Longitudinal Internal Training Load and Exposure in a High-Performance Basketball Academy.

ABSTRACT: Lever, JR, Duffield, R, Murray, A, Bartlett, JD, and Fullagar, HHK. Longitudinal internal training load and exposure in a high-performance basketball academy. J Strength Cond Res 38(8): 1464-1471, 2024-This study describes the longitudinal training exposure (session counts) and internal training load (Rating of Perceived Exertion [RPE] and Session Rating of Perceived Exertion [sRPE]) of youth basketball players at a high-performance academy, based on the training year, training term, and playing position. Historical internal training load and training exposure data were collated from 45 male high-performance youth basketball athletes between 2015 and 2019. Data included session duration, RPE, sRPE, training type, and date. Linear mixed models and pairwise comparisons were performed on the weekly means and categorized by training year (year 1, year 2, year 3), term (term 1, term 2, term 3, term 4), and playing position (Backcourt, Frontcourt). Linear mixed models indicate that the individual athlete had the greatest influence on variance in training load and exposure. Significant differences were observed for increased session count, duration, and sRPE ( p < 0.001) in year 2 compared with year 1. These measures also increased within each year whereby term 3 and term 4 ( p < 0.001) were significantly greater than term 1 and term 2. No significant differences were observed between playing position ( p > 0.05). Training exposure and internal training load increase in year 2 from year 1 for high-performance youth basketball academy athletes. Differences between training load and exposure for terms (i.e., training blocks) suggest the phase of season influences training prescription, while playing position has limited effect.

A pragmatic strength and conditioning intervention for firefighters: Feasibility of the Tactical Athlete Resilience Program (TARP).

ISSUE ADDRESSED: Firefighting is physically and mentally taxing and recruits are expected to have optimal health and fitness. However, physical fitness tends to decline following initial training, placing firefighters at an increased risk for stress and injury. Efforts are needed to engage and support firefighters in maintaining adequate health and fitness to withstand the rigorous demands of their occupation. This study examined the feasibility of TARP, a pragmatic strength and conditioning intervention for metropolitan-based firefighters, delivered in collaboration with a professional National Rugby League club. METHODS: A mixed-methods approach was utilised to examine program implementation, recruitment and sample characteristics, intervention satisfaction and acceptability, and participants' response to the intervention. Evaluation measures included field notes taken during steering committee meetings, participant flow data, baseline and follow-up outcome measures, self-report questionnaires, and telephone interviews with a sample of participants. RESULTS: Participants (N = 113) were predominantly men (82%) with a mean age of 43 ± 9.3 years and BMI of 26.6 ± 2.9 kg/m2 . Program satisfaction was high (95% very satisfied or somewhat satisfied) among program completers (42% retention). Key strengths of the program included delivery through the professional sports club, quality of facilities and equipment, and scheduling flexibility. Future programs should consider incorporating education or training to support behaviour change maintenance and strategies to retain participants at follow-up. CONCLUSIONS: Results provide valuable insights into the design and delivery of interventions for firefighters and demonstrate the importance of strong partnerships between community stakeholders.

Cooling strategies for firefighters: Effects on physiological, physical, and visuo-motor outcomes following fire-fighting tasks in the heat.

OBJECTIVES: Due to the nature of firefighting, most effective cooling interventions to reduce heat strain and optimise performance are not practically viable. This study quantified the effects of two practical cooling strategies, co-designed with subject-matter experts, on physiological strain and physical, perceptual, and visuo-motor performance during simulated firefighting in the heat. DESIGN: Randomised cross-over. METHODS: On three occasions 14 firefighters completed an 80-min simulation in a hot-humid environment (32.0[0.9]°C, 59[3]%RH) including two 20-min firefighting tasks in full protective clothing, each followed by 20-min seated recovery. Recovery involved removal of protective clothing and one of three interventions - control (CON; ambient-temperature water consumption), basic (BASIC; cool-water consumption, ambient-forearm immersion/towels, fan), and advanced (ADV; ice-slushy consumption, cool-forearm immersion/ice packs, misting-fan). Thermal (core temperature) and cardiovascular (heart rate, arterial pressure) responses were measured throughout, whilst physical (handgrip/balance), visuo-motor (reaction time/memory recall) and perceptual (fatigue/thermal sensation/comfort) measures were assessed pre- and post-trial. RESULTS: Compared to CON, core temperature was lower in BASIC and ADV following the second task (ADV: 37.7[0.4]; BASIC: 38.0[0.4]; CON: 38.3[0.4]°C) and recovery protocol (ADV: 37.5[0.3]; BASIC: 37.7 [0.3] CON: 38.3[0.4]°C). This was paralleled by lowered heart rate, rate pressure product, and thermal sensation following the recovery protocols, in the ADV and BASIC condition compared to CON (p < .05). No physical or visuo-motor outcomes differed significantly between conditions. CONCLUSION: Whilst these observations need to be extended to field conditions, our findings demonstrate that two novel cooling interventions developed in collaboration with subject-matter experts offered benefits for reducing thermal strain and optimising firefighter safety.

How to manage travel fatigue and jet lag in athletes? A systematic review of interventions.

OBJECTIVES: We investigated the management of travel fatigue and jet lag in athlete populations by evaluating studies that have applied non-pharmacological interventions (exercise, sleep, light and nutrition), and pharmacological interventions (melatonin, sedatives, stimulants, melatonin analogues, glucocorticoids and antihistamines) following long-haul transmeridian travel-based, or laboratory-based circadian system phase-shifts. DESIGN: Systematic review Eligibility criteria Randomised controlled trials (RCTs), and non-RCTs including experimental studies and observational studies, exploring interventions to manage travel fatigue and jet lag involving actual travel-based or laboratory-based phase-shifts. Studies included participants who were athletes, except for interventions rendering no athlete studies, then the search was expanded to include studies on healthy populations. DATA SOURCES: Electronic searches in PubMed, MEDLINE, CINAHL, Google Scholar and SPORTDiscus from inception to March 2019. We assessed included articles for risk of bias, methodological quality, level of evidence and quality of evidence. RESULTS: Twenty-two articles were included: 8 non-RCTs and 14 RCTs. No relevant travel fatigue papers were found. For jet lag, only 12 athlete-specific studies were available (six non-RCTs, six RCTs). In total (athletes and healthy populations), 11 non-pharmacological studies (participants 600; intervention group 290; four non-RCTs, seven RCTs) and 11 pharmacological studies (participants 1202; intervention group 870; four non-RCTs, seven RCTs) were included. For non-pharmacological interventions, seven studies across interventions related to actual travel and four to simulated travel. For pharmacological interventions, eight studies were based on actual travel and three on simulated travel. CONCLUSIONS: We found no literature pertaining to the management of travel fatigue. Evidence for the successful management of jet lag in athletes was of low quality. More field-based studies specifically on athlete populations are required with a multifaceted approach, better design and implementation to draw valid conclusions. PROSPERO registration number The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42019126852).

Sleep and the athlete: narrative review and 2021 expert consensus recommendations.

Elite athletes are particularly susceptible to sleep inadequacies, characterised by habitual short sleep (<7 hours/night) and poor sleep quality (eg, sleep fragmentation). Athletic performance is reduced by a night or more without sleep, but the influence on performance of partial sleep restriction over 1-3 nights, a more real-world scenario, remains unclear. Studies investigating sleep in athletes often suffer from inadequate experimental control, a lack of females and questions concerning the validity of the chosen sleep assessment tools. Research only scratches the surface on how sleep influences athlete health. Studies in the wider population show that habitually sleeping <7 hours/night increases susceptibility to respiratory infection. Fortunately, much is known about the salient risk factors for sleep inadequacy in athletes, enabling targeted interventions. For example, athlete sleep is influenced by sport-specific factors (relating to training, travel and competition) and non-sport factors (eg, female gender, stress and anxiety). This expert consensus culminates with a sleep toolbox for practitioners (eg, covering sleep education and screening) to mitigate these risk factors and optimise athlete sleep. A one-size-fits-all approach to athlete sleep recommendations (eg, 7-9 hours/night) is unlikely ideal for health and performance. We recommend an individualised approach that should consider the athlete's perceived sleep needs. Research is needed into the benefits of napping and sleep extension (eg, banking sleep).

Influence of Training Schedules on Objective Measures of Sleep in Adolescent Academy Football Players.

Brown, GA, Veith, S, Sampson, JA, Whalan, M, and Fullagar, HHK. Influence of training schedules on objective measures of sleep in adolescent academy football players. J Strength Cond Res 34(9): 2515-2521, 2020-Football academy settings may pose risks to adolescent athletes achieving sufficient sleep because of the contextual challenges these players face (e.g., psychosocial pressure, changes in training, competition, and academic stress). Given the importance of sleep to overall health as well as physical athletic development and injury risk, this study aimed to investigate whether differences in training schedules (morning vs. evening training sessions) affected objective measures of sleep in adolescent academy football (soccer) players. Twelve academy players (mean age 14.18 ± 1.36 years) wore an ActiGraph accelerometer on nights before, and nights of, training days in 2 separate weeks where morning (09:00-11:00 hours) and evening (18:00-20:00 hours) training occurred. Objective sleep parameters and training load data were collected. Night-time sleep periods were categorized as sleep preceding morning training, preceding evening training, or after evening training. One-way univariate and multivariate analyses of variance for repeated measures were performed to determine the impact of the training schedule on sleep. Significance levels were set at p < 0.05. The total sleep time was below the recommended guidelines (<8 hours) across conditions. A large significant effect of the training schedule on time attempted to fall asleep (p = 0.004, effect size [ES] = 0.40) and time of sleep (p = 0.003, ES = 0.41) was present, with post-evening sessions resulting in the latest times. Overall, the players' sleep behavior was resilient to changes in training schedules. However, the low sleep durations (and potential risks to physical performance/injury) suggest that sleep education coupled with practical interventions are required in this cohort.

Practitioner Perceptions of Evidence-Based Practice in Elite Sport in the United States of America.

Fullagar, HHK, Harper, LD, Govus, A, McCunn, R, Eisenmann, J, and McCall, A. Practitioner perceptions of evidence-based practice in elite sport in the United States of America. J Strength Cond Res 33(11): 2897-2904, 2019-Practitioners' perceptions regarding the use and effectiveness of research evidence in sport is not well understood. The purpose of the present study was to examine practitioners' perceptions around the use, implementation, and barriers to evidence-based practice (EBP) in sport science in the United States of America (USA). A survey (28 items) was completed by 67 full-time staff who were a physical performance team member employed by universities or professional sporting organizations in the USA. Questions included the use of research, contribution of research areas, barriers to accessing and implementing EBP, and methods of feedback to the coach and players. All respondents (100%) stated they used research evidence in their performance/training program, ranking research as contributing most (largest contribution = 1 to smallest contribution = 4) to individualized preparation or recovery recommendations (1.98 ± 1.02). The top 3 preferred sources of information were "peer-reviewed research" (100% of respondents), "conferences/seminars" (76%), and "practitioners within your sport" (63%). Commonly reported perceived barriers between accessing and implementing research were "lack of staff" (accessing = 33%, implementing = 46%) "time" (accessing = 38%, implementing = 48%) and nonapplicable research (accessing = 33%, implementing = 37%), whereas "poor player compliance" was a clear barrier to implementing EBP (56%). Practitioners most preferred, and actual, method of feedback for coaching staff (87% for both) and players (94 and 95%, respectively) was "informal conversations/speaking." Improved access to educational and financial resources, increased integration of staff in coach settings and understanding of player/coach contexts may help to alleviate barriers to EBP.

Subjective Wellness, Acute: Chronic Workloads, and Injury Risk in College Football.

Sampson, JA, Murray, A, Williams, S, Sullivan, A, and Fullagar, HHK. Subjective wellness, acute: chronic workloads and injury risk in college football. J Strength Cond Res 33(12): 3367-3373, 2019-Acute:chronic workload ratios (ACWRs) are associated with injury risk across team sports. In this study, one season of workload and wellness data from 42 collegiate football players were retrospectively analyzed. Daily 7:21 day exponentially weighted moving average (EWMA) ACWRs were calculated, and z-score fluctuations ("normal," "better," and "worse") in sleep, soreness, energy, and overall wellness were assessed relative to the previous day ACWRs and considered as an interactive effect on the risk of noncontact injury within 0-3 days. Fifty-five noncontact injuries were observed, and injury risks were very likely higher when ACWRs were 2 SDs above (relative risk [RR]: 3.05, 90% confidence interval [CI]: 1.14-8.16) and below (RR: 2.49, 90% CI: 1.11-5.58) the mean. A high ACWR was trivially associated (p < 0.05) with "worse" wellness (r = -0.06, CI: -0.10 to -0.02), muscle soreness (r = -0.07, CI: -0.11 to -0.03), and energy (r = -0.05, CI: -0.09 to -0.01). Feelings of "better" overall wellness and muscle soreness with collectively high EWMA ACWRs displayed likely higher injury risks compared with "normal" (RR: 1.52, 90% CI: 0.91 to 2.54; RR: 1.64, 90% CI: 1.10-2.47) and likely or very likely (RR: 2.36, 90% CI: 0.83 to 674; RR: 2.78, 90% CI: 1.21-6.38) compared with "worse" wellness and soreness, respectively. High EWMA ACWRs increased injury risk and negatively impacted wellness. However, athletes reporting "better" wellness, driven by "better" muscle soreness presented with the highest injury risk when high EWMA ACWRs were observed. This suggests that practitioners are responsive to, and/or athletes are able to self-modulate workload activities.

Individual Patterns in Blood-Borne Indicators of Fatigue-Trait or Chance.

Julian, R, Meyer, T, Fullagar, HHK, Skorski, S, Pfeiffer, M, Kellmann, M, Ferrauti, A, and Hecksteden, A. Individual patterns in blood-borne indicators of fatigue-trait or chance. J Strength Cond Res 31(3): 608-619, 2017-Blood-borne markers of fatigue such as creatine kinase (CK) and urea (U) are widely used to fine-tune training recommendations. However, predictive accuracy is low. A possible explanation for this dissatisfactory characteristic is the propensity of athletes to react to different patterns of fatigue indicators (e.g., predominantly muscular [CK] or metabolic [U]). The aim of the present trial was to explore this hypothesis by using repetitive fatigue-recovery cycles. A total of 22 elite junior swimmers and triathletes (18 ± 3 years) were monitored for 9 weeks throughout 2 training phases (low-intensity, high-volume [LIHV] and high-intensity, low-volume [HILV] phases). Blood samples were collected each Monday (recovered) and Friday (fatigued) morning. From measured values of CK, U, free-testosterone (FT), and cortisol (C) as determined in the rested and fatigued state, respectively, Monday-Friday differences (Δ) were calculated and classified by magnitude before calculation of ratios (ΔCK/ΔU and ΔFT/ΔC). Coefficient of variation (CV) was calculated as group-based estimates of reproducibility. Linear mixed modeling was used to differentiate inter- and intraindividual variability. Consistency of patterns was analyzed by comparing with threshold values (<0.9 or >1.1 for all weeks). Reproducibility was very low for fatigue-induced changes (CV ≥ 100%) with interindividual variation accounting for 45-60% of overall variability. Case-wise analysis indicated consistent ΔCK/ΔU patterns for 7 individuals in LIHV and 7 in HILV; 5 responded consistently throughout. For ΔFT/ΔC the number of consistent patterns was 2 in LIHV and 3 in HILV. These findings highlight the potential value of an individualized and multivariate approach in the assessment of fatigue.

Time to wake up: individualising the approach to sleep promotion interventions.

Sleep is fundamental to normal physiological and cognitive function. Sleep promotion strategies have been used extensively in clinical settings, as a treatment for various ailments (ie, insomnia). However, sleep problems are prevalent outside these realms, with 56% of American, 31% of Western European and 29% of Japanese people suffering from sleep problems the previous year. The global public health concern over sleep has increased the demand for sleep promotion interventions, but the efficacy of these strategies is unclear in otherwise healthy and athletic populations. One possibility is due to the presentation and analysis of grouped data, despite sleep naturally being a highly variable and inherent trait. We argue the case for (1) presenting sleep data at the individual level and (2) individualising sleep promotion interventions.

Impaired sleep and recovery after night matches in elite football players.

Despite the perceived importance of sleep for elite footballers, descriptions of the duration and quality of sleep, especially following match play, are limited. Moreover, recovery responses following sleep loss remain unclear. Accordingly, the present study examined the subjective sleep and recovery responses of elite footballers across training days (TD) and both day and night matches (DM and NM). Sixteen top division European players from three clubs completed a subjective online questionnaire twice a day for 21 days during the season. Subjective recall of sleep variables (duration, onset latency, time of wake/sleep, wake episode duration), a range of perceptual variables related to recovery, mood, performance and internal training loads and non-exercise stressors were collected. Players reported significantly reduced sleep durations for NM compared to DM (-157 min) and TD (-181 min). In addition, sleep restfulness (SR; arbitrary scale 1 = very restful, 5 = not at all restful) and perceived recovery (PR; acute recovery and stress scale 0 = not recovered at all, 6 = fully recovered) were significantly poorer following NM than both TD (SR: +2.0, PR: -2.6), and DM (SR: +1.5; PR: -1.5). These results suggest that reduced sleep quantity and quality and reduced PR are mainly evident following NM in elite players.

Knowledge of bout duration influences pacing strategies during small-sided games.

This investigation examines pacing during intermittent team sports. Sixteen junior Rugby League players participated in eight different small-sided offside touch games. All games were 24 min, but bout durations differed in continuous (1 × 24 min) or repeated (2 × 12, 3 × 8, 4 × 6, 6 × 4, 8 × 3, 12 × 2 or 24 × 1 min) formats. Repeat bouts were interspersed by 2 min of passive rest, and participants were informed of the bout duration immediately prior to the game. Heart rates, ratings of perceived exertion and data gathered from global positioning system devices were used to investigate the pacing strategies employed within each game. No significant (P > 0.05) between-game differences were observed in total distance; however, during the 1-min bouts, high-speed movement was significantly (P < 0.05) increased, during the first and second quarters of the 24 × 1-min game compared to all other formats (effect size range: 0.75 ± 0.61-1.38 ± 0.47). Furthermore, the rate of decline in high-speed movement over-time was greatest during the 24 × 1-min game with large differences observed between the first and third quarters (effect size: 0.90 ± 0.58). Greater moderate-speed (effect size range: 0.62 ± 0.63-1.56 ± 0.40) and less low-speed (effect size range: 0.69 ± 0.62-1.54 ± 0.40) distances were also observed during the 1-min bouts, yet heart rates were higher during the continuous 1 × 24-min game. Pacing strategies during intermittent activities are influenced by the number and duration of exercise bouts. Practitioners should consider within-game bout durations when prescribing game-based activities to improve aerobic capacity.

Sleep and Sport Performance.

SUMMARY: Elite athletes and coaches believe sleep is the most important recovery strategy and widely consider it critical to optimal performance. Despite this perceived importance, there are numerous circumstances that can reduce sleep quantity and quality in athletic populations. Because of the effects of sleep loss on various physical, neurophysiological, and cognitive parameters, such perturbations can have consequences for performance and recovery outcomes. Although peer-reviewed literature examining the interaction between sleep, performance, and recovery in athletes is increasing, understanding of these issues remains equivocal. Perhaps most pertinently, the effect of sleep on sport performance does not align with a one-size-fits-all approach and rather depends on numerous factors such as type of sport, scheduling, time of the season, and the intraindividual requirements for sleep. The relationship between brain plasticity and memory, which in turn can influence learning processes and long-term memory consolidation, suggests that sleep may play an important role in learning new skills and tactics for both elite and developing athletes. The aim of this special issue review was to analyze the evidence of sleep loss on sport performance and recovery, with a specific focus on elite athletes. An assessment of these sleep-compromising situations that elite athletes may face during a typical season and practical considerations for alleviating these issues is also provided to further the understanding for medical professionals, scientists, and applied sporting practitioners alike.

The effects of travel on performance: a 13-year analysis of the National Rugby League (NRL) competition.

The purpose was to investigate the effects of travel on performance in the National Rugby League (NRL). A total of 4,704 observations from 2,352 NRL matches (2007-2019) were analysed. The effect of travel on match outcome (i.e., win/loss) was analysed using a generalized linear mixed model, and the points difference using a linear mixed model. For every 1,000 km travelled in the NRL, the estimated probability of winning a match was reduced by -2.7% [-5.7 to 0.3%] and the estimated points difference by -1.1 [-2.0 to -0.2] points. In relation to every 1,000 km travelled, the 2007-2009 seasons had the greatest reduction in the likelihood of winning a match (-2.7% [-4.7 to -0.6%]), with the 2018-2019 seasons having the greatest likelihood (1.1% [-1.2 to 3.3%]). Regarding inter-state travel, teams from the state of Queensland had the greatest reduction in the likelihood of winning a match while the team from the state of Victoria had the greatest likelihood, although there were no clear differences between states. These data suggest that travel has impacted performance in NRL matches although this effect has reduced over time. These findings are useful for practitioners that prepare athletes in sports where frequent short-haul travel is required.

Subjective Sleep Patterns and Jet Lag Symptoms of Junior Netball Players Prior to and During an International Tournament: A Case Study.

PURPOSE: To assess the impact of long-haul transmeridian travel on subjective sleep patterns and jet lag symptoms in youth athletes around an international tournament. METHODS: An observational descriptive design was used. Subjective sleep diaries and perceived responses to jet lag were collected and analyzed for a national junior netball team competing in an international tournament. Sleep diaries and questionnaires were completed daily prior to and during travel, and throughout the tournament. Results were categorized into pretravel, travel, training, and match nights. Means were compared performing a paired Student t test with significance set at P < .05. Data are presented as mean (SD) and median (minimum, maximum). RESULTS: Athletes reported significantly greater time in bed on match days compared with training (P < .001) and travel (P = .002) days, and on pretravel days compared with travel (P < .001) and training (P = .028) days. Sleep ratings were significantly better on pretravel days compared with match (P = .013) days. Perceived jet lag was worse on match (P = .043) days compared with pretravel days. Significant differences were also observed between a number of conditions for meals, mood, bowel activity, and fatigue. CONCLUSION: Youth athletes experience significantly less opportunity for sleep during long-haul transmeridian travel and face disruptions to daily routines during travel which impact food intake. Young athletes also experience disturbed sleep prior to and during competition. These results highlight the need for practices to alleviate jet lag symptoms and improve the sleep of young athletes traveling for tournaments in an effort to optimize recovery and performance.

Heat Adaptation and Nutrition Practices: Athlete and Practitioner Knowledge and Use.

PURPOSE: To survey elite athletes and practitioners to identify (1) knowledge and application of heat acclimation/acclimatization (HA) interventions, (2) barriers to HA application, and (3) nutritional practices supporting HA. METHODS: Elite athletes (n = 55) and practitioners (n = 99) completed an online survey. Mann-Whitney U tests (effect size [ES; r]) assessed differences between ROLE (athletes vs practitioners) and CLIMATE (hot vs temperate). Logistic regression and Pearson chi-square (ES Phi [ϕ]) assessed relationships. RESULTS: Practitioners were more likely to report measuring athletes' core temperature (training: practitioners 40% [athletes 15%]; P = .001, odds ratio = 4.0, 95% CI, 2%-9%; competition: practitioners 25% [athletes 9%]; P = .020, odds ratio = 3.4, 95% CI, 1%-10%). Practitioners (55% [15% athletes]) were more likely to perceive rectal as the gold standard core temperature measurement site (P = .013, ϕ = .49, medium ES). Temperate (57% [22% hot]) CLIMATE dwellers ranked active HA effectiveness higher (P < .001, r = .30, medium ES). Practitioners commonly identified athletes' preference (48%), accessibility, and cost (both 47%) as barriers to HA. Increasing carbohydrate intake when training in the heat was more likely recommended by practitioners (49%) than adopted by athletes (26%; P = .006, 95% CI, 0.1%-1%). Practitioners (56% [28% athletes]) were more likely to plan athletes' daily fluid strategies, adopting a preplanned approach (P = .001; 95% CI, 0.1%-1%). CONCLUSIONS: Practitioners, and to a greater extent athletes, lacked self-reported key HA knowledge (eg, core temperature assessment/monitoring methods) yet demonstrated comparatively more appropriate nutritional practices (eg, hydration).

COVID-19 Lockdowns: A Worldwide Survey of Circadian Rhythms and Sleep Quality in 3911 Athletes from 49 Countries, with Data-Driven Recommendations.

OBJECTIVE: In a convenience sample of athletes, we conducted a survey of COVID-19-mediated lockdown (termed 'lockdown' from this point forward) effects on: (i) circadian rhythms; (ii) sleep; (iii) eating; and (iv) training behaviors. METHODS: In total, 3911 athletes [mean age: 25.1 (range 18-61) years, 1764 female (45%), 2427 team-sport (63%) and 1442 elite (37%) athletes] from 49 countries completed a multilingual cross-sectional survey including the Pittsburgh Sleep Quality Index and Insomnia Severity Index questionnaires, alongside bespoke questions about napping, training, and nutrition behaviors. RESULTS: Pittsburgh Sleep Quality Index (4.3 ± 2.4 to 5.8 ± 3.1) and Insomnia Severity Index (4.8 ± 4.7 to 7.2 ± 6.4) scores increased from pre- to during lockdown (p < 0.001). Pittsburgh Sleep Quality Index was predominantly influenced by sleep-onset latency (p < 0.001; + 29.8%), sleep efficiency (p < 0.001; - 21.1%), and total sleep time (p < 0.001; - 20.1%), whilst Insomnia Severity Index was affected by sleep-onset latency (p < 0.001; + 21.4%), bedtime (p < 0.001; + 9.4%), and eating after midnight (p < 0.001; + 9.1%). During lockdown, athletes reported fewer training sessions per week (- 29.1%; d = 0.99). Athletes went to bed (+ 75 min; 5.4%; d = 1.14) and woke up (+ 150 min; 34.5%; d = 1.71) later during lockdown with an increased total sleep time (+ 48 min; 10.6%; d = 0.83). Lockdown-mediated circadian disruption had more deleterious effects on the sleep quality of individual-sport athletes compared with team-sport athletes (p < 0.001; d = 0.41), elite compared with non-elite athletes (p = 0.028; d = 0.44) and older compared with younger (p = 0.008; d = 0.46) athletes. CONCLUSIONS: These lockdown-induced behavioral changes reduced sleep quality and increased insomnia in athletes. Data-driven and evidence-based recommendations to counter these include, but are not limited to: (i) early outdoor training; (ii) regular meal scheduling (whilst avoiding meals prior to bedtime and caffeine in the evening) with appropriate composition; (iii) regular bedtimes and wake-up times; and (iv) avoidance of long and/or late naps.

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

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).

Australian firefighters perceptions of heat stress, fatigue and recovery practices during fire-fighting tasks in extreme environments.

OBJECTIVES: The aim of this study was to assess current perceptions of heat stress, fatigue and recovery practices during active duty in Australian firefighters. DESIGN: Prospective survey. METHODS: 473 firefighters from Fire and Rescue New South Wales completed a two-part, 16-item survey. Questions included perceptions of the operational activities and body areas associated with the most heat stress, the most mentally and physically demanding activities, and levels of fatigue felt. Further questions focussed on the use and importance of recovery practices, effectiveness of currently used heat-mitigation strategies and additional cooling strategies for future use. RESULTS: Around a third of firefighters (62%) reported structural fire-fighting as the hottest operational activities experienced, followed by bushfire-fighting (51%) and rescue operations (38%). The top three responses for which body-parts get the hottest ranked as 'the head' (58%), 'the whole body' (54%) and 'the upper back' (40%), respectively. The majority of firefighters (~90%) stated they always or sometimes use the opportunity to recover at an incident, with the top three being 'sit in the shade' (93%), 'cold water ingestion (drinking)' (90%) and 'removing your helmet, flash hood and jacket' (89%). Firefighters reported higher usefulness for more easily deployed strategies compared to more advanced strategies. Limited age and gender differences were found, although location of active service differences were present. CONCLUSION: These findings may inform future research, and translation to operational directives for recovery interventions; including exploration of protective gear and clothing, education, resources and provision of cooling methods, as well as recovery aid development.

A Combined Sleep Hygiene and Mindfulness Intervention to Improve Sleep and Well-Being During High-Performance Youth Tennis Tournaments.

PURPOSE: To investigate the effects of combined sleep hygiene recommendations and mindfulness on actigraphy-based sleep parameters, perceptual well-being, anxiety, and match outcomes during high-performance junior tennis tournaments. METHODS: In a randomized crossover design, 17 high-performance junior tennis players completed the baseline, control, and intervention (INT) conditions across 3 separate weeks. The baseline consisted of unassisted, habitual sleep during a regular training week, and the control was unassisted sleep during a tournament week. The players attended a sleep education workshop and completed a nightly sleep hygiene protocol during a tournament week for the INT. Analysis was performed on the weekly means and on the night prior to the first match of the tournament (T-1). RESULTS: Significant differences were observed for increased time in bed, total sleep time, and an earlier bedtime (P < .05) across the INT week. These parameters also significantly improved on T-1 of the INT. A moderate effect size (P > .05, d > 1.00) was evident for decreased worry on T-1 of the INT. Small effect sizes were also evident for improved mood, cognitive anxiety, and sleep rating across the INT week. The match performance outcomes remained unchanged (P > .05). CONCLUSIONS: Sleep hygiene INTs increase the sleep duration of high-performance junior tennis players in tournament settings, including the night prior to the tournament's first match. The effects on perceptual well-being and anxiety are unclear, although small trends suggest improved mood, despite no effect on generic match performance outcomes.