Menstrual cycle characteristics, perceived impact on performance, and barriers to communication: Perspectives of high-performance adolescent athletes in Singapore.

The purpose of this study was to examine the menstrual cycle (MC) characteristics, explore the impact on performance, and identify barriers to and facilitators of MC-related communication among high-performance female adolescent athletes in Singapore. Ninety athletes (15.4 ± 1.8 years) from multiple sports completed an online questionnaire. Eighty-four athletes were postmenarcheal (menarcheal age 11.9 ± 1.3 years), including two who were using an oral contraceptive pill (OCP). Secondary amenorrhea, current or history of, was self-reported in 16% of athletes. Sixty-two percent and 67% of non-OCP athletes perceived that the MC affected their ability to train and compete, respectively. Athletes preferred speaking to a parent (85%) and a female figure (67%) about MC-related concerns. Through thematic analysis, three barriers to communication were constructed: (1) pervasive menstrual stigma, (2) constraints of the training environment, and (3) the low value placed on MC-related conversations. Two facilitators of communication were constructed: (1) respect athletes' individual experiences as menstruating girls and (2) foster a safe space for MC-related conversations. Findings demonstrated that menstrual irregularities are common in adolescent athletes and screening for MC disorders, particularly primary amenorrhea should be undertaken in this population, with clear support pathways for management including symptom mitigation. To support athletes in raising MC-related concerns when needed, structured communication pathways that consider individual preferences and involve a (female) point of contact should be established within the training environment. Improving menstrual health literacy among adolescent athletes before any misinformation or negative perceptions are firmly established may contribute to longevity in their athletic careers.

A Strategy to Inform Athlete Sleep Support From Questionnaire Data and Its Application in an Elite Athlete Cohort.

PURPOSE: Information from the Pittsburgh Sleep Quality Index (PSQI) and Athlete Sleep Behavior Questionnaire (ASBQ) provide the ability to identify the sleep disturbances experienced by athletes and their associated athlete-specific challenges that cause these disturbances. However, determining the appropriate support strategy to optimize the sleep habits and characteristics of large groups of athletes can be time-consuming and resource-intensive. The purpose of this study was to characterize the sleep profiles of elite athletes to optimize sleep-support strategies and present a novel R package, AthSlpBehaviouR, to aid practitioners with athlete sleep monitoring and support efforts. METHODS: PSQI and ASBQ data were collected from a cohort of 412 elite athletes across 27 sports through an electronic survey. A k-means cluster analysis was employed to characterize the unique sleep-characteristic typologies based on PSQI and ASBQ component scores. RESULTS: Three unique clusters were identified and qualitatively labeled based on the z scores of the PSQI components and ASBQ components: cluster 1, "high-priority; poor overall sleep characteristics + behavioral-focused support"; cluster 2, "medium-priority, sleep disturbances + routine/environment-focused support"; and cluster 3, "low-priority; acceptable sleep characteristics + general support." CONCLUSIONS: The findings of this study highlight the practical utility of an unsupervised learning approach to perform clustering on questionnaire data to inform athlete sleep-support recommendations. Practitioners can consider using the AthSlpBehaviouR package to adopt a similar approach in athlete sleep screening and support provision.

Predicting Youth Athlete Sleep Quality and the Development of a Translational Tool to Inform Practitioner Decision Making.

BACKGROUND: Identifying key variables that predict sleep quality in youth athletes allows practitioners to monitor the most parsimonious set of variables that can improve athlete buy-in and compliance for athlete self-report measurement. Translating these findings into a decision-making tool could facilitate practitioner willingness to monitor sleep in athletes. HYPOTHESIS: Key predictor variables, identified by feature reduction techniques, will lead to higher predictive accuracy in determining youth athletes with poor sleep quality. STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 3. METHODS: A group (N = 115) of elite youth athletes completed questionnaires consisting of the Pittsburgh Sleep Quality Index and questions on sport participation, training, sleep environment, and sleep hygiene habits. A least absolute shrinkage and selection operator regression model was used for feature reduction and to select factors to train a feature-reduced sleep quality classification model. These were compared with a classification model utilizing the full feature set. RESULTS: Sport type, training before 8 am, training hours per week, presleep computer usage, presleep texting or calling, prebedtime reading, and during-sleep time checks on digital devices were identified as variables of greatest influence on sleep quality and used for the reduced feature set modeling. The reduced feature set model performed better (area under the curve, 0.80; sensitivity, 0.57; specificity, 0.80) than the full feature set models in classifying youth athlete sleep quality. CONCLUSION: The findings of our study highlight that sleep quality of elite youth athletes is best predicted by specific sport participation, training, and sleep hygiene habits. CLINICAL RELEVANCE: Education and interventions around the training and sleep hygiene factors that were identified to most influence the sleep quality of youth athletes could be prioritized to optimize their sleep characteristics. The developed sleep quality nomogram may be useful as a decision-making tool to improve sleep monitoring practice among practitioners.

Palatable Flavoured Fluids without Carbohydrates and Electrolytes Do Not Enhance Voluntary Fluid Consumption in Male Collegiate Basketball Players in the Heat.

Using palatable fluids to enhance drinking in athletes who display insufficient compensatory hydration behaviour may mitigate the risks of hypohydration and performance deficits. However, it is unclear whether flavour can independently enhance fluid consumption. This study examined the effects of a colourless, artificially sweetened flavoured water (FW), without carbohydrates and with negligible amounts of sodium, compared to plain water (W) on fluid consumption in male collegiate basketball players in a practical game setting. Eighteen male basketball players (age 23.1 ± 1.3 years) played a 3v3 basketball small-sided game. The players were randomly assigned to consume either FW or W. Pre-game urine-specific gravity, fluid consumption, body mass, and hedonic taste perceptions were assessed. Basketball performance was analysed through notational analysis. Ratings of perceived exertion and thirst were recorded at pre-, post-game, and at each rest period. Heart rate was recorded throughout the gameplay. Despite significantly higher hedonic ratings for FW than W (6.78 ± 0.83 vs. 5.56 ± 1.33, p = 0.033, d = 1.36), there were no significant differences in fluid consumption (1083 ± 32 mL vs. 1421 ± 403 mL, p = 0.068, d = 0.92). Our result highlighted that using palatable fluids as a strategy to increase fluid consumption during high-intensity gameplay in the heat may not be effective if used without carbohydrates and electrolytes. Practitioners could consider both fluid palatability and composition in establishing a hydration plan for athletes.

Relationships between Physical Activity, Work Ability, Absenteeism and Presenteeism in Australian and New Zealand Adults during COVID-19.

Public health movement and social restrictions imposed by the Australian and New Zealand governments in response to the COVID-19 pandemic influenced the working environment and may have affected health behaviours, work ability, and job performance. The aim of this study was to determine the associations between health behaviours and work ability and performance during COVID-19 restrictions and if health behaviours were related to demographic or population factors. A cross-sectional survey was used to gather responses from 433 adult employees in Australia and New Zealand between June and August 2020. The survey requested demographic information and used the International Physical Activity Questionnaire, Work Ability Index, and the World Health Organisation's Health and Work Performance Questionnaire. Multivariate regression models were used to explore relationships between the identified variables while controlling for several possible confounders. Being sufficiently physically active was associated with higher reported physical (aOR = 2.1; p = 0.001) and mental work abilities (aOR = 1.8; p = 0.007) and self-reported job performance (i.e., lower presenteeism) (median +7.42%; p = 0.03). Part-time employees were 56% less likely (p = 0.002) to report a good or very good mental work ability. Those with existing medical conditions were 14% less likely (p = 0.008) to be sufficiently active and 80% less likely (p = 0.002) to report rather good or very good physical work ability. Being sufficiently active was associated with higher physical and mental work abilities and better job performance during the COVID-19 pandemic. Employers should support opportunities for regular physical activity and provide specific support to individuals with medical conditions or in part-time employment.

Hydration Status and Fluid Replacement Strategies of High-Performance Adolescent Athletes: An Application of Machine Learning to Distinguish Hydration Characteristics.

There are limited data on the fluid balance characteristics and fluid replenishment behaviors of high-performance adolescent athletes. The heterogeneity of hydration status and practices of adolescent athletes warrant efficient approaches to individualizing hydration strategies. This study aimed to evaluate and characterize the hydration status and fluid balance characteristics of high-performance adolescent athletes and examine the differences in fluid consumption behaviors during training. In total, 105 high-performance adolescent athletes (male: 66, female: 39; age 14.1 ± 1.0 y) across 11 sports had their hydration status assessed on three separate occasions-upon rising and before a low and a high-intensity training session (pre-training). The results showed that 20-44% of athletes were identified as hypohydrated, with 21-44% and 15-34% of athletes commencing low- and high-intensity training in a hypohydrated state, respectively. Linear mixed model (LMM) analyses revealed that athletes who were hypohydrated consumed more fluid (F (1.183.85)) = 5.91, (p = 0.016). Additional K-means cluster analyses performed highlighted three clusters: "Heavy sweaters with sufficient compensatory hydration habits," "Heavy sweaters with insufficient compensatory hydration habits" and "Light sweaters with sufficient compensatory hydration habits". Our results highlight that high-performance adolescent athletes with ad libitum drinking have compensatory mechanisms to replenish fluids lost from training. The approach to distinguish athletes by hydration characteristics could assist practitioners in prioritizing future hydration intervention protocols.

Sleep Characteristics of Elite Youth Athletes: A Clustering Approach to Optimize Sleep Support Strategies.

PURPOSE: Elite athletes experience chronic sleep insufficiency due to training and competition schedules. However, there is little research on sleep and caffeine use of elite youth athletes and a need for a more nuanced understanding of their sleep difficulties. This study aimed to (1) examine the differences in sleep characteristics of elite youth athletes by individual and team sports, (2) study the associations between behavioral risk factors associated with obstructive sleep apnea and caffeine use with sleep quality, and (3) characterize the latent sleep profiles of elite youth athletes to optimize the sleep support strategy. METHODS: A group (N = 135) of elite national youth athletes completed a self-administered questionnaire consisting of the Pittsburgh Sleep Quality Index (PSQI) and questions pertaining to obstructive sleep apnea, napping behavior, and caffeine use. K-means clustering was used to characterize unique sleep characteristic subgroups based on PSQI components. RESULTS: Athletes reported 7.0 (SD = 1.2) hours of sleep. Out of the total group, 45.2% of the athletes had poor quality sleep (PSQI global >5), with team-sport athletes reporting significantly poorer sleep quality than individual-sport athletes. Multiple logistic regression analysis indicated that sport type significantly correlated with poor sleep quality. The K-means clustering algorithm classified athletes' underlying sleep characteristics into 4 clusters to efficiently identify athletes with similar underlying sleep issues to enhance interventional strategies. CONCLUSION: These findings suggest that elite youth team-sport athletes are more susceptible to poorer sleep quality than individual-sport athletes. Clustering methods can help practitioners characterize sleep-related problems and develop efficient athlete support strategies.

Effects of a Short Daytime Nap on Shooting and Sprint Performance in High-Level Adolescent Athletes.

PURPOSE: To investigate the sport-specific performance effect of a brief afternoon nap on high-level Asian adolescent student-athletes who were habitually short sleepers. METHODS: Participants were randomly assigned to a nap or nonnap (reading) condition. In the first study, 12 male shooters (13.8 [1.0] y) performed a shooting assessment (20 competition shots) with heart-rate variability monitored during the assessment. In the second study, 19 male track-and-field athletes (14.8 [1.1] y) performed a 20-m sprint-performance assessment. Subjective measures of sleepiness and alertness were obtained in both studies. RESULTS: The brief nap had no effect on any measure of shooting performance (P > .05) or autonomic function (P > .05) in shooters. However, the fastest 20-m sprint times increased significantly (P < .05) from 3.385 (0.128) s to 3.411 (0.143) s, with mean 2-m times trending toward significance (P < .1) among the track-and-field athletes. No significant differences were observed in any other measures. CONCLUSIONS: The results of the research indicate varying effects of naps between sport-specific performance measures. Napping had no effect on shooting performance, whereas a negative effect existed in 20-m sprint performance, potentially due to sleep inertia. Considering these findings, some caution is warranted when advocating naps for adolescent athletes.

Effects of Sport-Specific Training Intensity on Sleep Patterns and Psychomotor Performance in Adolescent Athletes.

PURPOSE: Adolescent student-athletes face time constraints due to athletic and scholastic commitments, resulting in habitually shortened nocturnal sleep durations. However, there is a dearth of research on the effects of sleep debt on student-athlete performance. The study aimed to (i) examine the habitual sleep patterns (actigraphy) of high-level student-athletes during a week of training and academic activities, (ii) ascertain the effects of habitual sleep durations experienced by high-level student-athletes on psychomotor performance, and (iii) examine the impact of sport training intensities on the sleep patterns of high-level student-athletes that participate in low and high intensity sports. METHODS: Sleep patterns of 29 high-level student-athletes (14.7 ± 1.3 yrs) were monitored over 7 days. A psychomotor vigilance task was administered on weekdays to ascertain the effects of habitual sleep durations. RESULTS: Weekend total sleep time was longer than weekdays along with a delay in bedtime, and waketimes. Psychomotor vigilance reaction times on Monday were faster than on Thursday and Friday, with reaction times on Tuesday also faster than on Friday. False starts and lapses were greater on Friday compared with Monday. CONCLUSION: There was a negative impact of sleep debt on student-athletes' psychomotor performance.

Detecting and developing youth athlete potential: different strokes for different folks are warranted.

Sport talent identification and development (TI and TD) in youth continues to attract strong interest among coaches, sport scientists and sport administrators. TI for sport in youth with the anticipation of future elite level sport achievement is both an art and a science, and is strongly influenced by within athlete and extraneous-to-athlete factors (ecosystem of support or the lack of). The returns from investment on current TI and TD models of sport in youth are subpar in that few continue in the sport to achieve podium positions at the elite sport level in adulthood. Why, where and how one succeeds in sport, and what that success means to the athlete and stakeholders are dependent on the culture and context of the country. We advocate harnessing the power of sport to help in youth development, to be holistic in its nurturance, to allow for individual idiosyncratic expressions of the athletes, to provide for talent transfer across sport, and to facilitate key stakeholders to 'join' hands to work for the common interest and understanding for as many youth and adults so as to provide them with opportunities through support and coaching to compete at the different levels of competition in sport. Governments, policy makers and administrators of sport must decide, within their specific circumstances, if TI and TD in sport in youth is serving a meaningful purpose and is a viable return on investment; in short, is it mission possible or is it… a quest for the Holy Grail for a podium finish in elite level sport competition?