Objective: To analyze chronotype, duration and quality of sleep among elite athletes, to compare differences in sleep variables between sex, and to compare differences between athletes of individual and team sports. Method: The sample included 70 Brazilian elite athletes of both sex (male=37; female=33) with a mean age 23.0 ± 4.0 years old. To measure sleep-wake cycle, athletes wore an actigraph on the wrist for 10 days. Moreover, athletes answered the chronotype questionnaire of Horne and Östberg. Results: The most athletes are intermediate-type (n=55, 78.6%), with a mean of 07h:18min of sleep per night. The athletes demonstrated higher sleep fragmentation (39.26 ± 23.66 minutes) and higher sleep latency (30.88 ± 16.19 minutes) during pre-competition training days. Additionally, the athletes of individual sports demonstrated more fragmentation (p<0.001) and less sleep efficiency (p<0.001) compared athletes of team sports. However, there was no significant difference in all sleep variables between the male and female sex. Conclusion: The overall elite athletes presented poor sleep quality during the training periods prior to the Rio 2016 Olympic Games, and individual athletes showed higher fragmentation and poorer sleep efficiency compared to team athletes.

Introduction As a common but modifiable chronic condition, obstructive sleep apnea (OSA) has been identified as the top secondary cause of many other diseases including cardiovascular diseases and type 2 diabetes. Diagnosing and managing OSA provides neurological, cardiovascular and metabolic benefits, however real-world studies indicate disconnections between evidence and outcomes. Using an engagement approach and qualitative design, this project aims to better understand care and research gaps in OSA in a community healthcare setting. Methods: Methods Patient and family representatives were identified and recruited through OSA support meetings hosted by MultiCare Sleep Medicine Centers, to form a board of 12, with three key patient advocates. Six meetings, each facilitated by one or two members of the board, were held to encourage focus group discussion and accommodate interactive conversations on the topic. Discussions were audio recorded and edited to exclude patients’ identifiable information, then transcribed. Manual open coding was completed by two coders for each transcription to develop a codebook, followed by auto-coding and inductive content analysis using Nvivo 11. Results All enrolled patients had diagnosed moderate-to-severe OSA and were prescribed with continuous positive airway pressure (CPAP) therapy. Two participants were African American and one was multiethnic. Patients’ age ranged from early 30s to 80s. Seven main themes were identified: OSA diagnostic issues; treatment experiences and options; comorbidities; patient community and support needs; long-term management challenges beyond “compliance”; knowledge of OSA, CPAP and care; and patient-driven research. The first few weeks after CPAP initiation appeared to be a critical time window that impacted patients’ adaptation and use. Conclusion Our study revealed barriers and facilitators in OSA diagnosis and treatment. Results showed highly prevalent chronic co-morbidities and the needs to care for patients in the comorbid scenario. It was highlighted that a paradigm of patient-centered care and research is lacking and warranted. Participants also called for better coordination between sleep medicine, primary care, other specialists, durable device suppliers and insurance. Key research efforts are expected to focus on the first 30-day post CPAP dispense to improve compliance. Support Patient Centered Outcomes Research Institute (PCORI) (Contract #: 7717241)