A Practical Guide to Improving Sleep and Performance in Athletes

Summary

The research states that sleep is a crucial aspect of optimising both mental and physical health. For athletes, sleep is becoming an increasingly popular strategy to improve athletic performance. However, athletes often experience sleep problems, including insufficient sleep and insomnia symptoms, and are also at a higher risk for sleep-disordered breathing. Sleep disorders and inadequate sleep can lead to excessive sleepiness, daytime dysfunction, and performance issues. In contrast, improved sleep provides benefits for physical health and athletic performance. Several factors can contribute to insufficient sleep in athletes, including sport-specific factors such as travel across time zones, competition and training schedules, high training loads, and sleeping in unfamiliar environments. Non-sport-related factors include work, social, and family commitments; attitudes and beliefs about sleep; individual characteristics, such as chronotype or preference for morning or evening; and lifestyle choices.

The research recommends several strategies to improve sleep in athletes:

• Education and emphasis on the importance of sleep
• Sleep screening
• Providing extra sleep opportunities, such as banking sleep and napping
• Improving sleep hygiene, including proper light exposure, a good pre-sleep routine, and a conducive sleep environment
• Utilising circadian timing adjustments
• Jet lag management
• A strategy for supplementation

The research highlights the significant importance of sleep for athletes, emphasizing its crucial role in optimising both their physical and mental well-being, and ultimately enhancing their athletic performance.

The research suggests that while sleep is vital for everyone, it is particularly crucial for athletes due to the demanding nature of their training and competition schedules. The sources point out the various benefits of adequate sleep for athletes, which include:

• Improved physical health: Sufficient sleep contributes to better physical recovery from strenuous training, reduces the risk of injuries, and supports a healthy immune system.
• Enhanced athletic performance: Better sleep leads to improvements in reaction time, speed, accuracy, and overall physical and cognitive performance, allowing athletes to perform at their best.
• Optimised mental health: Adequate sleep improves mood, motivation, focus, and cognitive function, all essential for athletes to handle pressure, make sound decisions, and maintain a positive mindset.

Conversely, the sources stress that sleep deprivation and sleep disorders can significantly hinder athletic performance and overall health, leading to:

• Excessive sleepiness and daytime dysfunction: This can result in impaired alertness, focus, and reaction time, making training and competition more challenging and potentially increasing the risk of injuries.
• Performance problems: Sleep deprivation negatively impacts physical and cognitive performance, affecting speed, accuracy, endurance, and decision-making abilities, ultimately hindering an athlete's ability to achieve their full potential.
• Increased risk of sleep-disordered breathing and other sleep problems: Athletes are at a higher risk for conditions like obstructive sleep apnea (OSA), which further disrupts sleep and exacerbates the negative consequences of sleep deprivation.

Increased recognition of the importance of sleep from sports professionals and screening for sleep disorders and disturbances will be key for future athlete health, well-being, and performance.

Sleep Challenges in Athletes

Many elite athletes report daytime sleepiness (28%), poor sleep quality (50–52%), and long sleep onset latency, and they display risk factors for obstructive sleep apnea (OSA; 38%). In a study of elite rugby players, 24% had OSA confirmed on a polysomnogram, and 12% had periodic limb movements. The high prevalence of OSA in rugby players may be related to a higher body mass index (BMI) and skin-fold thickness in sports where physical size is emphasised. Additionally, compared to controls, athletes take longer to fall asleep, spend more time awake, have reduced sleep efficiency, use sleep medication more often, and experience greater sleep fragmentation. Athletes are more likely to report a morning chronotype, and those with an evening chronotype report greater dissatisfaction with sleep quality. Due to the lack of flexibility in training schedules based on individual sleep needs, athletes may be misaligned with their preferred sleep schedules.

Sport-Specific and Non-Sport-Related Factors Affecting Sleep

For athletes, insufficient sleep can result from a combination of sport-specific and non-sport-related factors. Non-sport-related factors include work, social, and family commitments, attitudes and beliefs, individual characteristics, and lifestyle choices. Athletes, however, face additional factors that contribute to insufficient or poor-quality sleep beyond those affecting the general population. These factors include travel fatigue and frequent travel across time zones resulting in jet lag, competition and training schedules, which may occur at high altitudes, high training loads, and the need to sleep in unfamiliar environments. All these factors combined highlight the need for athletes to improve sleep behaviours, potentially leading to performance benefits.

The Role of Circadian Rhythms in Sleep

When exploring how to improve sleep in athletes, the interaction with circadian factors is crucial. Both sleep pressure (Process S) and circadian influences (Process C) work together to regulate sleep and the timing of both sleep and wake periods. As time since awakening increases, the need and pressure for sleep increases, but this pressure dissipates over the course of the subsequent sleep period (Process S). This process interacts with the body's circadian rhythms, which oscillate on an approximately 24-hour cycle and are typically synced with the external environment (Process C).

The circadian system includes three main chronotypes:

• Morning-type individuals who prefer to go to bed and wake up early
• Evening-type individuals who prefer to go to bed and wake up late
• Intermediate types who prefer bed and wake times in between

Understanding how circadian factors can impact athletes is essential for achieving peak performance. When implementing sleep improvement strategies, it is important to consider each athlete as an individual with sleep challenges that could arise due to the interaction of both sleep and circadian factors.

Strategies to Improve Sleep in Athletes

Coaches and athletes can implement several strategies to enhance sleep or lessen the effects of poor sleep. These strategies, which have shown promise in athletes and the general population, include:

• Education: Given the prevalence of myths about sleep, the first step in improving athlete sleep is identifying and educating athletes, their teams, and managers about the problem. Sleep screening can also help target vulnerable individuals for further intervention.
• Sleep Screening: Sleep screening helps identify athletes with sleep issues who may require additional intervention beyond education to improve their sleep.
• Providing Extra Sleep Opportunities:
  • Banking Sleep: Banking sleep involves extending sleep in preparation for insufficient sleep or as recovery after a period of poor sleep.
  • Napping: Napping can be used by athletes to sleep on demand or to supplement poor night-time sleep.