A narrative review of sleep deprivation in ultra-endurance cycling

Abstract

Abstract. Introduction: The popularity of ultra-endurance cycling is increasing. Amongst race participants, sleep deprivation and periods of intermittent or acutely short sleep are common. Scientific research has typically focussed on the physiological or competitive performance based impact of these sleep-related paradigms. However, there is limited evidence about the mental health effects of sleep patterns in ultra-endurance cycling, despite established links between sleep deprivation and psychiatric and psychological issues. Methods: We conducted a narrative review synthesising extant empirical literature about sleep deprivation in ultra-endurance cycling. Results: Based on our search criteria, seven papers were identified discussing sleep patterns in ultra-endurance races. Each of these indicate that sleep deprivation is a prominent aspect of ultra-endurance competitions, with varying implications for riders. Discussion: Using these findings, we highlight the possible mental health consequences of sleep deprivation in these races, with reference to general scientific literature and other ultra-endurance sports. We also advocate for increased knowledge exchanges, regulatory emphasis, and additional research. Conclusion: Sleep deprivation and extreme sleep patterns are a substantial issue in elite-level cycling competitions, raising potential mental health concerns. More attention to this topic is necessary amongst organisers, participants, researchers, and community-level platforms, like the Global Cycling Network.

Mental Health Disorders in Ultra Endurance Athletes per ICD-11 Classifications: A Review of an Overlooked Community in Sports Psychiatry

“…Equally, suicide risk is not discussed in the literature, though personal accounts from UEAs who have psychiatric disorders note that depression and suicidal ideation are intertwined with training for long distance events [ 60 , 61 ]. The associations between extreme sleep patterns in-competition and mental health disorders after the race are also missing from extant literature in our review, but these onset possibilities have been identified in other contexts [ 62 ].…”

A Review of Mental Health Issues in High-Performance and Elite-Level Cycling

“…Latella et al's simulated Grand Tour demonstrated how substantial physical demands intra-race may induce adverse implications for mood, vigour, and sleep amount and quality [41]. In ultraendurance cycling events, where sleep deprivation can be a prominent phenomenon, it has been suggested that this can potentially entail short-and long-term psychological difficulties [55]. Additionally, whilst they did not estimate prevalence rates, Liebrenz et al hypothesise that ADHD may likely be pharmacotherapeutically undertreated in elite-level riders, due to mental health and doping stigma [42].…”

Regulatory proposals to support athlete mental health in the Race Across America

“…The physical challenges of RAAM are well-documented in general media and academic research; for example, nutrition and hydration needs are of critical importance for successful race completion [5], particularly given RAAM's high-altitude environments [12]. However, concurrently, RAAM's stringent intra-race demands raise concerns for athlete mental health, especially in relation to sleep deprivation [10]. Ultra-endurance competitions are largely underexamined in sports psychiatry literature [11], yet phenomenological insights from RAAM reveal inherent risk factors.…”

“…Likewise, there could be other obstacles given RAAM’s sociocultural reputation [34] and the wider persistence of mental health stigma within sporting contexts [37]. To that end, alongside community engagement, detailed scholarly research into the mental health effects of ultra-endurance cycling races is needed to inform relevant appropriate regulatory schemes, especially since findings remain limited within sports psychiatry [10, 11].…”

“…Resultantly, since its introduction in 1982, RAAM has engendered a cultural “fascination” as “cycling’s hardest race” (e.g., [3, 8, 9]). Yet, correspondingly, RAAM’s distinctive parameters and intra-race conditions could have associated harms for the mental health of participants [10, 11]. To mitigate against these, we outline potential regulatory policies to help safeguard the wellbeing of competitors.…”