Does Elite Sport Degrade Sleep Quality? A Systematic Review

Abstract

BackgroundInformation on sleep quality and insomnia symptomatology among elite athletes remains poorly systematised in the sports science and medicine literature. The extent to which performance in elite sport represents a risk for chronic insomnia is unknown.ObjectivesThe purpose of this systematic review was to profile the objective and experienced characteristics of sleep among elite athletes, and to consider relationships between elite sport and insomnia symptomatology.MethodsStudies relating to sleep involving participants described on a pre-defined continuum of ‘eliteness’ were located through a systematic search of four research databases: SPORTDiscus, PubMed, Science Direct and Google Scholar, up to April 2016. Once extracted, studies were categorised as (1) those mainly describing sleep structure/patterns, (2) those mainly describing sleep quality and insomnia symptomatology and (3) those exploring associations between aspects of elite sport and sleep outcomes.ResultsThe search returned 1676 records. Following screening against set criteria, a total of 37 studies were identified. The quality of evidence reviewed was generally low. Pooled sleep quality data revealed high levels of sleep complaints in elite athletes. Three risk factors for sleep disturbance were broadly identified: (1) training, (2) travel and (3) competition.ConclusionWhile acknowledging the limited number of high-quality evidence reviewed, athletes show a high overall prevalence of insomnia symptoms characterised by longer sleep latencies, greater sleep fragmentation, non-restorative sleep, and excessive daytime fatigue. These symptoms show marked inter-sport differences. Two underlying mechanisms are implicated in the mediation of sport-related insomnia symptoms: pre-sleep cognitive arousal and sleep restriction.Electronic supplementary materialThe online version of this article (doi:10.1007/s40279-016-0650-6) contains supplementary material, which is available to authorized users.

Effects of training and competition on the sleep of elite athletes: a systematic review and meta-analysis

“…It is important to understand how the demands of training and competition affect sleep, and this has become a priority for coaches and scientists 9. It is recommended that adults sleep at least 7 hours per night and achieve a sleep efficiency (ie, time asleep as a percentage of time in bed) of at least 85% on a regular basis to promote health 10 11.…”

“…It is recommended that adults sleep at least 7 hours per night and achieve a sleep efficiency (ie, time asleep as a percentage of time in bed) of at least 85% on a regular basis to promote health 10 11. However, there is a high prevalence of insomnia symptoms among athletes 9. Much of the research examining athletes’ sleep has been derived from subjective tools (eg, diaries) 12.…”

Sleep Quality and Chronotype Differences between Elite Athletes and Non-Athlete Controls

“…Research has shown benefits of optimized sleep for athletic performance [10][11][12]. Even so, knowledge regarding the sleep behaviors of athletes is limited [13,14].…”

“…A recent, systematic review found a high prevalence of poor sleep quality in elite athletes [13]. However, the overall quality of evidence was found to be poor, with few controlled comparisons between elite athletes and non-athlete controls.…”

Author’s Reply to Bender and Samuels “Does Elite Sport Degrade Sleep Quality? A Systematic Review”

“…In their response to our review [1] Bender and Samuels [this issue] raise some important issues concerning the need to better understand sleep and sleep dysfunction in elite sport. Certainly, we accept that, in addition to insomnia, symptoms arising from circadian rhythm and sleep-related breathing disorders can contribute to the athlete sleep profiles reported in the sports literature.…”