Sleep And Performance In Professional Athletes: A Comprehensive Review Of The Latest Research
A group of reputable American and Canadian researchers, along with their Departments of Psychology, Psychiatry, Kinesiology, and Sleep and Human Performance, conducted a comprehensive literature review including the last five years of publishing on the relationship between sleep and performance in professional athletes.
Introduction
Sleep is a fundamental aspect of human behavior that significantly contributes to biopsychosocial development and overall well-being in terms of biological, physical, psychological, and cognitive health. Its influence extends beyond individual health and encompasses social, occupational, and academic functionality. Notably, sleep plays a crucial role in athletic performance, impacting training, actual performance, and recovery. As a result, there has been a notable increase in empirical attention towards the sleep health of athletes, sparked by the seminal work of Mah and colleagues in 2011, which demonstrated the positive effects of improved sleep health on the performance of collegiate basketball players. Over the last decade, the recognition of the significance of sleep within the realm of professional sports has become prevalent. Professional athletes face distinctive challenges that pose risks to their sleep health. These challenges include frequent travel, which disrupts their internal body rhythms and sleep patterns, demanding training regimens that can take a toll on their rest and recovery, as well as the considerable anxiety and stress associated with competitive performance. Consequently, the overall risk of poor sleep health among athletes is heightened. Despite still being an area of active exploration, the domain of empirical research related to sleep in professional athletes has witnessed considerable growth in recent years. This increase reflects the growing acknowledgment of the crucial role of sleep in an athlete’s training, recovery, performance, and overall well-being. The exploration of sleep’s impact on athletic performance holds immense potential to optimize athletes’ sleep health, enhance their recovery processes, and maximize their on-field performance. By addressing the unique demands and challenges faced by athletes and emphasizing the importance of sleep, researchers and practitioners strive to promote the overall well-being, longevity, and success of professional athletes in their respective sports.
Scope of Research
This review aims to summarize recent research conducted in the past five years specifically focusing on the relationship between sleep and performance in professional athletes. Hence, the review will only include literature published in 2018 and onwards. Prior to 2018, authors recommend referring to the works of Watson (2017), Gupta and colleagues (2017), Simpson and colleagues (2017), and Nedelec and colleagues (2018) for a comprehensive review of related literature. It is important to note that this review exclusively focuses on professional athletes and, therefore, does not include literature related to nonprofessional high-level athletes, such as collegiate athletes. For specific information on sleep and performance in nonprofessional high-level athletes, authors suggest consulting works by Knufinke and colleagues (2017), Kroshus and colleagues (2019), Wilkes JR and colleagues (2021), and Charest and Grandner (2022). Furthermore, the authors excluded research pertaining to professional eSports, and the intention was to primarily focus on traditional athletic contexts. While there is limited literature available on sleep in eSports professionals, it is worth noting that this population of professional athletes may have unique vulnerabilities to poor sleep health due to factors such as irregular sleep-wake schedules, prolonged exposure to electronic screens, and elevated caffeine consumption. If interested in exploring sleep within this particular population, authors recommend considering the works of Bonnar and colleagues (2019), Bonnar and colleagues (2022), and Lee and colleagues (2021). The authors found a total of 38 articles that met the criteria for this review. These articles were used to analyze the latest research on the relationship between sleep and performance in professional athletes.
Relationship of Sleep with Training
Achieving optimal athletic performance is dependent upon effective training. While the specifics may vary across different sports and among individual athletes within the same sport, professional athletes typically engage in year-round training, both during and outside of competition seasons. The intensity of their training is adjusted throughout the calendar year and competition schedule. Sleep plays a vital role in an athlete’s ability to adhere to demanding training schedules and maximize the benefits of training by ensuring peak effort and endurance. Through the examination of relevant literature, the authors discovered four articles that specifically explore the significance of sleep in the training of professional athletes. In a study involving professional mixed martial arts athletes undergoing a 6-week training camp, Peacock and colleagues (2018) established a correlation between higher sleep quality and regularity with fewer missed practice sessions. This association can be attributed to reductions in fatigue, illness, and injuries. This finding aligns with the research conducted by Fitzgerald and colleagues (2019), which revealed that decreased sleep quantity was linked to a higher incidence of illness among professional Australian football athletes. Peacock et al. also demonstrated that improved sleep characteristics, such as reduced sleep latency, were associated with enhanced physical performance abilities during the 6-week training period. Similarly, Teece and colleagues (2021) highlighted the detrimental effects of shorter sleep duration on the aerobic capacity of professional rugby athletes during preseason training. Finally, Serpell et al. (2019) identified significant connections between sleep duration and efficiency, and salivary testosterone and cortisol levels in a sample of professional rugby athletes. This is particularly important since these hormones greatly impact an athlete’s training ability and outcomes.In summary, sleep has been demonstrated to affect professional athletes’ training by influencing their attendance at training sessions and enhancing the outcomes of training sessions through improved physical performance and physiological factors. Further research is needed to evaluate how promoting healthy sleep habits among professional athletes can influence training outcomes and help manage variations in training load and intensity. Additionally, it is important to produce research that highlights the positive effects of good sleep health in terms of illness prevention, increased training attendance, and enhanced training effectiveness. While research often focuses on the consequences, emphasizing positive outcomes related to training may be more motivating for athletes, coaches, teams, and organizations to initiate change.
Relationship of Sleep with Physical Injury (Prevention and Recovery)
Engaging in athletic training and competition inherently comes with the risk of physical injury. Injuries not only disrupt training and hinder competitive performance but also have psychological ramifications. Consequently, there is a need to identify modifiable factors that can improve the prevention and recovery of injuries in professional athletes. Studies have shown that sleep plays a crucial role in an athlete’s susceptibility to injury and their ability to effectively recuperate from injuries. While this association applies to all types of athletic injuries, it has been extensively investigated within the realm of concussions. Inadequate sleep not only acts as a primary risk factor for sports-related concussions but also negatively affects the severity of concussions, the time required for recovery, and overall treatment outcomes. Surprisingly, this review uncovered a dearth of recent studies (involving only three) examining the relationship between sleep health and injury prevention and recovery in professional athletes. Peacock and colleagues (2019) discovered a significant correlation between an inconsistent sleep schedule and the number of injuries in a group of mixed martial arts professionals. On the other hand, Serpell and colleagues (2019) failed to establish significant connections between measured sleep parameters and daily muscle soreness over a six-week training period in professional rugby athletes. However, this study did find that poor sleep health had unfavorable effects on hormones like testosterone and cortisol, which are vital for musculoskeletal growth and repair. This aligns with the work of Swinbourne and colleagues (2018), which demonstrated a decrease in average cortisol levels following a sleep extension intervention among professional rugby players.Overall, sleep plays a pivotal role in preventing and recovering from physical injuries. However, there is a paucity of empirical research directly investigating the link between sleep health and injury prevention and recovery in professional athletes. It is essential to conduct longitudinal studies that monitor athletes’ sleep patterns, injury status, and relevant physiological markers throughout an entire season or calendar year. This comprehensive research approach is vital for improving our understanding of the impact of sleep health on injury prevention and recovery. Furthermore, it is necessary to explore variations across different sports due to varying risks for injuries, differences in physical demands, length of competition seasons, travel requirements, and training and competition schedules.
Relationship of Sleep with Mental Health
The mental well-being of athletes is crucial for optimal athletic performance. Athletes, being susceptible to mental health problems and disorders, face various factors such as performance anxiety, pressure from peers, trainers, and media, mental exhaustion from intense training and frequent travel, diminished self-esteem within the sports culture, and certain personality traits associated with mental health issues. It has been estimated that approximately one-third of elite athletes, including professionals and Olympic athletes, experience mental health problems like anxiety and depression. Therefore, it is essential to identify factors that protect against or exacerbate mental health issues in professional athletes, not only for their performance but also for their overall well-being.We have written before about the mental health of elite athletes within our review of the IOC Consensus Statement which you can read by clicking here. Sleep health and mental health have a closely intertwined relationship. Sleep problems can be indicative of existing mental health problems or disorders, and vice versa. Concurrent sleep and mental health issues often lead to more severe mental health symptoms. Consequently, the sleep health of professional athletes acts as both a risk factor and a protective factor for mental health problems. Despite the significant link between sleep health and mental health, as well as the impact of mental health on athletic performance and athlete well-being, only four relevant pieces of literature have been identified. Gouttebarge and colleagues (2018) found high rates of mental health problems among professional rugby players, including anxiety, depression, alcohol misuse, eating disorders, and general psychological distress. It is likely that many individuals experiencing symptoms of anxiety/depression or other mental health issues also reported sleep disturbances due to the close connection between sleep and mental health. Facer-Childs and colleagues (2022) demonstrated the significant role of sleep health in mental health among Australian Football League athletes. Multiple sleep monitoring measures accounted for a considerable portion of the variance in depression, anxiety, and stress symptoms. Jurecka and colleagues (2021) conducted a systematic review of the impact of the COVID-19 pandemic on the mental well-being and quality of life of professional athletes, revealing a deteriorating relationship between sleep ability, mental health, and overall well-being. Teece and colleagues (2021) found small yet meaningful correlations between improved sleep efficiency and reduced sleep latency with enhanced wellness and mood in professional rugby players.However, there remains a lack of research on the relationship between sleep and mental health in professional athletes. Considering the bidirectional nature of this relationship and the potential for improving mental health by enhancing sleep health and vice versa, it is crucial for future studies to investigate these dynamics among professional athletes in different sports and individual contexts. This will contribute to a better understanding of the influence of sleep health on the mental well-being of professional athletes within the unique settings of their respective sports.
Relationship of Sleep with Competitive Performance
Poor sleep health can negatively impact competitive performance in various ways, including insufficient training, increased risk of injury and illness, and compromised mental health. It can also directly affect cognitive, psychological, and physical functioning during athletic competitions, leading to slower reaction times, emotional instability, fatigue, reduced accuracy, strength, speed, endurance, motivation, and resilience. Conversely, adequate sleep before competition can enhance performance. Therefore, it is crucial for professional athletes to prioritize sleep throughout the year, particularly in the days leading up to competitions, to optimize their performance and overall well-being. Authors literature search yielded six relevant articles highlighting the effects of sleep on competitive performance. Swinbourne et al. (2018) studied professional rugby players who extended their sleep duration, resulting in improved vigilance indicated by reduced reaction times. Stavrou et al. (2021) found a similar association between poor sleep quality and impaired reaction time and perceptual ability in professional soccer players. They also observed a link between poor sleep quality and reduced oxygen capacity during exercise training. Peacock et al. (2018) demonstrated that longer sleep initiation time and lower sleep efficiency were related to compromised physiological functioning and physical activity in professional mixed martial artists. Lipert et al. (2021) showed that good sleep quality protected against performance deficits in endurance athletes during Ramadan fasting. Sargent et al. (2022) found that top performers in a professional cycling race obtained more sleep during the competition compared to lower-ranked athletes. Jones et al. (2019) investigated the effects of late-night tweeting, associated with sleep restriction, on game performance in professional NBA players, revealing reduced scoring, rebounds, and shooting accuracy.These findings collectively emphasize the importance of sleep for optimizing competitive performance. Professional athletes should prioritize sleep quality and duration not only for their overall well-being but also to enhance their performance outcomes during training and competitions.
Relationship of Sleep with Travel and Time Zones
Apart from the mentioned studies, we found six other investigations that examined the effects of traveling across time zones on performance outcomes in professional athletes. Traveling across time zones often leads to decreased sleep quality due to factors like disruptions in circadian rhythms, fatigue from travel, and irregular sleep patterns. These findings are particularly relevant to the review as they highlight the relationship between travel across time zones, a significant factor affecting the sleep health of professional athletes, and performance outcomes. Roy and Forest (2018) analyzed five consecutive seasons (2010-2015) of the NBA, NHL, and NFL to study the impact of time zone changes on team performance. They observed that traveling westward resulted in a significantly lower winning percentage in the NBA and NHL, while no clear disadvantage was found in the NBA for afternoon games. The authors also found a linear reduction in winning percentage with each additional time zone traveled. Charest et al. (2021) conducted a study on back-to-back games in the NBA from 2013 to 2020, showing a 3.69% lower winning percentage when teams traveled westward compared to eastward. However, the study revealed that factors other than direction and time zone change, such as game sequence and travel distance, also influenced team performance. Glinski and Chandy (2022) explored the impact of jet lag on NBA free throw shooting and found that teams had a significantly lower free throw percentage when experiencing jet lag from traveling westward across at least three time zones. Conversely, Leota et al. (2022) demonstrated that eastward time zone changes were associated with reduced performance in the NBA, including winning percentage and various statistical differentials. Zacharko et al. (2022) concluded that eastward travel across time zones had a more negative impact on performance outcomes than westward travel in professional soccer players. McHill and Chinoy (2020) showed lower winning percentages and reduced shooting accuracy, effort, and defensive performance in professional athletes when traveling across time zones, regardless of travel direction. However, the magnitude of the relationships varied based on the direction of travel.Overall, it is clear that travel across time zones can negatively affect competitive performance, with sleep health being a major contributing factor. Nevertheless, more research is needed to address discrepancies in the literature and better understand the influence of travel direction on performance outcomes, considering methodological differences and sport-specific variations. It is evident that both acute and chronic sleep disturbances can directly impact the competitive performance of professional athletes by affecting cognitive, psychological, and physical functioning.However, there is still a lack of research specifically examining the relationship between sleep health and performance before, during, and after competitions. It is recommended that professional teams and athletes collaborate with researchers to investigate these relationships and gain a clearer understanding of how various aspects of sleep health, such as duration, regularity, continuity, and quality, influence competitive performance.
Most Common Sleep Problems in Professional Athletes
Professional athletes face unique challenges that can negatively impact their sleep health, leading to an increased risk of developing sleep problems. This section aims to describe common sleep problems in professional athletes, including poor sleep quality, insufficient sleep duration, insomnia-related characteristics, daytime sleepiness, and sleep-disordered breathing. Multiple studies have explored sleep characteristics and problems in professional athletes. Poor sleep quality was found to be prevalent, with many studies using the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. For instance, studies on professional rugby players and professional athletes’ sleep quality prior to Ramadan revealed clinically significant poor sleep quality. Gender differences also played a role, as female professional cross-country mountain bikers reported worse sleep quality than males. Insufficient sleep duration, characterized as habitual sleep duration of less than 7 hours per night according to the National Sleep Foundation guidelines, was a common problem among professional athletes. Studies on professional soccer players and rugby players indicated high rates of insufficient sleep duration. Professional Australian rules footballers and road cyclists also experienced insufficient sleep duration regularly, as did professional cricketers, despite reporting a nightly sleep need of over 8 hours. Sleep duration was affected by individual characteristics such as circadian preference. Insomnia characteristics, such as difficulty falling asleep and maintaining sleep, were prevalent among professional athletes. These characteristics had significant daytime consequences for physical, psychological, cognitive, and social functioning. Insomnia prevalence was captured through various measurements, including the Insomnia Severity Index (ISI). Studies revealed that professional soccer players and Australian Football League athletes had subthreshold or clinically significant symptoms of insomnia. Sleep onset latency and wake after sleep onset were also affected, leading to lower sleep efficiency. Sleep behaviors, such as irregular sleep schedules and maladaptive sleeping environments, were more pronounced in professional athletes compared to non-athlete cohorts.Daytime sleepiness, although not a sleep problem on its own, often indicates underlying sleep problems or disorders. Professional athletes with unhealthy sleep patterns commonly experienced daytime sleepiness. Studies on professional soccer players and Australian Football League athletes identified a significant proportion reporting higher levels of daytime sleepiness. Future investigations on sleep problems in professional athletes are encouraged to utilize daytime sleepiness as an indicator of poor sleep health. Sleep-disordered breathing, particularly obstructive sleep apnea (OSA), was found to be prevalent among professional athletes, although individual and sport-related differences influenced its occurrence. Screening for sleep-disordered breathing, especially in high-risk sports such as football and rugby, should be an integral part of health evaluations. The limited research available showed that a substantial number of professional rugby athletes displayed mild or moderate sleep-disordered breathing. Ethnicity also played a role, with Polynesian athletes showing a higher prevalence of mild or moderate sleep-disordered breathing. While sleep problems are common among professional athletes, there is evidence of good sleep quality and sufficient sleep duration in some cases. Professional basketball players, male Australian Football League athletes, female Australian Football League athletes with a morning or intermediate circadian preference, and professional mountain bikers demonstrated healthy sleep patterns.Overall, the findings suggest that poor sleep health is not universal among professional athletes and should be analyzed considering individual and sport-specific characteristics.Summary
Sleep health plays a crucial role in professional athletes’ training, recovery, performance, and well-being. However, sleep problems and disorders are common in this population. While some progress has been made in addressing sleep health, more research is needed. Partnerships between athletes, teams, organizations, and independent researchers can help advance the research and develop interventions. Standardized guidelines for research methodology and sleep measurement tools specific to professional athletes are necessary. Improving sleep health can significantly enhance athletes’ performance and overall well-being.
A schematic depiction of the complex, bidirectional relationship between sleep health and performance, along with the core influencing factors. Check the original paper for the relevant references.
Key Takeaways
- Sleep health is vital for professional athletes’ training, recovery, performance, and well-being.
- Sleep problems and disorders are prevalent among professional athletes.
- Enhanced attention to sleep health is emerging among professional athletes.
- Unique challenges related to training, travel, and competition can impact healthy sleep behaviors.
- Partnerships between athletes, teams, organizations, and researchers are crucial for advancing research and interventions.
- Standardized guidelines for research methodology and sleep measurement tools specific to professional athletes are needed.
- Improving sleep health can significantly benefit athletes’ performance and overall well-being.
If you would like to learn more about the specific factors that pose challenges to the sleep health of professional athletes, such as training, travel, competition, physical injuries and illnesses, electronic device usage, and dietary habits please proceed to the original study here.
