Consensus statement - Sleep and the athlete: narrative review and 2021 expert consensus recommendations
Why is this important?
Sleep is increasingly being recognised as a crucial element to health, recovery and ultimately performance. This performance element extends beyond the swim, bike or run and into everyday life and performing at your best. I have recently written a new article for Triathlete magazine that reviews the effect of alcohol on sleep, heart rate and heart rate variability (HRV) with me being the N= 1. There were certainly some insights and I encourage each of you to read it and to also explore what I describe with your own social experiment.
Please remember that wearables are only as good as the information they collect and as discussed later, most are likely to be inaccurate and overestimate (much like activity performed and calories burnt). Also, important to note, data is one thing, don’t obsess over it - how you wake and feel on a day to day basis is likely to be just as good an indicator to how you are sleeping.
What was studied?
Not so much studied, rather discussed. The paper does a really nice job of breaking down the relevant sections of sleep and its importance to the elite athlete. I do believe that every athlete can still benefit from the insights provided. From the relative decline in sleep stages as we age (sad I know), through to measuring devices and their use, reliability and accuracy. Nice to see a recent study comparing the Oura Ring and finding it had acceptable mean differences to a medically-approved actigraphy device (1). The commercial devices are certainly not as accurate so please take the information as markers rather than absolutes.
It is interesting to read that the evidence of restriction and elongation of sleep on acute sports performance is equivocal. It appears that the type of sport and requirements may play a vital role in an individual's response. Improving sleep hygiene - a factor outlined in the Tinlane program - is seen as a positive influence on sports performance. Napping is also seen as a viable option for those who are constantly missing uninterrupted, prolonged sleep across a night.
The chronic effects of sleep deprivation have more robust evidence to suggest that it is detrimental to sports performance (we know it has negative health effects). Likewise, improving sleep will have a reverse effect over periods of weeks and months. Like all research, there are limitations to the design and populations studied, especially a lack of controls and lack of female participants. This later factor could have huge implications on sleep research and recommendations. It will surely come in time.
This is a timely consensus statement and one that is very useful for anyone who is attempting to compete in a sport. I will take it further to state that it holds true for everyday life as well. Sleep is underrated and as the saying goes;
“I will sleep when I am dead”
If you do not pay attention to your sleep, that may come a lot sooner than you would hope for! A nice interaction between overreaching, overtraining and lack of recovery resulting in detrimental performance, is discussed that is worth a mention, too. There is the chicken or egg scenario whereby overreaching can alter mood, immune response and stress resulting in poor sleep yet so too can poor sleep have similar effects on the body. A mention of cryotherapy is made yet not factored in is the potential of blunting (3) the overreaching training effect as a result of this potential intervention. Perhaps closer attention to strategies such as room temperature, use of melatonin, abstinence from alcohol, elimination of electrical devices 2-3 hours prior to bedtime could be better options.
Jetlag and its influence on sleep is discussed without any clear direction on ways to improve. From my own experience and others, with addressing jetlag for athletes, if it is an overnight flight, set your watch to the destination time zone immediately when on the plane and stick to that time zone (4) I also recommend fasting on long haul flights, avoiding alcohol and caffeine along with 5mg melatonin to assist sleep onset. This is then individualised depending on response. Some nice nutritional strategies are touched on including caffeine avoidance late in the day, and eating a high GI containing meal 4 hours prior to bedtime being of use to trial if getting to sleep is an issue.
Finally, the notion of training in line with your chronotype is fascinating and I am sure not considered by many Triathletes. The tradition is to train first thing in the morning yet if you are a “night owl” rather than a “lark” then you may be doing yourself a disservice. Potentially mid-day training might suit you better.
This paper is a timely review of sleep, its importance and its relevance to professional athletes. The recommendations can be utilised by any athlete and used in context specific to their lifestyle, sport and current sleep program. Definitely worth a read and take from it what you will.