Int J Sports Med
DOI: 10.1055/a-2421-9310
1
IRCCS Istituto Ortopedico Galeazzi, Milan,
Italy (Ringgold ID: RIN46767)
,
Sara Bizzozero
1
IRCCS Istituto Ortopedico Galeazzi, Milan,
Italy (Ringgold ID: RIN46767)
,
Jacopo A. Vitale
2
Schulthess Klinik, Zurich, Switzerland (Ringgold ID: RIN46767)
,
Elisa Tallini
3
Department of Biomedical Science for Health, Università
degli Studi di Milano, Milano, Italy (Ringgold ID: RIN30699)
,
Francesco Corazza
3
Department of Biomedical Science for Health, Università
degli Studi di Milano, Milano, Italy (Ringgold ID: RIN30699)
,
Antonio La Torre
3
Department of Biomedical Science for Health, Università
degli Studi di Milano, Milano, Italy (Ringgold ID: RIN30699)
,
Giuseppe Banfi
1
IRCCS Istituto Ortopedico Galeazzi, Milan,
Italy (Ringgold ID: RIN46767)
4
Vita-Salute San Raffaele University, Milan,
Italy (Ringgold ID: RIN9304)
,
3
Department of Biomedical Science for Health, Università
degli Studi di Milano, Milano, Italy (Ringgold ID: RIN30699)
5
Department of Endocrinology, Nutrition and Metabolic
Diseases, IRCCS MultiMedica, 20138 Milan, Italy (Ringgold ID: RIN18985)
› Author Affiliations
Funding
This research did not receive any specific grant funding from public agency,
commercial, and not-for-profit sectors.
› Further Information
Also available at
Buy Article Permissions and Reprints
Abstract
The objective of the study was to assess chronotype, sleep hygiene, and sleep
characteristics of Italian athletes in order to identify differences among sport
disciplines (team- vs individual-sports), level of competition (Elite vs
Non-Elite) and sexes. Moreover, correlations between chronotype, sleep hygiene
and sleep quality were evaluated. Two hundred eighty Italian athletes
(Females:113; Males:167) participated in the study. They completed the
Pittsburgh Sleep Quality Index (PSQI), the Sleep Hygiene Index (SHI) and the
MorningnessEveningness Questionnaire (MEQ). Among the athletes, 66.4% were
intermediate-type, 21.8% were morning-type and 11.8% were evening-type. 55.4% of
the sample was classified as good sleeper (PSQI<5), while 16.1% had poor
sleep hygiene (SHI≥35). Females had higher total sleep time (p=0.022) than
males. Individual-sports showed more morning-oriented score (p=0.001) and lower
PSQI (p=0.006) and SHI (p<0.001) scores, with earlier timing of sleep
(bedtime:p<0.001; wake-up time:p<0.001) compared to teamsports. Elite
athletes exhibited greater sleep efficiency (p=0.009), and lower sleep latency
(p=0.018) and wake after sleep onset (p=0.043) than Non-Elite athletes.
Additionally, significant correlations were found between PSQI and SHI (r=0.43,
p<0.001), and between MEQ and SHI (r=−0.35, p<0.001). This study yields
crucial insights into the sleep behaviors of Italian athletes, revealing that
nearly half of the sample were bad sleepers.
Keywords
Sleep -
Athlete -
Chronotype -
Sport -
sexes
Publication History
Received: 24 June 2024
Accepted after revision: 16 September 2024
Article published online:
22 October 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
References
1
Baranwal N,
Yu PK,
Siegel NS.
Sleep physiology, pathophysiology, and sleep hygiene. Prog Cardiovasc Dis 2023; 77: 59-69 DOI:
10.1016/j.pcad.2023.02.005.
2
Nedelec M,
Aloulou A,
Duforez F.
et al.
The Variability of Sleep Among Elite Athletes. Sports Med Open 2018; 4: 34 DOI:
10.1186/s40798-018-0151-2.
3
Lastella M,
Roach GD,
Halson SL.
et al.
The chronotype of elite athletes. J Hum Kinet 2016; 54: 219-225 DOI:
10.1515/hukin-2016-0049.
4
Suppiah HT,
Swinbourne R,
Wee J.
et al.
Sleep Characteristics of Elite Youth Athletes: A Clustering Approach to Optimize
Sleep Support Strategies. Int J Sports Physiol Perform 2021; 16: 1225-1233 DOI:
10.1123/IJSPP.2020-0675.
5
Vitale JA,
Borghi S,
Piacentini MF.
et al.
To Sleep Dreaming Medals: Sleep Characteristics, Napping Behavior, and
Sleep-Hygiene Strategies in Elite Track-and-Field Athletes Facing the Olympic
Games of Tokyo 2021. Int J Sports Physiol Perform 2023; 18: 1412-1419 DOI:
10.1123/ijspp.2023-0144.
6
Hirshkowitz M,
Whiton K,
Albert SM.
et al.
National sleep foundation’s sleep time duration recommendations: Methodology and
results summary. Sleep Health 2015; 1: 40-43 DOI:
10.1016/j.sleh.2014.12.010.
7
Lastella M,
Roach GD,
Halson SL.
et al.
Sleep/wake behaviours of elite athletes from individual and team sports. Eur J Sport Sci 2015; 15: 94-100 DOI:
10.1080/17461391.2014.932016.
8
Fullagar HHK,
Skorski S,
Duffield R.
et al.
Sleep and Athletic Performance: The Effects of Sleep Loss on Exercise
Performance, and Physiological and Cognitive Responses to Exercise. Sports Medicine 2015; 45: 161-186
9
Charest J,
Grandner MA.
Sleep and Athletic Performance: Impacts on Physical Performance, Mental
Performance, Injury Risk and Recovery, and Mental Health. Sleep Med Clin 2020; 15: 41-57 DOI:
10.1016/j.jsmc.2019.11.005.
10
Belenky G,
Wesensten NJ,
Thorne DR.
et al.
Patterns of performance degradation and restoration during sleep restriction and
subsequent recovery: A sleep dose-response study. J Sleep Res 2003; 12: 1-12 DOI:
10.1046/j.1365-2869.2003.00337.x.
11
Krishnan V,
Collop NA,
Williams L.
Gender differences in sleep disorders. Curr Opin Pulm Med 2006; 12: 383-389 DOI:
10.1097/01.mcp.0000245705.69440.6a.
12
Silva A,
Narciso FV,
Rosa JP.
et al.
Gender differences in sleep patterns and sleep complaints of elite athletes. Sleep Science 2019; 12: 242-248 DOI:
10.5935/1984-0063.20190084.
13
Walsh NP,
Halson SL,
Sargent C.
et al.
Sleep and the athlete: Narrative review and 2021 expert consensus
recommendations. Br J Sports Med 2021; 55: 356-368 DOI:
10.1136/bjsports-2020-102025.
14
Von Elm E,
Altman DG,
Egger M.
et al.
The Strengthening the Reporting of Observational Studies in Epidemiology
(STROBE) statement: Guidelines for reporting observational studies. Lancet 2007; 370: 1453-1457 DOI:
10.1016/S0140-6736(07)61602-X.
15
Artino AR,
Durning SJ,
Sklar DP.
Guidelines for reporting survey-based research submitted to academic
medicine. Academic Medicine 2018; 93: 337-340 DOI:
10.1097/ACM.0000000000002094.
16
Horne JA,
Ostberg O.
A Self-Assessment Questionnaire to Determine Morningness Eveningness in Human
Circadian Rhythms. Int J Chronobiol 1976; 4: 97-110
17
Curcio G,
Tempesta D,
Scarlata S.
et al.
Validity of the Italian Version of the Pittsburgh Sleep Quality Index (PSQI. Neurological Sciences 2013; 34: 511-519 DOI:
10.1007/s10072-012-1085-y.
18
Buysse DJ,
Reynolds CF,
Monk TH.
et al.
The Pittsburgh sleep quality index: A new instrument for psychiatric practice
and research. Psychiatry Res 1989; 28: 193-213 DOI:
10.1016/0165-1781(89)90047-4.
19
Bacaro V,
Curati S,
Baglioni C.
Validation study of the Italian version of the Sleep Hygiene Index. J Sleep Res 2022; 31: e13445 DOI:
10.1111/jsr.13445.
20
Zagaria A,
Ballesio A,
Musetti A.
et al.
Psychometric properties of the Sleep Hygiene Index in a large Italian community
sample. Sleep Med 2021; 84: 362-367 DOI:
10.1016/j.sleep.2021.06.021.
21
Mastin DF,
Bryson J,
Corwyn R.
Assessment of sleep hygiene using the sleep hygiene index. J Behav Med 2006; 29: 223-227 DOI:
10.1007/s10865-006-9047-6.
22
Mukaka MM.
Statistics Corner: A guide to appropriate use of Correlation coefficient in
medical research. Malawi Med J 2012; 24: 69-71
23
Cohen J.
A power primer. Psychol Bull 1992; 112: 155-159 DOI:
10.1037//0033-2909.112.1.155.
24
Doherty R,
Madigan SM,
Nevill A.
et al.
The Sleep and Recovery Practices of Athletes. Nutrients 2021; 13: 1330 DOI:
10.3390/nu13041330.
25
Vitale JA,
Banfi G,
La Torre A.
et al.
Effect of a habitual late-evening physical task on sleep quality in neither-type
soccer players. Front Physiol 2018; 9: 1582 DOI:
10.3389/fphys.2018.01582.
26
Vitale JA,
Weydahl A.
Chronotype, Physical Activity, and Sport Performance: A Systematic Review. Sports Med 2017; 47: 1859-1868 DOI:
10.1007/s40279-017-0741-z.
27
Vitale JA,
Calogiuri G,
Weydahl A.
Influence of chronotype on responses to a standardized, self-paced walking task
in the morning vs afternoon: A pilot study. Percept Mot Skills 2013; 116: 1020-1028 DOI:
10.2466/06.19.PMS.116.3.1020-1028.
28
Adan A,
Archer SN,
Hidalgo MP.
et al.
Circadian typology: A comprehensive review. Chronobiol Int 2012; 29: 1153-1175 DOI:
10.3109/07420528.2012.719971.
29
Montaruli A,
Castelli L,
Mulè A.
et al.
Biological rhythm and chronotype: New perspectives in health. Biomolecules 2021; 11: 487 DOI:
10.3390/biom11040487.
30
Mah CD,
Kezirian EJ,
Marcello BM.
et al.
Poor sleep quality and insufficient sleep of a collegiate student-athlete
population. Sleep Health 2018; 4: 251-257 DOI:
10.1016/j.sleh.2018.02.005.
31
Carter JR,
Gervais BM,
Adomeit JL.
et al.
Subjective and objective sleep differ in male and female collegiate
athletes. Sleep Health 2020; 6: 623-628 DOI:
10.1016/j.sleh.2020.01.016.
32
Smith RS,
Efron B,
Mah CD.
et al.
The impact of circadian misalignment on athletic performance in professional
football players. Sleep 2013; 36: 1999-2001 DOI:
10.5665/sleep.3248.
33
Vitale KC,
Owens R,
Hopkins SR.
et al.
Sleep Hygiene for Optimizing Recovery in Athletes: Review and
Recommendations. Int J Sports Med 2019; 40: 535-543 DOI:
10.1055/a-0905-3103.
34
Halson SL,
Juliff LE.
Sleep, sport, and the brain. Prog Brain Res 2017; 234: 13-31 DOI:
10.1016/bs.pbr.2017.06.006.
35
Chellappa SL,
Aeschbach D.
Sleep and anxiety: From mechanisms to interventions. Sleep Med Rev 2022; 61: 101583 DOI:
10.1016/j.smrv.2021.101583.
36
Oh CM,
Kim HY,
Na HK.
et al.
The effect of anxiety and depression on sleep quality of individuals with high
risk for insomnia: A population-based study. Front Neurol 2019; 10: 849 DOI:
10.3389/fneur.2019.00849.
37
Pham HT,
Chuang HL,
Kuo CP.
et al.
Electronic device use before bedtime and sleep quality among university
students. Healthcare (Basel) 2021; 9: 1091 DOI:
10.3390/healthcare9091091.
38
Miller DJ,
Sargent C,
Roach GD.
et al.
Moderate-intensity exercise performed in the evening does not impair sleep in
healthy males. Eur J Sport Sci 2020; 20: 80-89 DOI:
10.1080/17461391.2019.1611934.
39
Pacheco D,
Rehman A.
What’s the Best Time of Day to Exercise for Sleep?. National Sleep Foundation. 2023
https://www.sleepfoundation.org/physical-activity/best-time-of-day-to-exercise-for-sleep
40
Souissi M,
Chtourou H,
Zrane A.
et al.
Effect of time-of-day of aerobic maximal exercise on the sleep quality of
trained subjects. Biol Rhythm Res 2012; 43: 323-330 DOI:
10.1080/09291016.2011.589159.
41
Driller MW,
Suppiah H,
Rogerson D.
et al.
Investigating the sleep habits in individual and team-sport athletes using the
Athlete Sleep Behavior Questionnaire and the Pittsburgh Sleep Quality Index. Sleep Science 2022; 15: 112-117 DOI:
10.5935/1984-0063.20210031.
42
Alves Facundo L,
Brant VM,
Guerreiro RC.
et al.
Sleep regularity in athletes: Comparing sex, competitive level and sport
type. Chronobiol Int 2022; 39: 1381-1388 DOI:
10.1080/07420528.2022.2108716.
43
Goel N,
Kim H,
Lao RP.
Gender differences in polysomnographic sleep in young healthy sleepers. Chronobiol Int 2005; 22: 905-915 DOI:
10.1080/07420520500263235.
44
Orff H,
Meliska C,
Martinez LF.
et al.
The influence of sex and gonadal hormones on sleep disorders. ChronoPhysiology and Therapy 2014; 4: 15-25 DOI:
10.2147/cpt.s44667.
45
Leeder J,
Glaister M,
Pizzoferro K.
et al.
Sleep duration and quality in elite athletes measured using wristwatch
actigraphy. J Sports Sci 2012; 30: 541-545 DOI:
10.1080/02640414.2012.660188.
46
Szuhany KL,
Simon NM.
Anxiety Disorders: A Review. JAMA 2022; 328: 2431-2445 DOI:
10.1001/jama.2022.22744.
47
Pilar Matud M,
Díaz A,
Bethencourt JM.
et al.
Stress and psychological distress in emerging adulthood: A gender analysis. J Clin Med 2020; 9: 1-11 DOI:
10.3390/jcm9092859.
48
Biggins M,
Purtill H,
Fowler P.
et al.
Sleep in elite multi-sport athletes: Implications for athlete health and
wellbeing. Physical Therapy in Sport 2019; 39: 136-142 DOI:
10.1016/j.ptsp.2019.07.006.
49
Clark I,
Landolt HP.
Coffee, caffeine, and sleep: A systematic review of epidemiological studies and
randomized controlled trials. Sleep Med Rev 2017; 31: 70-78 DOI:
10.1016/j.smrv.2016.01.006.
50
Wams EJ,
Woelders T,
Marring I.
et al.
Linking light exposure and subsequent sleep: A field polysomnography study in
humans. Sleep 2017; 40: zsx165 DOI:
10.1093/sleep/zsx165.
51
Zheng G,
Li K,
Wang Y.
The effects of high-temperature weather on human sleep quality and appetite. Int J Environ Res Public Health 2019; 16: 270 DOI:
10.3390/ijerph16020270.
52
Sun J,
Chen M,
Cai W.
et al.
Chronotype: Implications for sleep quality in medical students. Chronobiol Int 2019; 36: 1115-1123 DOI:
10.1080/07420528.2019.1619181.
53
Lim ST,
Kim DY,
Kwon HT.
et al.
Sleep quality and athletic performance according to chronotype. BMC Sports Sci Med Rehabil 2021; 13: 2 DOI:
10.1186/s13102-020-00228-2.
54
Vitale JA,
Roveda E,
Montaruli A.
et al.
Chronotype influences activity circadian rhythm and sleep: Differences in sleep
quality between weekdays and weekend. Chronobiol Int 2015; 32: 405-415 DOI:
10.3109/07420528.2014.986273.
55
Bender AM,
Lawson D,
Werthner P.
et al.
The Clinical Validation of the Athlete Sleep Screening Questionnaire: An
Instrument to Identify Athletes that Need Further Sleep Assessment. Sports Med Open 2018; 4: 23 DOI:
10.1186/s40798-018-0140-5.
56
Driller MW,
Mah CD,
Halson SL.
Development of the athlete sleep behavior questionnaire: A tool for identifying
maladaptive sleep practices in elite athletes. Sleep Science 2018; 11: 37-44 DOI:
10.5935/1984-0063.20180009.
57
Lastella M,
Halson SL,
Vitale JA.
et al.
To Nap or Not to Nap? A Systematic Review Evaluating Napping Behavior in
Athletes and the Impact on Various Measures of Athletic Performance. Nat Sci Sleep 2021; 13: 841-862 DOI:
10.2147/NSS.S315556.
58
Drews HJ,
Wallot S,
Brysch P.
et al.
Bed-Sharing in Couples Is Associated with Increased and Stabilized REM Sleep and
Sleep-Stage Synchronization. Front Psychiatry 2020; 11: 583 DOI:
10.3389/fpsyt.2020.00583.
59
Costa JA,
Figueiredo P,
Nakamura FY.
et al.
Monitoring Individual Sleep and Nocturnal Heart Rate Variability Indices: The
Impact of Training and Match Schedule and Load in High-Level Female Soccer
Players. Front Physiol 2021; 12: 678462 DOI:
10.3389/fphys.2021.678462.
60
Costa J,
Figueiredo P,
Nakamura F.
et al.
Intra-individual variability of sleep and nocturnal cardiac autonomic activity
in elite female soccer players during an international tournament. PLoS One 2019; 14: e0218635 DOI:
10.1371/journal.pone.0218635.
Comments (0)