adults with no diagnosed sleep disorders and no recent use of medications or substances known to affect sleep patterns were assessed across 77 nights. Subjects participated in a single night of in-lab PSG and two nights of at-home data collection. The Happy Ring includes sensors for skin conductance, movement, heart rate, and skin temperature. The Happy Ring utilized two machine-learning derived scoring algorithms: a "generalized" algorithm that applied broadly to all users, and a "personalized" algorithm that adapted to individual subjects' data. Epoch-by-epoch analyses compared the wearable devices to in-lab PSG and to at-home EEG Headband.

RESULTS

Compared to in-lab PSG, the "generalized" and "personalized" algorithms demonstrated good sensitivity (94% and 93%, respectively) and specificity (70% and 83%, respectively). The Happy Personalized model demonstrated a lower bias and more narrow limits of agreement across Bland-Altman measures.

CONCLUSION

The Happy Ring performed well at home and in the lab, especially regarding sleep/wake detection. The personalized algorithm demonstrated improved detection accuracy over the generalized approach and other devices, suggesting that adaptable, dynamic algorithms can enhance sleep detection accuracy.

Case Report: Effect of low energy availability and training load on sleep in a male combat sport athlete

Purpose

The aim of this case report was to describe the sleep responses in a male combat sport athlete, who was engaging in both chronic (CWL) and acute (AWL) weight loss practices in order to reduce body mass for a national competition.

Methods

During the first seven weeks of training (Phases 1 and 2), the athlete adhered to a daily energy intake (EI) equating to their resting metabolic rate (1700 kcal·day^-1) followed by a reduction in EI (915-300 kcal·day^-1) in the 5 days before weighing in (Phase 3). Nocturnal sleep was monitored throughout the 8-week training period using wristwatch actigraphy and frequent measurements of body mass/composition, daily exercise energy expenditure and training load (TL) were taken.

Results

The athlete was in a state of low energy availability (LEA) during the entire training period. There was a very large decrease in LEA status during phase 3 compared with phases 1 and 2 (3 vs. 20 kcal·kgFFM·day^-1) and there was a small decrease in TL during phase 3 compared with phase 2 (410 vs. 523 AU). The athlete's sleep efficiency increased throughout the training period, but total sleep time displayed a small to moderate decrease in phase 3 compared with phases 1 and 2 (386 vs. 429 and 430 min). However, correlational analysis demonstrated trivial to small, non-significant relationships between sleep characteristics and the athlete's LEA status and TL.

Conclusion

These findings suggest that CWL and AWL practices that cause fluctuations in LEA and TL may be implemented without compromising the sleep of combat sport athletes.

Sleep and Performance in Professional Athletes

Purpose of Review

Sleep is an essential human behavior that plays a key role in proper biopsychosocial development as well as short- and long-term biological, physical, psychological, and cognitive health. Sleep plays a key role in athletic performance, influencing an athlete's ability to train, recover, and perform, as well as their overall wellness. Over the recent decade, the awareness of sleep's import has penetrated just about every professional sport domain. The purpose of the review was to identify and synthesize the literature published within the past 5 years (2018-2022) that relates to sleep and performance in professional athletes. Literature related to nonprofessional, high-level athletes (e.g., collegiate; Olympic) was omitted as well as those associated with non-traditional professional sports (e.g., eSports).

Recent Findings

Results from 38 articles were incorporated into this review, which covered (1) the sleep's role in the training, physical injury prevention and recovery, competitive performance, and mental health of professional athletes, (2) common sleep problems and disorders in professional athletes, and (3) the impact of unique challenges from training, travel, competition, and other factors on sleep health. Additionally, we provide an orientation to utilized strategies and interventions to assist with sleep health in professional athletes, as well as conclude with a commentary on critical steps forward.

Summary

Sleep plays a critically important role in the training, recovery, performance, and overall wellness of professional athletes. Professional athletes are vulnerable to a variety of sleep-related problems and disorders, due to unique factors related to training, travel, and competition, among other factors. Improved, standardized research methodology and partnerships between professional athletes, coaches, teams, and organizations and researchers are necessary to advance the knowledge of sleep and performance in professional athletes, including identifying sport-specific differences and variation across individual characteristics, as well as developing individualizable, dynamic, and appropriate interventions for improving sleep health among professional athletes.

Exploratory Systematic Review of Mixed Martial Arts: An Overview of Performance of Importance Factors with over 20,000 Athletes

This review aimed to analyze the findings in the literature related to Mixed Martial Arts (MMA) through an exploratory systematic review and to present the state of the art from a multifactorial perspective. The review was conducted in accordance with the PRISMA statement, with a search performed in the Scopus, PubMed, and Web of Science databases. Participants were competitive athletes (amateurs or professionals) of regional, national, or international levels. Of the 2763 registries identified, 112 studies met the eligibility criteria. The pooled sample size and age were 20,784 participants, with a mean age of 27.7 ± 6 years for male and 28.9 ± 3 years for female, with the vast majority of athletes being male (94.9%). MMA athletes were 17.2% amateurs, 73.8% professionals, and 9% were not reported. The scientific literature related to MMA reported injuries (n = 28), weight loss (n = 21), technical and tactical analysis (n = 23), physical fitness (n = 8), physiological responses and training characteristics (n = 13), psychobiological parameters (n = 12), and interventions applied to MMA athletes (n = 7). Therefore, this exploratory systematic review presents practitioners and researchers with seven broad summaries of each facet of performance of importance in this population of athletes.

The Association Between Poor Sleep and the Incidence of Sport and Physical Training-Related Injuries in Adult Athletic Populations: A Systematic Review

BACKGROUND

The importance of achieving an adequate amount of sleep to optimize health and athletic performance is well recognized. Yet, a systematic evidence compilation of the risk for sport-related injury in adult athletic populations due to poor sleep does not exist.

OBJECTIVE

To examine the association between poor sleep and sport and physical training-related injuries in adult athletic populations.

DATA SOURCES

Electronic databases were searched using keywords relevant to sleep quantity and quality, and musculoskeletal injury and sport-related concussion (SRC).

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies were included in this systematic review if they were comprised of adult athletic populations, reported measures of sleep quantity or quality, followed participants prospectively for injury, and reported an association between sleep and incidence of sport or physical training-related injury.

STUDY APPRAISAL

The methodological quality of each study was assessed using the Newcastle-Ottawa Scale for Cohort Studies.

RESULTS

From our review of 12 prospective cohort studies, we found limited evidence supporting an association between poor sleep and injury in adult athletic populations. Specifically, there is (a) insufficient evidence supporting the associations between poor sleep and increased risk of injury in specific groups of athletic adults, including professional or elite athletes, collegiate athletes, elite or collegiate dancers, and endurance sport athletes; and (b) limited evidence of an association between poor sleep and increased risk of SRC in collegiate athletes.

CONCLUSIONS

The current evidence does not support poor sleep as an independent risk factor for increased risk of sport or physical training-related injuries in adult athletic populations. Given the methodological heterogeneity and limitations across previous studies, more prospective studies are required to determine the association between sleep and injury in this population.

Sleep quality monitoring in individual sports athletes: parameters and definitions by systematic review

In the present review, we identify which instruments and parameters are used for sleep quality monitoring in individual sport athletes and which definitions were used for sleep quality parameters in this literature field. Systematic searches for articles reporting the qualitative markers related to sleep in team sport athletes were conducted in PubMed, Scopus and Web of Science online databases. The systematic review followed the Preferred Reporting Items for Systematic Reviews. The initial search returned 3316 articles. After the removal of duplicate articles, eligibility assessment, 75 studies were included in this systematic review. Our main findings were that the most widely used measurement instruments were Actigraphy (25%), Rating Likert Scales (16%) and Sleep Diary (13%). On sleep quality parameters (Sleep duration = 14%; Wake after sleep onset = 14%; Sleep Quality = 12%; Sleep Effciency = 11% and Sleep Latency = 9%), the main point is that there are different definitions for the same parameters in many cases reported in the literature. We conclude that the most widely used instruments for monitoring sleep quality were Actigraphy, Likert scales and Sleep diary. Moreover, the definitions of sleep parameters are inconsistent in the literature, hindering the understanding of the sleep-sport performance relationship.

The physical demands of mixed martial arts: A narrative review using the ARMSS model to provide a hierarchy of evidence

The physical demands of mixed martial arts (MMA) training and competition is not yet well quantified. The Applied Research Model for the Sport Sciences (ARMSS) provides a framework through which to conduct sport science, determining pertinent questions to test research findings in real-world settings. The aim of this review was to evaluate MMA research within the context of ARMSS to critically analyse our understanding of the physical requirements of MMA training and competition. Research databases were searched, with 70 peer-reviewed articles being discussed in relation to the specific stage of the ARMSS in which their results best fit. MMA research was found to be mostly foundational and descriptive in nature and has generally not developed along systematic lines. The internal and external loads and responses to training and competition have not been adequately identified. Therefore, it is not currently possible to state which variables are key predictors of success, or how coaches can optimally manipulate these variables. We propose that MMA research be refocused to be conducted within ARMSS. Specifically, stage 2 studies describing the physical, physiological and technical demands of MMA training and competition, and stage 3 studies determining the physiological predictors of performance should be initially prioritised.