Effects of training and competition on the sleep of elite athletes: a systematic review and meta-analysis.

OBJECTIVES: To characterise the sleep of elite athletes and to identify factors associated with training and competition that negatively affect sleep.
DESIGN: Prognosis systematic review. DATA SOURCES: Three databases (PubMed, SCOPUS and SPORTDiscus) were searched from inception to 26 February 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Included studies objectively reported total sleep time (TST) and/or sleep efficiency (SE) in elite athletes. Studies were required to be observational or to include an observational trial.
RESULTS: Fifty-four studies were included. During training, many studies reported athletes were unable to achieve TST (n=23/41) and/or SE (n=16/37) recommendations. On the night of competition, most studies reported athletes were unable to achieve TST (n=14/18) and/or SE (n=10/16) recommendations. TST was shorter (60 min) the night of competition compared with previous nights. SE was lower (1%) the night of competition compared with the previous night. TST was shorter the night of night competition (start ≥18:00; 80 min) and day competition (20 min) compared with the previous night. SE was lower (3%-4%) the night of night competition but unchanged the night of day competition compared with previous nights. Early morning training (start <07:00), increases in training load (>25%), late night/early morning travel departure times, eastward air travel and altitude ascent impaired sleep.
CONCLUSION: Athletes were often unable to achieve sleep recommendations during training or competition periods. Sleep was impaired the night of competition compared with previous nights. Early morning training, increases in training load, travel departure times, jet lag and altitude can impair athletes' sleep. PROSPERO REGISTRATION NUMBER: CRD42017074367. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.