Just like a training routine sets you up for athletic success, a bedtime routine sets you up for sleep success. Daily life is full of stressors that can sabotage your best attempts to establish a healthy sleep routine.

One of those stressors may be a wearable device tracking your sleep. If you're sleep deprived, seeing regular reminders of your lack of sleep can be stressful.

Just like learning and gaining proficiency in your sport takes practice, so does getting a good night's sleep. The sleep habits you develop and practice now will last a lifetime.

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Heart disease refers to a rangeRead more. By Dan Lea. Share this:. Amy Rantala. Mayo Clinic Minute: Hypertension and cardiovascular disease in the Black community. Lastly, McHill and Chinoy evidenced lower winning percentages, as well as decreased shooting accuracy, effort, and defensive performance, when traveling across time zones, regardless of travel direction [ 49 ].

However, there was variation in the magnitude of the relationships based on whether travel was eastward or westward. Taken together, their results suggest that time zone change, in any direction, likely degrades competitive performance but highlights the potential for different aspects of basketball performance to be differentially affected based on the amount of time zone change and direction of travel, among other factors.

Overall, it is clear that travel across time zones is likely to negatively influence competitive performance, with degraded sleep health—a consequence of travel across time zones—playing a central role in these relationships [ 51 , 52 ].

Yet, further research is necessary to address contrasting findings among existing studies regarding the unique import of directionality of travel, with inconsistencies across results likely driven by differences in methodologies employed in the investigations as well as sample specific variation e.

As it evident, poor sleep health—whether acute or chronic—has the potential to directly impact competitive performance in professional athletes through its effects on cognitive, psychological, and physical functioning. However, there remains a deficiency of research within professional athletes directly evaluating the relationship between sleep health and performance abilities and outcomes preceding, during, and following competition.

Professional teams and athletes should formulate relationships with researchers to appropriately assess these relationships to better clarify the magnitude of impact of various components of sleep health e. The unique challenges that professional athletes experience, which are presented and discussed in later sections, have the potential to negatively influence sleep health, resulting in an increased risk for developing sleep problems.

This section of the review is purposed to merely describe common sleep problems within professional athletes, including poor sleep quality, insufficient sleep duration, insomnia-related characteristics, daytime sleepiness, and sleep-disordered breathing.

Poor sleep quality was extremely common across the literature, with most studies relying on the Pittsburgh Sleep Quality Index PSQI to assess for sleep quality. Teece and colleagues had a nearly identical finding in a separate sample of professional rugby players, whereby average mean PSQI suggested clinically significant poor sleep quality [ 22 ], which also aligned with the findings of Lipert and colleagues in their investigation of professional athlete sleep quality prior to Ramadan [ 41 ].

Khalladi and colleagues showed that Facer-Childs and colleagues evidenced a clinically significant average PSQI across a sample of professional Australian Football League athletes, with Importantly, Garbelloto and colleagues evidenced the importance of individual characteristics e.

Based on the National Sleep Foundation guidelines, insufficient sleep duration for adults is characterized by habitual sleep duration less than 7 h per night [ 65 ]. Insufficient sleep duration is an extremely common problem among professional athletes.

In their sample of professional soccer players, Khalladi and colleagues concluded that Similarly, Teece and colleagues showed that insufficient sleep duration was experienced by nearly half of professional rugby sample [ 22 ].

Sargent and colleagues also evidenced an alarming prevalence of insufficient sleep duration, whereby average sleep duration across an entire season fell below 7 h in a sample of professional Australian rules footballers [ 55 ].

Additionally, Facer-Childs and colleagues demonstrated a Importantly, Lastella and colleagues highlighted the potential influence of individual characteristics on likelihood for insufficient sleep duration [ 57 ]. In this investigation of professional female Australian footballers, insufficient sleep duration was not observed in those identifying as a morning or intermediate circadian preference, but rather only in those with evening preference [ 57 ].

These problems result in notable daytime consequences related to physical, psychological, cognitive, and social functioning, which can have widespread ramifications for an athlete on-and-off the field [ 66 ]. Insomnia characteristics are often captured either through prolonged sleep onset latency SOL or wake after sleep onset WASO , with these unique insomnia characteristics globally captured by low sleep efficiency SE.

Additionally, the Insomnia Severity Index ISI exists as one of the most widely utilized questionnaires for capturing insomnia characteristics. Research investigations commonly leverage the ISI for the purpose of capturing insomnia prevalence. Similarly, Facer-Childs and colleagues evidenced that Ballesio and colleagues also showed a high rate of insomnia characteristics across a different sample of professional soccer players, with Importantly, Lastella and colleagues evidenced that professional female Australian footballers with evening circadian preference were more likely to experience lower SE, relative to those with morning and intermediate circadian preference [ 57 ].

This may be a particularly focal contributing factor to insomnia-related characteristics in professional athletes, as Cameron and colleagues evidenced worse sleep behaviors schedule irregularity and maladaptive sleeping environments in professional athletes, relative to and age-matched non-athlete cohort, which also coincided with significantly more general sleep disturbances [ 60 ].

Daytime sleepiness is not necessarily a sleep problem but can be viewed as a proxy into existing sleep problems or disorders as it is a common consequence of unhealthy sleep.

Given the high frequency of unhealthy sleep among professional athletes, it is likely that daytime sleepiness is prevalent among professional athletes. Indeed, Khalladi and colleagues showed that Facer-Childs and colleagues showed that However, we were unable to find any other literature over the last 5 years that assessed daytime sleepiness in professional athletes.

Since daytime sleepiness can serve as a broad-spanning indicator of poor sleep health, leveraging this conveniently capturable characteristic in future investigations evaluating sleep problems in professional athletes is highly encouraged.

Sleep-disordered breathing SDB , most commonly obstructive sleep apnea OSA , is a highly prevalent sleep problem, which highlights the likelihood of this being a common problem among professional athletes as well. However, there are likely to be major individual and sport-related differences in terms of SDB prevalence across professional athletes since certain characteristics, such as being male and having thick necks, heighten the risk for SDB.

Since SDB not only exists as a contributor to poor sleep health but also is a major risk factor for severe medical conditions, such as cardiovascular disease, SDB screening should be a focal component of health evaluations in professional athletes, especially those with features heightening risk for SDB e.

Somewhat surprisingly, we were only able to identify one study that recently assessed SDB in a sample of professional athletes. Caia and colleagues assessed a sample of adult professional rugby athletes using home-based polysomnography [ 61 ]. Utilizing established severity thresholds for the apnea—hypopnea index AHI , a valid measure of SDB, As is evident, sleep problems, such as poor sleep quality, insufficient sleep duration, insomnia characteristics, daytime sleepiness, and sleep-disordered breathing, are common among professional athletes.

Yet, encouragingly, the relevant literature did not universally showcase poor sleep health or sleep problems among professional athletes.

Clemente and colleagues evidenced generally good sleep quality in a sample of professional basketball players across a full season [ 62 ]. Furthermore, Caia and colleagues demonstrated healthy SOL and sleep efficiency in their sample of professional rugby athletes, measured through actigraphy [ 63 ].

These findings may reflect the increased attention and consideration to sleep health of professional athletes over the recent years. Additionally, these findings concretely showcase that poor sleep health is not a universal problem among professional athletes but rather needs to be analyzed at a more granular level, with recognition of the influence from individual and sport-specific characteristics.

As is evident by the previous section, poor sleep health and sleep problems are common among professional athletes. Principally, these sections will draw attention to the impact of training, travel, and competition on the sleep health of professional athletes.

Additionally, other factors emerged from the literature search, such as physical injury and illness, electronic use, and nutritional habits, that exist as challenges for professional athletes in their pursuit of sleep health.

For professional athletes to perform at their best during competition, consistent and effective training is necessary. Although the training period, frequency, timing, and load will vary across sport, it is often the case that professional athletes train year-round, with variations in the frequency, timing, and load of training based on season status in-season vs.

off-season , number of and proximity to upcoming competitions, and the goal of training maintenance vs. Professional athletes may be more susceptible to degraded sleep health during periods of high training loads, relative to periods of low training loads, due to influence from increased physical and mental fatigue, heightened psychological distress over meeting training demands, and merely due to the fact that increasing the amount of training inherently requires more time commitment and, generally, earlier training sessions that can infringe upon healthy sleep behaviors and sufficient sleep opportunity [ 13 , 71 , 72 , 73 ].

Caia and colleagues evidenced a significant reduction in sleep duration on training days in a sample of professional rugby athletes [ 61 ].

Teece and colleagues showed a similar relationship between general training and sleep in professional athletes, whereby professional rugby athletes on average displayed a min reduction in nightly sleep duration during preseason training [ 22 ].

Since this reduction also coincided with a significant increase in training load and physical fatigue scores, the authors posited that the increased physical fatigue resulting from increased training load was driving the reduction in nightly sleep duration. The negative influence of increased training load on sleep health of professional athletes was further evidenced by Conlan and colleagues in their study of a sample of professional rugby league athletes [ 59 ].

Relative to low training load weeks, sleep duration was significantly reduced by 32 min, which was a product of later bedtimes and earlier risetimes.

As such, it is not necessarily the increased physical fatigue associated with increasing training load that is negatively influencing sleep health, but also the timing of training. Yet, encouragingly, not all the identified literature evidenced negative changes in sleep health associated with training.

Serpell and colleagues found no significant differences in sleep duration or sleep onset latency across a short, 4-day preseason camp for professional rugby union athletes [ 24 ]. Somewhat surprisingly, a statistically significant increase in sleep efficiency was observed across the preseason camp period, with this most pronounced when comparing night 2 to night 3.

Yet, sleep duration on training days was still slightly reduced relative to rest days, which was principally driven by earlier wake times, as sleep efficiency remained comparable between the two periods. Lastly, Ballesio and colleagues did not find a significant association between late night training and insomnia symptom severity, which was surprising given the theoretical belief that late night training should induce pre-sleep arousal which in turn could lead to difficulties falling asleep or maintaining sleep [ 58 ].

Thus, it is clear that training has the potential, and is likely, to negatively influence the sleep health of professional athletes through multiple pathways, including increased physical fatigue and earlier wake times.

However, the magnitude of degradation on sleep health is going to depend on training characteristics e. Professional athletes often have to travel frequently, which creates a unique challenge for sleep health due principally to disruption of the circadian rhythm as well as travel fatigue that impacts both mental and physical function [ 50 , 51 , 52 , 71 ].

Given that many professional athletes frequently are subjected to travel across time zones, especially during competitive season, constant circadian disruption is inevitable which leaves these individuals vulnerable to degraded sleep health that has the potential to negatively impact performance.

Additionally, frequent travel is mentally and physically fatiguing, which can result in degraded sleep health as well as performance deficits [ 50 ].

We were only able to identify three studies that directly analyzed the effects of travel on sleep health in professional athletes [ 74 , 75 , 76 ].

Lastella and colleagues showed that long-haul air travel, despite minimal change across time zones, significantly disrupted the sleep—wake behaviors and degraded sleep health of professional soccer players [ 74 ]. Specifically, sleep initiation was delayed by 3.

The authors posited that physical factors associated with travel, such as exposure to mild hypoxia as well as cramped conditions, long layovers, and restricted movement that increase fatigue, were likely driving these changes in sleep—wake behaviors and sleep health given the minimal circadian disruption associated with this specific long-haul travel.

Smithies and colleagues showed similar effects of long-distance transmeridian travel LDTT on sleep duration in a sample of professional Super Rugby athletes, with LDTT defined as travel across more than 3 time zones [ 75 ].

Significant irregularities in the timing of sleep onset and offset, as well as sleep duration, were observed across travel periods. Although variation was observed across the paradigm, likely due to influence from circadian acclimation and competition-related factors, sleep duration generally was significantly reduced when experiencing LDTT.

Additionally, the reductions in sleep duration associated with LDTT generally persisted for at a least a day following the travel. Lastly, Lo and colleagues showed similar relationships in their study of four different professional Super Rugby teams traveling overseas for competition [ 76 ].

Three of the four teams showed a substantial reduction in sleep duration when overseas, which the authors explained as a combination of travel fatigue, jet lag, and disruption of normal sleep behaviors. Although competition start times will vary notably across sports, competitions often occur in the late evening for professional sports to maximize viewership.

The late start times of competition likely drive delayed sleep behaviors. Additionally, competition is likely to result in heighted pre-sleep arousal given the timing of physical exertion and psychological response post-competition, which could negatively influence sleep ability and quality.

Pre-competition psychological worry and post-competition psychological distress over undesired outcomes are two other competition-related factors that may degrade sleep health. We identified eight pieces of literature that pertain to the influence of competition factors on sleep health in professional athletes [ 55 , 60 , 62 , 74 , 75 , 76 , 77 , 78 , 79 ].

In a sample of professional athletes across rugby, netball, and soccer, Cameron and colleagues evidenced the perception of significant, negative effects of competition on sleep [ 60 ].

The authors theorized that precognitive arousal following competition plays a key role in this finding. Sargent and colleagues demonstrated the effects of competition and competition timing on sleep health in a sample of professional Australian rules footballers [ 55 ].

Bedtime was delayed while risetime was advanced on nights following competition, relative to nights prior to competition, which resulted in about 2. Furthermore, these relationships were moderated by competition start time, with athletes obtaining about 40 min less sleep on nights of evening competition, relative to nights of day competition.

Bedtime was the latest on nights following competition while risetime was the earliest on mornings following competition, relative to other conditions training, rest, and pre-competition , which resulted in significantly reduced total sleep time. Some of the reduction in sleep duration for this sample was due to earlier risetimes necessary to meet early travel departure following competition.

Caia and colleagues further showcased the unique, deleterious effects of competition on sleep behaviors, ability, and quality in a sample of professional rugby league athletes [ 77 ].

Specifically, these athletes displayed significantly delayed bedtime, shorter sleep duration, greater sleep onset latency, and worse sleep efficiency on competition nights. The authors theorized that pre-sleep arousal principally contributed to these outcomes and emphasized the role of caffeine use prior to and during competition as a contributor to pre-sleep arousal.

The relationships between competition timing and delay of behaviors likely to negatively influence sleep was also shown by Falkengberg and colleagues in a sample of professional Australian football players, where meal timing was delayed on competition days which seemingly contributed to later bedtimes and increased wake after sleep onset [ 78 ].

Lo and colleagues also showed significantly reduced sleep duration on competition nights in a sample of professional rugby athletes, with these results recognizing competition-related psychological stressors as one factor contributing to the reduction in sleep duration [ 76 ].

When considering the congestion of competition on sleep, Clemente and colleagues saliently showcased the exacerbating nature of more competition congestion on sleep health in professional athletes [ 62 ]. Congested weeks associated with lower sleep quality ratings, relative to regular weeks.

Differences in methodology may explain inconsistencies in findings, as each study utilized a different questionnaire to capture sleep quality. There are also granular factors that contribute to the relationships between match congestion and sleep health, such as the locational sequence of matches, travel to accommodate match congestion, and timing of competition within the congested match schedule.

As such, it is likely that increased competition congestion heightens the deleterious impact of competition on sleep health, yet research that accounts for the nuances moderating these relationships is necessary.

Training, travel, and competition factors are certainly the primary, unique challenges that professional athletes regularly navigate which has the potential to negatively affect sleep health. Yet, there are other factors, such as regularity and magnitude of physical injury and illness, timing of electronic use, and nutritional habits e.

We identified five articles that pertain to other factors with the potential to negatively impact sleep health that may be particularly common among professional athletes [ 21 , 43 , 58 , 77 , 78 ]. Due to many influences, such as constant physical toil and frequent psychological stress, professional athletes are likely at an increased risk for developing illness, which has the potential to negatively influence sleep health.

Indeed, Fitzgerald and colleagues showed that Australian football professional athletes experiencing either acute or chronic illness were at a significantly increased likelihood of having lower sleep duration and reduced sleep quality [ 21 ].

Evening electronic and social media use are common factors among modern life that have the potential to greatly disrupt healthy sleep behaviors as well as degrade sleep ability and quality. Nutrition habit, such as the timing and composition of meals, is another factor that has the potential to influence sleep health of professional athletes [ 80 ].

Falkenberg and colleagues showed the negative impact of meal timing following competition on sleep health in Australian football professional athletes [ 78 ].

Specifically, this study evidenced a relationship between a delay in meal timing, often associated with competition, and delay in bedtime. Furthermore, results from this investigation suggested that increased daily protein intake associated with significantly worse sleep efficiency and increased wake after sleep onset.

Moreover, increasing daily caloric intake associated with increased WASO. Lastly, this study suggested that increasing evening caloric intake associated with longer sleep onset latency and highlighted the deleterious effects of evening sugar intake on sleep duration, sleep efficiency, and wake after sleep onset.

Caffeine and other stimulant use is another component of nutrition that can have a negative influence on sleep health, especially in professional athletes given that these are often leveraged before and during competition to enhance performance.

The findings from Caia and colleagues suggested that caffeine supplementation prior to and during professional rugby league competition resulted in increased post competition salivary caffeine concentration, which—in turn—correlated with a more delayed bedtime, increased sleep onset latency, and reduced sleep efficiency [ 77 ].

The heighted insomnia characteristics, such as elongated sleep onset latency and reduced sleep efficiency, associated with caffeine use was also evidenced by Ballesio and colleagues , whereby consumption of stimulants caffeine, nicotine, and chocolate was associated with insomnia-related characteristics in a sample of professional soccer players [ 58 ].

The relationships between nutrition, meal timing, and sleep health are understudied generally, yet improving clarity on these dynamics may be particularly relevant to professional athletes given their unique dietary needs and obstacles that constrain meal timing behaviors.

Considering the paramount role of sleep health in the training, recovery, performance, and overall well-being of professional athletes, the unique challenges faced by professional athletes that negatively impact sleep health, and the high prevalence of sleep problems and disorders among professional athletes, there is a clear need for accessible, tailored, and effective strategies and interventions to enhance sleep health in professional athletes.

At a foundational level, sleep health education should be provided not just to athletes, but also to individual coaches, professional teams and their supporting staff, and professional organizations.

Providing education on sleep health to athletes would not only improve the knowledge of sleep health, sleep problems, and factors that interfere with healthy sleep but also may contribute to enhanced prioritization of healthy sleep behaviors.

For example, Caia and colleagues showed that sleep hygiene education improved the sleep behavior of athletes in a sample of professional rugby league athletes [ 63 ]. However, the durability of the effects was limited, which suggests that additional strategies and efforts are necessary. Beyond providing sleep education to athletes, education to coaches and teams should be prioritized as this could result in modifications to training and travel schedules purposed to limit the deleterious effects of these factors on the sleep health of their affiliated professional athletes.

Additionally, by educating organizations on the import of sleep health and factors that degrade sleep health in professional athletes, adjustments to competition schedules e.

Furthermore, education to organizations and teams could result in increased allocation of resources for screening professional athletes for sleep problems and disorders as well as connecting them with the appropriate care, when necessary. Ultimately, there is a major need for enhancing the accessibility and quality of sleep health screening and monitoring among professional athletes.

Education is a necessary strategy but is unlikely to be sufficient for the needs of all professional athletes.

Rather, the development of accessible sleep health interventions for professional athletes is warranted. Given the sizeable variation in training, travel, and competition demands across sport types, as well as variation in individual characteristics across sport types, interventions should be constructed to be delivered in a personalized manner.

In their study among professional cricketers, athletes were randomly assigned to either a control group or intervention group. Sleep was monitored for 2 weeks across each condition, with all athletes receiving feedback on compliance after week 1.

However, the intervention group received additional, individualized provision of sleep e. Unsurprisingly, the intervention group displayed significantly better change in sleep health characteristics related to bedtime, time in bed, and total sleep time, relative to the control group, when comparing differences between week 1 and week 2 data.

Furthermore, there is major variation across the calendar year that highlights the need for sleep-focused interventions to be dynamic in their ability to adapt to the challenges being faced at a given time in a competition schedule e.

As such, future work is warranted to develop and evaluate interventions, appropriately tailored to the lifestyle and demands of professional athletes across various sport types, that can not only be delivered in a personalized manner but also dynamically adjust to differential challenges and constraints faced by professional athletes across a calendar year.

Research efforts purposed to evaluate these interventions should measure the impact of improved sleep health on competition-related outcomes as well as those beyond competition e. Lastly, interventions need to be appropriately designed for professional athletes given the idiosyncratic nature of their lifestyles and, as a result, their sleep [ 81 ].

Treating insomnia is a salient example of the need to tailor traditional sleep interventions for professional athletes. Cognitive behavioral therapy for insomnia CBT-I is the gold standard treatment for insomnia. For example, avoidance of daytime napping is a principle of CBT-I, since daytime napping is viewed as a perpetuating factor for insomnia.

However, napping is extremely common among professional athletes and is recognized as a viable, effective strategy for helping a professional athlete navigate accumulated sleep debt [ 82 , 83 ]. As such, universally providing the recommendation of avoiding daytime naps would appear to be inappropriate in this context.

Furthermore, sleep restriction therapy SRT is a key component of CBT-I. When undergoing SRT, a trained provider structures a sleep opportunity window that is intentionally restricting sleep duration so that a client increases their homeostatic need for sleep which in turn results in extinguishing insomnia characteristics.

Over time, the sleep opportunity window is gradually expanded to a healthy duration absent of insomnia characteristics, but this may take multiple months.

Utilizing this strategy during an off-season may be viable, but attempting to implement this during the competition season would be impossible, given the need to maintain a strict sleep—wake schedule and the factors that interfere with schedule consistency.

Additionally, professional athletes are generally functioning under a high homeostatic need for sleep, which seemingly negates the rationale for this strategy.

Thus, universally delivering CBT-I in its traditional form for treating insomnia in professional athletes appears unwarranted, especially during competition season. Rather, there is a major need to identify which components of existing interventions are appropriate and useful for professional athletes, with these integrated into novel sleep interventions tailored specifically to the needs, challenges, and lifestyle of professional athletes.

Although there is an imminent need for appropriately tailored sleep interventions for professional athletes, there are existing interventions for improving sleep health among professional athletes that have been previously shown to be efficacious among professional and non-professional athletes [ 81 ].

Among the existing interventions, sleep extension paradigms, implementation of structured, supplementary daytime naps, sleep hygiene practices, and circadian-based strategies are most common. Sleep extension paradigms are employed to assist athletes with achieving sufficient sleep duration across their main sleep period.

Supplementary daytime naps can also be useful for helping athletes navigate periods when achieving sufficient sleep duration is not viable due to factors related to travel and competition timing.

Additionally, daytime naps may be helpful for improving vigilance prior to competition. Yet, the duration of daytime naps and proximity to competition start times are key factors that must be considered.

Furthermore, completing a nap immediately prior to competition will likely result in worse performance due to residual sleep inertia. Thus, a fruitful avenue for research is to determine the best practices for duration and timing of daytime napping that leaves the athlete refreshed and vigilant for competition.

Yet, there will be a need to account for differential scenarios, such as napping prior to competition on a day with travel versus one without travel.

Similarly, the timing of competition must be considered, as a nap prior to a midday or early afternoon competition seems potentially more harmful than helpful compared to a nap prior to a late evening competition.

Sleep hygiene is another common intervention to assist with sleep health in professional athletes. Fundamentally, sleep hygiene is a set of recommendations that help entrain healthy sleep behaviors and practices e. Indeed, sleep hygiene can have positive effects on the sleep health of athletes, but the effects are likely limited due to absence of provision and reliance on self-accountability, as well as the fact that sleep hygiene may not enhance sleep ability or quality as a standalone intervention due to other existing sleep problems and disorders.

Caia and colleagues showcased both the strengths and limitations of a sleep hygiene intervention in professional rugby league athletes [ 63 ].

The sleep hygiene intervention initially resulted in significant increases in time in bed and total sleep time, yet sleep quality, as captured by sleep efficiency, was degraded. Furthermore, the positive effects on time in bed and total sleep time were not maintained at a 1-month follow-up post sleep hygiene intervention, which highlights the poor durability of sleep hygiene as a standalone intervention.

This study suggests that sleep hygiene has a role as a component in interventions to enhance sleep health among professional athletes, but standalone administration is unlikely to produce desired short-term or long-term effects.

Lastly, circadian-based strategies, such as chronotherapy and prescribed use of melatonin, are useful to help athletes shift their circadian rhythm prior to travel for competition as well as mitigate the effects of jet lag and enhance acclimation to a novel time zone.

These strategies are not only helpful for reducing the negative effects of travel on performance but also are critical for regulating physiology to improve likelihood of good sleep ability and quality when adjusting to a novel circadian environment.

Beyond the literature related to the sleep hygiene intervention in professional rugby athletes, we were unable to identify any other literature over the recent 5 years that directly analyzed the effects of sleep extension, napping, or circadian-based strategies on the sleep healthy of professional athletes.

As such, it is critical for future research to clarify the efficacy of these interventions within diverse samples of professional athletes to determine which interventions should be employed for different sport types, individual characteristics, and competition scenarios.

Additionally, this type of research can help identify which interventions are appropriate for professional athletes in their current form, as well as identify gaps in existing interventions that can be filled by tailoring previously utilized approaches or developing novel sleep interventions tailored to professional athletes.

See Fig. Unfortunately, sleep problems and disorders, such as poor sleep quality, insufficient sleep duration, insomnia-related difficulties, obstructive sleep apnea, and heightened daytime sleepiness, remain common among professional athletes. Encouragingly, there is evidence that poor sleep health is not a universal problem among professional athletes, which may be an emerging trend due to enhanced attention to sleep health of professional athletes among individual athletes, coaches, teams, and organizations.

However, professional athletes still navigate a multitude of unique challenges related to training, travel, competition, and other factors e.

A schematic depiction of the complex, bidirectional relationship between sleep health and performance, along with the core influencing factors. Beyond actual physical and cognitive performance during competition, sleep health can improve performance through more consistent and higher quality training, reduced risk for injury and better recovery, enhanced mental health contributing to better motivation, attention, emotional regulation, and other psychological characteristics beneficial to performance, and resiliency to the deleterious effects of travel.

Yet, professional athletes experience unique challenges related to training demands, heightened injury risk, constant pressure and stress that can degrade mental health, and travel-related factors e.

Relevant references to focal literature are included, with these numbers corresponding to the order listed in the references section.

The path to novel initiatives and interventions purposed to improve sleep health among professional athletes requires addressing current shortcomings in the research of sleep health within professional athletes. Despite an uptick over the recent years in empirical attention to sleep health within professional athletes, this area of research is still relatively understudied.

Thus, a focal priority to move forward this critical area of research would be for athletes, teams, and organizations, across a variety of sport types, to form partnerships with independent sleep researchers and clinicians. Professional researchers can extend their expertise in methodology to design longitudinal studies, ideally across the full calendar year, that leverage the best available, modern measurement tools for subjectively e.

Increasing the amount and quality of research is necessary for determining more confident conclusions through techniques such as meta-analysis. However, heterogeneity among investigation approach is another existing shortcoming that would need to be addressed for enhancing the utility of meta-analysis.

As such, there is a need for standardized guidelines on research methodology within professional athletes that would not only afford better ability to make comparisons across studies but also provide the ability for productive meta-analysis due to increased congruency between studies.

Sleep measurement is a major point of heterogeneity among studies in professional athletes, which highlights the need for these standardized guidelines to emphasize tools most appropriate for measuring sleep in professional athletes, such as the athlete sleep screening questionnaire, as well as overview the strengths and limitations of using other commonly relied on sleep measurement tools for the specific purposes of assessing sleep in this unique population.

Presently, it is clear that sleep health plays a principal role in the training, recovery, performance, and wellness of professional athletes, but professional athletes also exist as a highly vulnerable population to poor sleep health due to unique challenges related to training, travel, and competition.

Advancing the quantity, quality, and utility of available research, through partnerships between athletes, teams, and organizations with independent researchers as well as improved, standardized methodological approaches and rigor, is a critical step for elucidating key sport-specific and individual e.

These off-the-field efforts have the potential to drastically enhance on-the-field performance and, more importantly, the overall well-being of professional athletes. Emma N. Simon M. Rice, Rosemary Purcell, … Alexandra G.

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Top 3 finishers in the race obtained significantly more sleep duration across the 5-day race than the bottom 3 finishers.

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