Sleep Science Friday: Sleep and Sports – UEFA recommendations

2 July 2021 

Throughout the month of June until mid-July, all of Europe will be closely monitoring the UEFA matches, cheering the teams on, celebrating intermediate wins and getting upset by lost goals. The emotional overload, as well as changes in lifestyle and routine (lack of sleep, hours spent in front of TV watching football matches and their replay etc.) can definitely have an impact on sleep in football fans. However, the long-awaited and stressful period of UEFA games can impact sleep and health in soccer players, too. Sleep loss is commonly observed prior to competition in athletes and can significantly impact their sports performance. Sleep-maintenance strategies and regular individualized sleep hygiene are of great importance (Fullagar et al. (2015)) for professional athletes in both pre-seasonal and seasonal periods.

In October 2020, the UEFA expert group released a statement on nutrition in elite football players (Collins et al. (2021)) published in British Medical Journal. This document contains important information about eating habits and dietary consumption in pre-season, in-season and off-season training. Undoubtedly, some of these recommendations are directly related to sleep because sleep is a potent natural metabolism modifier, it plays a restorative role and is responsible for energy conservation.

For example, protein synthesis is enhanced during sleep compared to wakefulness. On the other hand, sleep deprivation is associated with changes in glycogen metabolism and glycogen synthesis (Franken et al. (2006); Petit et al. (2010)).

Moreover, metabolic molecules and pathways are involved in vigilance regulation and can provide both sleep and wakefulness promoting effects. From this point of view, dietary chronotherapy can be a potent approach for metabolism and vigilance modification as shown by recent publications. The approaches can include not only modification of meal timing (Reid et al. (2014) and Culnan et al. (2021)) but also the variation on dietary compounds (Baron et al. (2013)).

 

UEFA Recommendations

This explains the recommendations of the UEFA expert group on pre-sleep protein consumption. The general recommendation for periods of intensive training includes pre-sleep protein ingestion in a full meal at a dose of about 0.4 g/kg of body mass within 3 hours of going to bed or about 0.5g/kg of body mass if consumed as supplemental protein 1–2 hours before going to bed. The experts emphasize that professional soccer players usually report a much lower intake (about 0.1 g/kg body mass) before bedtime. They also specify that casein protein (at a dose of 30–60 g) prior to sleep can be in particular beneficial for enhancing overnight protein synthesis (Trommelen (2016)).

The UEFA experts also mention that all potential causes which can affect sleep and decrease sleep quality should be controlled. They also state that adequate recovery and sleep should be guaranteed in order to prevent other illnesses.

In addition, the UEFA experts have also considered other environmental stressful factors (including temperature surges – hot and cold temperatures, high altitudes, changes of time zones) that can affect health and sleep of football players. Disrupted sleep patterns due to circadian misalignment is considered the main reason for reduced player performance after crossing time zones. Reduced performance is observed with travel distances of >10hours and 2–3 time zones and is proportional to the number of time zones crossed and cumulative sleep loss. It can also be associated with travel fatigue (decreased mood and motivation) and can last for up to 72 hours following the time-zone crossing travel. Therefore, jet lag is an extremely important factor which can define the results of the football match. Sleep hygiene, light therapy, oral melatonin and slow-release caffeine are recommended approaches for athletes with jet lag. However, high-dose caffeine should be avoided to prevent sleep disturbances, potential arrhythmias and other side effects. Some other dietary manipulations (variations in food amount, type and intake) can be implemented but are not well-evidenced.

 

Other Considerations

The UEFA experts, however, miss an important factor: athlete chronotype, which can affect performance and recovery and should be taken into account when scheduling training sessions (Vitale et al. (2017)). Chronotype should also considered when planning individualized sleep schedules and modifications for key games.

Another sleep-related risk factor in soccer players is night matches which are associated with shorter sleep duration, poorer perceived restoration and general self-reported sleep restfulness (Fullagar et al. (2016)).

Therefore, good sleep is an essential factor for high football performance, however, it is a vulnerable factor affected in stressful conditions which requires attention and strict individualized modification approaches.

Looking forward to following the UEFA football games 2021…

 

Recent publications from ESRS members: 

  1. O’Connor-Reina et al. (2021). Non-acid reflux and sleep apnea: the importance of drug induced sleep endoscopy. J Otolaryngol Head Neck Surg.
  2. Chylinski et al. (2021). Variability of sleep stage scoring in late midlife and early old age. J Sleep Res.
  3. Miano et al. (2021). Sleep microstructure in attention deficit hyperactivity disorder according to the underlying sleep phenotypes. J Sleep Res.
  4. Fulong et al. (2021). Morphological and Age-Related Changes in the Narcolepsy Brain. Cereb Cortex.
  5. Bayard et al. (2021). Diagnostic Validity of the Sleep Condition Indicator to Screen for Diagnostic and Statistical Manual-5 Insomnia Disorder in Patients with Parkinson’s Disease. Eur Neurol.
  6. Kallestad et al. (2021). Digital cognitive-behavioural therapy for insomnia compared with digital patient education about insomnia in individuals referred to secondary mental health services in Norway: protocol for a multicenter randomised controlled trial. BMJ Open.
  7. Olafsson et al. (2021). A validation study of an esophageal probe-based polygraph against polysomnography in obstructive sleep apnea. Sleep Breath.
  8. Lecca et al. (2021). Prevalence of sleep disruption and determinants of sleepiness in a cohort of Italian hospital physicians: The PRESOMO study. J Sleep Res.
  9. Sagaspe et al. (2021). Self-perceived sleep during the Maintenance of Wakefulness Test: how does it predict accidental risk in patients with sleep disorders? Sleep.
  10. Xerfan et al. (2021). Polycystic ovary syndrome and its possible association with sleep complaints: PCOS and sleep. Arch Womens Ment Health.
  11. Blissett et al. (2021). Breathing Synchronised Hypoglossal Nerve Stimulation with Inspire for Untreated Severe Obstructive Sleep Apnoea/Hypopnoea Syndrome: A Simulated Cost-Utility Analysis from a National Health Service Perspective. Pharmacoecon Open.
  12. Pengo et al. (2021). The ANDANTE Project: A Worldwide Individual Data Meta-Analysis of the Effect of Sleep Apnea Treatment on Blood Pressure. Arch Bronconeumol.

 

Just published an article? Want your research to be featured? Saw something interesting?  Contact us at esrs@esrs.eu.

 

 

ESRS Reminders 

Sleep Deprivation Webinar 

Next week Friday, 9-July 2021 between 10:00 and 11:30 CET, the ESRS will host its 2nd LIVE Webinar on the Adverse Effects of Sleep Deprivation. This will be chaired by Dr. Marta Gonçalves who previously led the charge on the Wake-Up Bus initiative in 2014. She will be joined by fellow colleagues Dr. Bárbara Strazisar and Prof. Torbjörn Åkerstedt. They will be presenting on various aspects of the adverse effects of sleep deprivation including its impact on academic performance and flight time regulation respectively.

Register Now

 

GEF Call for New Effective Members 

The freshly minted Gender Equality Forum (formerly Forum for Women in Sleep Research) has just launched a call for effective members to become a part of a new taskforce. Do not miss this opportunity to help balance the gender scales in (sleep) science.

For more information on the GEF’s mission, what will be expected of effective members and how to apply, peruse the announcement here. Applications will be accepted until 31-July 2021. 

 

Sources

  1. Fullagar et al. (2015). Sleep and athletic performance: the effects of sleep loss on exercise performance, and physiological and cognitive responses to exercise. Sports Med.
  2. Collins et al. (2021). UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research.
  3. Franken et al. (2006). Glycogen content in the cerebral cortex increases with sleep loss in C57BL/6J mice. Neurosci Lett.
  4. Petit et al. (2010). Metabolic response of the cerebral cortex following gentle sleep deprivation and modafinil administration. Sleep. 
  5. Reid et al. (2014). Meal timing influences daily caloric intake in healthy adults. Nutr Res.
  6. Culnan et al. (2021). Meal timing relative to DLMO: Associations with BMI and body fat. Sleep Health.
  7. Baron et al. (2013). Contribution of evening macronutrient intake to total caloric intake and body mass index. Appetite.
  8. Trommelen et al. (2016). Pre-Sleep protein ingestion to improve the skeletal muscle adaptive response to exercise training. Nutrients.
  9. Vitale et al. (2017). Sleep quality and high intensity interval training at two different times of day: A crossover study on the influence of the chronotype in male collegiate soccer players. Chronobiol Int.
  10. Fullagar et al. (2016). Impaired sleep and recovery after night matches in elite football players. Journal of Sports Sciences.
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