Sleep in elite athletes and nutritional interventions to enhance sleep

Sleep has numerous important physiological and cognitive functions that may be particularly important to elite athletes. Recent evidence, as well as anecdotal information, suggests that athletes may experience a reduced quality and/or quantity of sleep. Sleep deprivation can have significant effects on athletic performance, especially submaximal, prolonged exercise. Compromised sleep may also influence learning, memory, cognition, pain perception, immunity and inflammation. Furthermore, changes in glucose metabolism and neuroendocrine function as a result of chronic, partial sleep deprivation may result in alterations in carbohydrate metabolism, appetite, food intake and protein synthesis. These factors can ultimately have a negative influence on an athlete’s nutritional, metabolic and endocrine status and hence potentially reduce athletic performance. Research has identified a number of neurotransmitters associated with the sleep–wake cycle. These include serotonin, gamma-aminobutyric acid, orexin, melanin-concentrating hormone, cholinergic, galanin, noradrenaline, and histamine. Therefore, nutritional interventions that may act on these neurotransmitters in the brain may also influence sleep. Carbohydrate, tryptophan, valerian, melatonin and other nutritional interventions have been investigated as possible sleep inducers and represent promising potential interventions. In this review, the factors influencing sleep quality and quantity in athletic populations are examined and the potential impact of nutritional interventions is considered. While there is some research investigating the effects of nutritional interventions on sleep, future research may highlight the importance of nutritional and dietary interventions to enhance sleep

Monitoring Training Load to Understand Fatigue in Athletes

Many athletes, coaches, and support staff are taking an increasingly scientific approach to both designing and monitoring training programs. Appropriate load monitoring can aid in determining whether an athlete is adapting to a training program and in minimizing the risk of developing non-functional overreaching, illness, and/or injury. In order to gain an understanding of the training load and its effect on the athlete, a number of potential markers are available for use. However, very few of these markers have strong scientific evidence supporting their use, and there is yet to be a single, definitive marker described in the literature. Research has investigated a number of external load quantifying and monitoring tools, such as power output measuring devices, time-motion analysis, as well as internal load unit measures, including perception of effort, heart rate, blood lactate, and training impulse. Dissociation between external and internal load units may reveal the state of fatigue of an athlete. Other monitoring tools used by high-performance programs include heart rate recovery, neuromuscular function, biochemical/hormonal/immunological assessments, questionnaires and diaries, psychomotor speed, and sleep quality and quantity. The monitoring approach taken with athletes may depend on whether the athlete is engaging in individual or team sport activity; however, the importance of individualization of load monitoring cannot be over emphasized. Detecting meaningful changes with scientific and statistical approaches can provide confidence and certainty when implementing change. Appropriate monitoring of training load can provide important information to athletes and coaches; however, monitoring systems should be intuitive, provide efficient data analysis and interpretation, and enable efficient reporting of simple, yet scientifically valid, feedback

Overtraining syndrome symptoms and diagnosis in athletes : Where is the research? A systematic review

Context: To understand overtraining syndrome (OTS), it is important to detail the physiological and psychological changes that occur in athletes. Objectives: To systematically establish and detail the physiological and psychological changes that occur as a result of OTS in athletes. Methods: Databases were searched for studies that were (1) original investigations; (2) English, full-text articles; (3) published in peer-reviewed journals; (4) investigations into adult humans and provided (5) objective evidence that detailed changes in performance from prior to the onset of OTS diagnosis and that performance was suppressed for more than 4 weeks and (6) objective evidence of psychological symptoms. Results: Zero studies provided objective evidence of detailed changes in performance from prior to the onset of OTS diagnosis and demonstrated suppressed performance for more than 4 weeks accompanied by changes in psychological symptoms. Conclusions: All studies failed to provide evidence of changes in performance and mood from “healthy” to an overtrained state with evidence of prolonged suppression of performance. While OTS may be observed in the field, little data is available describing how physiological and psychological symptoms manifest. This stems from vague terminology, difficulties in monitoring for prolonged periods of time, and the need for prospective testing. Real-world settings may facilitate the collection of such data, but the ideal testing battery that can easily be conducted on a regular basis does not yet exist. Consequently, it must be concluded that an evidence base of sufficient scientific quality for understanding OTS in athletes is lacking

The chronotype of elite athletes

The aims of this study were (i) to compare the chronotype distribution of elite athletes to a young adult population and (ii) to determine if there was a tendency for athletes to select and/or participate in sports which suited their chronotype. A total of 114 elite athletes from five sports (cricket, cycling, hockey, soccer and triathlon) participated in this study. The participants’ chronotype, sleepiness, sleep satisfaction and sleep quality were determined using the Horne and Östberg Morningness and Eveningness questionnaire, the Epworth Sleepiness Scale and questions concerning their sleep satisfaction and quality. All questionnaires were administered during a typical training phase that was not in the lead up to competition and/or post competition. No differences between chronotype group for sleepiness, sleep satisfaction or sleep quality were found. There was a significantly higher proportion of triathletes that were morning and intermediate types compared to the control group χ2 (2) = 7.5, p = 0.02. A significant relationship between sport and chronotype group (χ2(4)=15.9, p = 0.04) was observed, with a higher frequency of morning types involved in sports that required morning training. There was a clear indication that athletes tended to select and pursue sports that suited their chronotype. This was evident by the amount of morning types involved in morning sports. Given that athletes are more likely to pursue and excel in sports which suit their chronotype, it is recommended that coaches consider the athlete’s chronotype during selection processes or if possible design and implement changes to training schedules to either suit the athletes’ chronotype or the timing of an upcoming competition

Sleep, circadian biology and skeletal muscle interactions : Implications for metabolic health

There currently exists a modern epidemic of sleep loss, triggered by the changing demands of our 21st century lifestyle that embrace ‘round-the-clock’ remote working hours, access to energy-dense food, prolonged periods of inactivity, and on-line social activities. Disturbances to sleep patterns impart widespread and adverse effects on numerous cells, tissues, and organs. Insufficient sleep causes circadian misalignment in humans, including perturbed peripheral clocks, leading to disrupted skeletal muscle and liver metabolism, and whole-body energy homeostasis. Fragmented or insufficient sleep also perturbs the hormonal milieu, shifting it towards a catabolic state, resulting in reduced rates of skeletal muscle protein synthesis. The interaction between disrupted sleep and skeletal muscle metabolic health is complex, with the mechanisms underpinning sleep-related disturbances on this tissue often multifaceted. Strategies to promote sufficient sleep duration combined with the appropriate timing of meals and physical activity to maintain circadian rhythmicity are important to mitigate the adverse effects of inadequate sleep on whole-body and skeletal muscle metabolic health. This review summarises the complex relationship between sleep, circadian biology, and skeletal muscle, and discusses the effectiveness of several strategies to mitigate the negative effects of disturbed sleep or circadian rhythms on skeletal muscle health

Reliability of a 2-Bout exercise test on a Wattbike cycle ergometer

Purpose: To determine the intraday and interday reliability of a 2 × 4-min performance test on a cycle ergometer (Wattbike) separated by 30 min of passive recovery (2 × 4MMP). Methods: Twelve highly trained cyclists (mean ± SD; age = 20 ± 2 y, predicted VO2max = 59.0 ± 3.6 mL · kg–1 · min–1) completed six 2 × 4MMP cycling tests on a Wattbike ergometer separated by 7 d. Mean power was measured to determine intraday (test 1 [T1] to test 2 [T2]) and interday reliability (weeks 1–6) over the repeated trials. Results: The mean intraday reliabilities of the 2 × 4MMP test, as expressed by the typical error of measurement (TEM, W) and coefficient of variation (CV, %) over the 6 wk, were 10.0 W (95% confidence limits [CL] 8.2–11.8), and 2.6% (95%CL 2.1–3.1), respectively. The mean interday reliability TEM and CV for T1 over the 6 wk were 10.4 W (95%CL 8.7–13.3) and 2.7% (95%CL 2.3–3.5), respectively, and 11.7 W (95%CL 9.8–15.1) and 3.0% (95%CL 2.5–3.9) for T2. Conclusion: The testing protocol performed on a Wattbike cycle ergometer in the current study is reproducible in highly trained cyclists. The high intraday and interday reliability make it a reliable method for monitoring cycling performance and for investigating factors that affect performance in cycling events

A systematic review on fitness testing in adult male basketball players : tests adopted, characteristics reported and recommendations for practice

Background: As basketball match-play requires players to possess a wide range of physical characteristics, many tests have been introduced in the literature to identify talent and quantify fitness in various samples of players. However, a synthesis of the literature to identify the most frequently used tests, outcome variables, and normative values for basketball-related physical characteristics in adult male basketball players is yet to be conducted. Objective: The primary objectives of this systematic review are to (1) identify tests and outcome variables used to assess physical characteristics in adult male basketball players across all competition levels, (2) report a summary of anthropometric, muscular power, linear speed, change-of-direction speed, agility, strength, anaerobic capacity, and aerobic capacity in adult male basketball players based on playing position and competition level, and (3) introduce a framework outlining recommended testing approaches to quantify physical characteristics in adult male basketball players. Methods: A systematic review of MEDLINE, PubMed, SPORTDiscus, Scopus, and Web of Science was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify relevant studies. To be eligible for inclusion, studies were required to: (1) be original research articles; (2) be published in a peer-reviewed journal; (3) have full-text versions available in the English language; and (4) include the primary aim of reporting tests used and/or the physical characteristics of adult (i.e., ≥ 18 years of age) male basketball players. Additionally, data from the top 10 draft picks who participated in the National Basketball Association combined from 2011–12 to 2020–21 were extracted from the official league website to highlight the physical characteristics of elite 19- to 24-year-old basketball players. Results: A total of 1684 studies were identified, with 375 being duplicates. Consequently, the titles and abstracts of 1309 studies were screened and 231 studies were eligible for full-text review. The reference list of each study was searched, with a further 59 studies identified as eligible for review. After full-text screening, 137 studies identified tests, while 114 studies reported physical characteristics in adult male basketball players. Conclusions: Physical characteristics reported indicate a wide range of abilities are present across playing competitions. The tests and outcome variables reported in the literature highlight the multitude of tests currently being used. Because there are no accepted international standards for physical assessment of basketball players, establishing normative data is challenging. Therefore, future testing should involve repeatable protocols that are standardised and provide outcomes that can be monitored across time. Recommendations for testing batteries in adult male basketball players are provided so improved interpretation of data can occur. Clinical Trial Registration: This review was registered with the International Prospective Register of Systematic Reviews and allocated registration number CRD42020187151 on 28 April, 2020. © 2022, The Author(s)

Development of the athlete sleep behavior questionnaire: A tool for identifying maladaptive sleep practices in elite athletes

INTRODUCTION: Existing sleep questionnaires to assess sleep behaviors may not be sensitive in determining the unique sleep challenges faced by elite athletes. The purpose of the current study was to develop and validate the Athlete Sleep Behavior Questionnaire (ASBQ) to be used as a practical tool for support staff working with elite athletes. METHODS: 564 participants (242 athletes, 322 non-athletes) completed the 18-item ASBQ and three previously validated questionnaires; the Sleep Hygiene Index (SHI), the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). A cohort of the studied population performed the ASBQ twice in one week to assess test-retest reliability, and also performed sleep monitoring via wrist-actigraphy. RESULTS: Comparison of the ASBQ with existing sleep questionnaires resulted in moderate to large correlations (r=0.32 - 0.69). There was a significant difference between athletes and non-athletes for the ASBQ global score (44±6 vs. 41±6, respectively, p<0.01) and for the PSQI, but not for the SHI or the ESS. The reliability of the ASBQ was acceptable (ICC=0.87) when re-tested within 7 days. There was a moderate relationship between ASBQ and total sleep time (r=-0.42). CONCLUSION: The ASBQ is a valid and reliable tool that can differentiate the sleep practices between athletes and non-athletes, and offers a practical instrument for practitioners and/or researchers wanting to evaluate the sleep behaviors of elite athletes. The ASBQ may provide information on areas where improvements to individual athletes' sleep habits could be made

Evaluating the typical day-to-day variability of WHOOP-derived heart rate variability in Olympic water polo athletes

Heart rate (HR) and HR variability (HRV) can be used to infer readiness to perform exercise in athletic populations. Advancements in the photoplethysmography technology of wearable devices such as WHOOP allow for the frequent and convenient measurement of HR and HRV, and therefore enhanced application in athletes. However, it is important that the reliability of such technology is acceptable prior to its application in practical settings. Eleven elite male water polo players (age 28.8 ± 5.3 years [mean ± standard deviation]; height 190.3 ± 3.8 cm; body mass 95.0 ± 6.9 kg; international matches 117.9 ± 92.1) collected their HR and HRV daily via a WHOOP strap (WHOOP 3.0, CB Rank, Boston, MA, USA) over 16 weeks ahead of the 2021 Tokyo Olympic Games. The WHOOP strap quantified HR and HRV via wrist-based photoplethysmography during overnight sleep periods. The weekly (i.e., 7-day) coefficient of variation in lnRMSSD (lnRMSSDCV) and HR (HRCV) was calculated as a measure of day-to-day variability in lnRMSSD and HR, and presented as a mean of the entire recording period. The mean weekly lnRMSSDCV and HRCV over the 16-week period was 5.4 ± 0.7% (mean ± 95% confidence intervals) and 7.6 ± 1.3%, respectively. The day-to-day variability in WHOOP-derived lnRMSSD and HR is within or below the range of day-to-day variability in alternative lnRMSSD (~3–13%) and HR (~10–11%) assessment protocols, indicating that the assessment of HR and HRV by WHOOP does not introduce any more variability than that which is naturally present in these variables

Compression-induced improvements in post-exercise recovery are associated with enhanced blood flow, and are not due to the placebo effect

The aim of this study was to investigate the physiological effects of compression tights on blood flow following exercise and to assess if the placebo effect is responsible for any acute performance or psychological benefits. Twenty-two resistance-trained participants completed a lower-body resistance exercise session followed by a 4 h recovery period. Participants were assigned a post-exercise recovery intervention of either compression tights applied for 4 h (COMP), placebo tablet consumed every hour for 4 h (PLA) or control (CON). Physiological (markers of venous return, muscle blood flow, blood metabolites, thigh girth), performance (countermovement jump, isometric mid-thigh pull), and psychological measures (perceived muscle soreness, total quality of recovery) were collected pre-exercise, immediately post-exercise, at 30 (markers of venous return and muscle blood flow) and 60 min (blood metabolites, thigh girth and psychological measures) intervals during 4 h of recovery, and at 4 h, 24 h and 48 h post-exercise. No significant (P > 0.05) differences were observed between interventions. However, effect size analysis revealed COMP enhanced markers of venous return, muscle blood flow, recovery of performance measures, psychological measures and reduced thigh girth compared to PLA and CON. There were no group differences in blood metabolites. These findings suggest compression tights worn after resistance exercise enhance blood flow and indices of exercise recovery, and that these benefits were not due to a placebo effect