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Does Elite Sport Degrade Sleep Quality? A Systematic Review.

ABSTRACT: Information 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.The 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.Studies 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.The 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.While 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.

SUBMITTER: Gupta L

PROVIDER: S-EPMC5488138 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Does Elite Sport Degrade Sleep Quality? A Systematic Review.

Gupta Luke L Morgan Kevin K Gilchrist Sarah S

Sports medicine (Auckland, N.Z.) 20170701 7

<h4>Background</h4>Information 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.<h4>Objectives</h4>The 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.<h4> ...[more]

PMID: 27900583

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Project description:CONTEXT:Cannabis use has increased, in large part due to decriminalization. Despite this increase in usage, it remains unclear what proportion of athletes use cannabis and what effect it has on athletic performance and recovery. OBJECTIVE:To systematically review cannabis use among athletes, including epidemiology, effect on performance and recovery, and regulations for use in sport. DATA SOURCES:PubMed, MEDLINE, and EMBASE databases were queried from database inception through November 15, 2018. A hand search of policies, official documents, and media reports was performed for relevant information. STUDY SELECTION:All studies related to cannabis use in athletes, including impact on athletic performance or recovery, were included. STUDY DESIGN:Systematic review. LEVEL OF EVIDENCE:Level 4. DATA EXTRACTION:Demographic and descriptive data of included studies relating to epidemiology of cannabis use in athletes were extracted and presented in weighted means or percentages where applicable. RESULTS:Overall, 37 studies were included, of which the majority were cross-sectional studies of elite and university athletes. Among 11 studies reporting use among athletes (n = 46,202), approximately 23.4% of respondents reported using cannabis in the past 12 months. Two studies found a negative impact on performance, while another 2 studies found no impact. There was no literature on the influence of cannabis on athletic recovery. Across athletic organizations and leagues, there is considerable variability in acceptable thresholds for urine tetrahydrocannabinol levels (>15 to 150 ng/mL) and penalties for athletes found to be above these accepted thresholds. CONCLUSION:Overall, these results suggest that approximately 1 in 4 athletes report using cannabis within the past year. Based on the available evidence, cannabis does not appear to positively affect performance, but the literature surrounding this is generally poor. Given the variability in regulation across different sport types and competition levels, as well as the growing number of states legalizing recreational cannabis use, there is a need to improve our understanding of the effects of cannabis use on the athlete and perhaps adopt a clearer and overarching policy for the use of cannabis by athletes in all sports and at all levels.

Project description:BackgroundInsomnia is common. However, no systematic reviews have examined the effect of exercise on patients with primary and secondary insomnia, defined as both sleep disruption and daytime impairment. This systematic review and meta-analysis aimed to examine the effectiveness/efficacy of exercise in patients with insomnia.MethodsWe searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov to identify all randomized controlled trials that examined the effects of exercise on various sleep parameters in patients with insomnia. All participants were diagnosed with insomnia, using standard diagnostic criteria or predetermined criteria and standard measures. Data on outcome measures were subjected to meta-analyses using random-effects models. The Cochrane Risk of Bias Tool and Grading of Recommendations, Assessment, Development, and Evaluation approach were used to assess the quality of the individual studies and the body of evidence, respectively.ResultsWe included nine studies with a total of 557 participants. According to the Pittsburgh Sleep Quality Index (mean difference [MD], 2.87 points lower in the intervention group; 95% confidence interval [CI], 3.95 points lower to 1.79 points lower; low-quality evidence) and the Insomnia Severity Index (MD, 3.22 points lower in the intervention group; 95% CI, 5.36 points lower to 1.07 points lower; very low-quality evidence), exercise was beneficial. However, exercise interventions were not associated with improved sleep efficiency (MD, 0.56% lower in the intervention group; 95% CI, 3.42% lower to 2.31% higher; moderate-quality evidence). Only four studies noted adverse effects. Most studies had a high or unclear risk of selection bias.DiscussionOur findings suggest that exercise can improve sleep quality without notable adverse effects. Most trials had a high risk of selection bias. Higher quality research is needed.

Project description:To systemically review all studies reporting return to sport following tibial plateau fracture, in order to provide information on return rates and times to sport, and to assess variations in sporting outcome for different treatment methods.A systematic search of CINAHAL, Cochrane, EMBASE, Google Scholar, MEDLINE, PEDro, Scopus, SPORTDiscus and Web of Science was performed in January 2017 using the keywords "tibial", "plateau", "fractures", "knee", "athletes", "sports", "non-operative", "conservative", "operative", "return to sport". All studies which recorded return rates and times to sport following tibial plateau fractures were included.Twenty-seven studies were included: 1 was a randomised controlled trial, 7 were prospective cohort studies, 16 were retrospective cohort studies, 3 were case series. One study reported on the outcome of conservative management (n = 3); 27 reported on the outcome of surgical management (n = 917). Nine studies reported on Open Reduction Internal Fixation (ORIF) (n = 193), 11 on Arthroscopic-Assisted Reduction Internal Fixation (ARIF) (n = 253) and 7 on Frame-Assisted Fixation (FRAME) (n = 262). All studies recorded "return to sport" rates. Only one study recorded a "return to sport" time. The return rate to sport for the total cohort was 70%. For the conservatively-managed fractures, the return rate was 100%. For the surgically-managed fractures, the return rate was 70%. For fractures managed with ORIF, the return rate was 60%. For fractures managed with ARIF, the return rate was 83%. For fractures managed with FRAME was 52%. The return rate for ARIF was found to be significantly greater than that for ORIF (OR 3.22, 95%CI: 2.09-4.97, P < 0.001) and for FRAME (OR 4.33, 95%CI: 2.89-6.50, P < 0.001). No difference was found between the return rates for ORIF and FRAME (OR 1.35, 95%CI: 0.92-1.96, P = 0.122). The recorded return time was 6.9 mo (median), from a study reporting on ORIF.Return rates to sport for tibial plateau fractures remain limited compared to other fractures. ARIF provides the best return rates. There is limited data regarding return times to sport. Further research is required to determine return times to sport, and to improve return rates to sport, through treatment and rehabilitation optimisation.

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Does Elite Sport Degrade Sleep Quality? A Systematic Review.

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Does Elite Sport Degrade Sleep Quality? A Systematic Review.

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