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Sleep – What effect does it have on me as a sports person?

More questions are now being asked into what predisposes athletes to injury. With research increasing, more factors are arising along with increased interventions for athlete and support staff alike. Psychosocial factors are becoming an increasingly key predisposition to injury when looking into psychological antecedents.

All injures are multifactorial, therefore we should have a multifactorial prevention and rehabilitation plan. According to the Model of Stress and Athletic Injury (Williams & Andersen, 1998), psychological interventions should be used to aid reduction in an athlete’s stress response. Reducing these stressors can decrease the risk of injury. The study used 12,000 participants using meta-analysis to gain a large quantity of valuable life information. One of the main findings, was that high levels of negative life-event stress and stress responsivity have strongest associations with injury risk. One potential factor for athletes is the prolonged exposure to stressors as this can have a neurological impact which in turn can impact on a reduction in clarity of thought processes or decision making processes and this is important as there is plenty of evidence to suggest that poor decision making increases injury risk (Ivarsson et al., 2017; McEwen, 2005).

With other stress responses, it is not uncommon to have poor sleep. Sleep quality reduction is related to reduced hormone release, and therefore, if the athletes’ sleep quality is reduced by sleep disturbance, is not sleeping through the night, repetitive waking up or are struggling to sleep at all, these behaviours can inhibit muscle recovery post exercise which are in turn an important association to injury risk. If there is a psychological risk that is linked with muscle growth and repair by the presence of catabolic hormones like cortisone, you get catabolic effects, which then result in the increase incidence of injury. Which may explain why there is evidence to suggest that adolescent athletes with reduced sleep of less than 8 hours per night are 1.7 times more likely to get injured (Milewski et al., 2014). Therefore, there is a potential mechanism that links psychophysiological and behavioural stressors with health outcomes. Equally, we are aware that fluctuations in life event stress may also influence cortisone levels, which again are involved in injury risk, perceptions of pain severity and positive response in muscle tension. Collectively, they are also associated to risk of injury (Alexanders, Anderson & Henderson, 2015; Driver, Kean, Oprescu & Lovell, 2017; Heaney, 2006; Heaney, Rostron, Walker & Green, 2017).

In Finan, Quartana & Smith’s (2015) study using three situational groups to determine sleep efficiency, uninterrupted sleep of 7Hr30 was averaged as 92% sleep efficiency, three consecutive nights of restrictive sleep of 4Hr-4Hr30 averaged as 98% sleep efficiency, three consecutive nights of disrupted sleep of 4Hr-4Hr30 averaged just 58% sleep efficiency creating increased negative mood.  This goes against other research where shorter sleep durations are seen to be associated with higher levels of pre-training fatigue and increased sleep hours being most important in the lead up to competition (Sargent, 2014). Rosen et al., (2017) studies the impact of sleep on injury risk and found a 61% reduction in injury in those who slept for around 8 hours per night on weekdays, supporting both studies above. This data was collected via questionnaire which evidence shows does not allow all information to be collated – some will give too much information and others not enough which weakens the methodology. However, the study was completed by 340 elite athletes on two occasions in autumn and spring term which increases reliability with repeated methodology. Milewski et al., (2014) also found a 1.7 increased risk of injury for an average of less than 8 hours sleep per night. They found that an average of 6 hours sleep has the highest implication of injury risk likelihood over 21 months with a 35% difference between that and 8 hours sleep. Likelihood of illness is also 4.5 times more likely with less than 5 hours sleep in comparison to those who sleep more than 7 hours (Prather, Janicki-Deverts, Hall & Cohen, 2015).

Kellmann et al., (2018) explore the effectiveness of athletes’ recovery from a physical and psychological angle. They highlight the importance of managing the risk factors to aid a more functional and effective recovery for athletes. They include the need for psychological support, healthy sleep patterns, load monitoring and management. However, they do use a small sample and are sport specific in comparison to other research (Kellmann & Beckmann, 2017). Interventions for enhanced sleep can create a positive routine for athletes to ensure a minimum of 7 hours sleep, however some athletes may need 9-10 hours. Bird et al. (2013) suggest 20-30 minute daytime napping can reduce the effects of sleep deprivation. However, Fullagar et al., (2015) a the importance of knowing the effects of napping on individuals as they found, dependant on personality, some were compromised by napping. Athletes should avoid blue light (screens), caffeine, nicotine, alcohol, fluids and food in the lead up to sleep to reduce the possibility of heightened brain stimulation and an active digestive system which makes falling asleep difficult and causes disrupted sleep. The environment should be quiet and dark with a temperature of ~18C, which improves sleep quality and quantity. Athletes with poor sleep habits would benefit from relaxation techniques and guided imagery. (Bird, 2013; Bonnar et al., 2018; Marshall & Turner, 2016)

In conclusion – we could all benefit from some much-improved sleep whether that be length or quality.

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