Lockdown Duration and Training Intensity Affect Sleep Behavior in an International Sample of 1,454 Elite Athletes

Abstract

Objective: To investigate the effect of 1) lockdown duration and 2) training intensity on sleep quality and insomnia symptoms in elite athletes.Methods: 1,454 elite athletes (24.1 ± 6.7 years; 42% female; 41% individual sports) from 40 countries answered a retrospective, cross-sectional, web-based questionnaire relating to their behavioral habits pre- and during- COVID-19 lockdown, including: 1) Pittsburgh sleep quality index (PSQI); 2) Insomnia severity index (ISI); bespoke questions about 3) napping; and 4) training behaviors. The association between dependent (PSQI and ISI) and independent variables (sleep, napping and training behaviors) was determined with multiple regression and is reported as semi-partial correlation coefficient squared (in percentage).Results: 15% of the sample spent < 1 month, 27% spent 1–2 months and 58% spent > 2 months in lockdown. 29% self-reported maintaining the same training intensity during-lockdown whilst 71% reduced training intensity. PSQI (4.1 ± 2.4 to 5.8 ± 3.1; mean difference (MD): 1.7; 95% confidence interval of the difference (95% CI): 1.6–1.9) and ISI (5.1 ± 4.7 to 7.7 ± 6.4; MD: 2.6; 95% CI: 2.3–2.9) scores were higher during-compared to pre-lockdown, associated (all p < 0.001) with longer sleep onset latency (PSQI: 28%; ISI: 23%), later bedtime (PSQI: 13%; ISI: 14%) and later preferred time of day to train (PSQI: 9%; ISI: 5%) during-lockdown. Those who reduced training intensity during-lockdown showed higher PSQI (p < 0.001; MD: 1.25; 95% CI: 0.87–1.63) and ISI (p < 0.001; MD: 2.5; 95% CI: 1.72–3.27) scores compared to those who maintained training intensity. Although PSQI score was not affected by the lockdown duration, ISI score was higher in athletes who spent > 2 months confined compared to those who spent < 1 month (p < 0.001; MD: 1.28; 95% CI: 0.26–2.3).Conclusion: Reducing training intensity during the COVID-19-induced lockdown was associated with lower sleep quality and higher insomnia severity in elite athletes. Lockdown duration had further disrupting effects on elite athletes’ sleep behavior. These findings could be of relevance in future lockdown or lockdown-like situations (e.g., prolonged illness, injury, and quarantine after international travel).

Athlete level, sport-type, and gender influences on training, mental health, and sleep during the early COVID-19 lockdown in Malaysia

“…Collaterally, decreases in training were linked with higher depression, anxiety, and stress symptoms during the COVID-19 lockdown ( Facer-Childs, et al, 2021 ). Some elite athletes reported psychological distress due to training cessation during lockdown ( di Cagno et al, 2020 ; Jia et al, 2022 ; Venturelli et al, 2022 ), changes in sleep ( Facer-Childs et al, 2021 ; Romdhani et al, 2022b ), financial problems, among others. In the current study, the majority of athletes reported financial difficulties, especially among individual-sport, and World-Class athletes; an extra stressor that potentially impacted the athletes’ mental health ( Busch et al, 2022 ).…”

“…Sleep quantity and quality are of paramount importance for recovery and performance of the athletes. Reduced training intensity and fewer training sessions result in circadian interference, which negatively impacts sleep quality ( Romdhani et al, 2022b ) and could potentially trigger mental health issues ( Facer-Childs et al, 2021 ), such as elevated stress and depression ( Facer-Childs et al, 2021 ; Romdhani et al, 2022b ). In this context, high intensity training can promote 1) increased sleep drive contributing to improved sleep ( Romdhani et al, 2022b ) and 2) activation of endogenous opioid release (inside the brain) resulting in mood elevation and stress reduction ( Saanijoki et al, 2018 ).…”

“…Reduced training intensity and fewer training sessions result in circadian interference, which negatively impacts sleep quality ( Romdhani et al, 2022b ) and could potentially trigger mental health issues ( Facer-Childs et al, 2021 ), such as elevated stress and depression ( Facer-Childs et al, 2021 ; Romdhani et al, 2022b ). In this context, high intensity training can promote 1) increased sleep drive contributing to improved sleep ( Romdhani et al, 2022b ) and 2) activation of endogenous opioid release (inside the brain) resulting in mood elevation and stress reduction ( Saanijoki et al, 2018 ). Unfortunately, mental distress and the athletes’ inability to maintain athletic routines have also been associated with an increased injury risk ( Wiese-Bjornstal, 2019 ; Rampinini et al, 2021b ).…”

The impact of COVID-19 lockdowns on physical activity amongst older adults: evidence from longitudinal data in the UK

“…Existing evidence from the international literature suggests that people from a range of populations became less active and/or increased sedentary activities during the pandemic [12][13][14][15][16][17][18]. Considering older adults, evidence from a German and an international study both suggest that containment measures from the early stages of the pandemic (April-June 2020) had a deleterious effect on energy expenditure and frequency of physical activity [14,18].…”

The Effect of Remote Consultations on Quality of Care for Patients During the COVID-19 Pandemic: An Update and a Review of Current Literature

“…COVID-19 enters the body through the eyes, nose, or mouth and is transmitted through droplets emitted when sneezing, coughing, or speaking [13][14][15][16][17]. Several social distancing and prevention and treatment measures have been implemented by governments around the world to protect the population and the health services that treat them, with the goal of eliminating this once immunity is achieved through vaccination and improvements in treatment are made [18][19][20][21][22][23][24][25][26][27][28].…”