Medications for Sleep Schedule Adjustments in Athletes

Abstract

Context:Sleep schedule adjustments are common requirements of modern-day athletes. Many nonpharmacologic and pharmacologic strategies exist to facilitate circadian rhythm shifts to maximize alertness and performance during competition. This review summarizes the evidence for commonly used pharmacologic agents and presents recommendations for the sports medicine provider.Evidence Acquisition:MEDLINE searches were performed using the following keywords: sleep aids, circadian rhythm adjustment, athletes and sleep, caffeine and sports, melatonin and athletes, and sleep aids and sports. Pertinent articles were extracted and discussed.Study Design:Clinical review.Level of Evidence:Level 2.Results:There are very few available studies investigating pharmacologic sleep aids in athletes. Data from studies involving shift workers and airline personnel are more abundant and were used to formulate recommendations and conclusions.Conclusion:Melatonin, caffeine, and nonbenzodiazepine sleep aids have a role in facilitating sleep schedule changes in athletes and maximizing sports performance through sleep enhancement.

Effects of two nights partial sleep deprivation on an evening submaximal weightlifting performance; are 1 h powernaps useful on the day of competition?

“…A 1-h power nap (13:00 h) was shown to alleviate deterioration in performance experienced after sleep restriction; raising some performance values up to levels found during N sleep condition, these findings have implications for athletes with restricted sleep during training or before competition. Work into the use of naps is worth pursuing rather than prescribing medications (Baird and Asif 2018). Future work should investigate the most effective nap duration, time-of-day in relation to prior sleep restriction (Hilditch et al 2017); incorporating relaxation techniques to further seek to 'improve' the effectiveness of sleep 'naps' (Debellemaniere et al 2018).…”

Impulsivity Mediates the Relationship between Sleep Quality and Interpersonal Functioning: A Cross-sectional Study in a Sample of University Students

“…117,118 . However, when a problem, such as inappropriate sleep, is already present and requires long-term adjustments, a reactive approach is often warranted (e.g., the use of melatonin to assist in the adjustment of the sleep schedule 119,120 ) in order to address the immediate reality of the situation, in addition to allowing for the appropriate disposition that would facilitate such adjustments. Such a reactive response is distinct from reactive responses geared towards simply counteracting the negative consequences associated with poor or inappropriate sleep.…”

Benzodiazepine abuse among athletes: Pain relief or just a weapon against insomnia? A clinical case study

“…For example, they might use them in an attempt to improve their sports performance, albeit often in the absence of real scientific evidence of their efficacy, or to achieve good quality sleep, with the aim of recovering from intense effort faster . Recent case reports on high levels of benzodiazepine use among athletes have underlined the lack of scientific data in this research field . Long‐term benzodiazepine use is generally avoided due to the risk of adverse reactions (eg, impaired psychomotor and cognitive functioning) and the potential to develop addiction .…”

“…2,6,7 Recent case reports on high levels of benzodiazepine use among athletes 2 have underlined the lack of scientific data in this research field. 8,9 Long-term benzodiazepine use is generally avoided due to the risk of adverse reactions (eg, impaired psychomotor and cognitive functioning) and the potential to develop addiction. 10,11 Even though levels of benzodiazepine consumption and abuse are increasing in Europe, 12 somewhat surprisingly scientific research seems to overlook this issue.…”