Burgeoning interest in marathons necessitates an understanding of performance determinants. Research has highlighted the importance of diet, training and sleep, yet relations of circadian preference and sleep inertia with marathon performance remain largely unexplored. Because marathons generally start early-to-mid morning, these characteristics may have relevant impact. This study investigates relationships of circadian preference, sleep inertia and their interaction with marathon completion time. Consenting participants in a 2016 large mass-participation city marathon completed self-report questionnaires capturing circadian preference and sleep inertia, along with demographics and other characteristics. Circadian preference and sleep inertia were described across subgroups. Analyses examined the associations and interactions of circadian preference and sleep inertia with marathon completion times, with adjusted analyses accounting for age, sex and sleep health. Participants were marathon finishers (n = 936; 64.5% male; 66.3% young-adults), with a majority reporting morningness tendencies (60.8%). Results supported a linear association between increasing eveningness preference with slower marathon times (p = 0.003; padjusted = 0.002), while some support was provided for a linear relationship between greater sleep inertia and slower marathon times (p = 0.04; padjusted = 0.07). A significant interaction was observed (p = 0.02; padjusted = 0.01), with the directionality suggesting that the circadian preference relationship weakened when sleep inertia severity increased, and vice-versa. Our results suggest deleterious associations of increasing eveningness preference and greater sleep inertia with marathon completion time. These features may aid identifying marathoners who could be at a disadvantage, while also serving as modifiable targets for personalized training regimens preceding competition.

ABSTRACT:McClean, ZJ, Pasanen, K, Lun, V, Charest, J, Herzog, W, Werthner, P, Black, A, Vleuten, RV, Lacoste, E, and Jordan, MJ. A biopsychosocial model for understanding training load, fatigue, and musculoskeletal sport injury in university athletes: A scoping review. J Strength Cond Res 38(6): 1177-1188, 2024-The impact of musculoskeletal (MSK) injury on athlete health and performance has been studied extensively in youth sport and elite sport. Current research examining the relationship between training load, injury, and fatigue in university athletes is sparse. Furthermore, a range of contextual factors that influence the training load-fatigue-injury relationship exist, necessitating an integrative biopsychosocial model to address primary and secondary injury prevention research. The objectives of this review were (a) to review the scientific literature examining the relationship between training load, fatigue, and MSK injury in university athletes and (b) to use this review in conjunction with a transdisciplinary research team to identify biopsychosocial factors that influence MSK injury and develop an updated, holistic biopsychosocial model to inform injury prevention research and practice in university sport. Ten articles were identified for inclusion in this review. Key findings were an absence of injury surveillance methodology and contextual factors that can influence the training load-fatigue-MSK injury relationship. We highlight the inclusion of academic load, social load, and mental health load as key variables contributing to a multifactorial, gendered environmental, scientific inquiry on sport injury and reinjury in university sport. An integrative biopsychosocial model for MSK injury in university sport is presented that can be used to study the biological, psychological, and social factors that modulate injury and reinjury risk in university athletes. Finally, we provide an example of how causal inference can be used to maximize the utility of longitudinally collected observational data that is characteristic of sport performance research in university sport.

Background: Sleep as a biological phenomenon is effective in the performance and recovery of athletes. Questionnaires can be used as a cost-effective initial assessment tool for sleep. The Athlete Sleep Screening Questionnaire (ASSQ) demonstrated a clinically valid instrument for screening relevant sleep issues in athletic populations. Due to the lack of validated tools for adequate screening for sleep difficulties in the Iranian athlete population, the present study was conducted to evaluate the validity and reliability of the Persian version of the ASSQ. Materials and Methods: The translation process was performed using instructions by Beaton et al . Content validity was assessed by a panel of experts. Exploratory and confirmatory factor analysis was performed for two 5-item sleep difficulty scores (SDS) and a 4-item chronotype score. Internal consistency based on Cronbach’s alpha and McDonald’s omega and stability reliability were used to evaluate reliability. Results: The ASSQ achieved conceptual and semantic equivalence with the original scale. The item-level content validity index (I-CVI) of each item ranged from 0.87 to 1, and the averaging scale-level CVI/average was 0.95. In factor analysis, one factor for SDS and one factor for chronotype score were identified and confirmed. The internal consistency of the SDS scale (a =0.77, W =0.83) and chronotype (a =0.74, W =0.77) was acceptable. Stability reliability was confirmed for SDS scale (intra-class correlation [ICC] =0.87) and for chronotype (ICC = 0.83). Conclusion: Persian ASSQ has acceptable psychometric measurement properties as a screening tool to assess sleep in Iranian athletes.

INTRODUCTION & AIMS Sleep health is recognised as an essential component to optimise overall wellbeing and athletic performance. However, athletes frequently report sleep disturbance prior to and during competition, with nearly a quarter of athletes experiencing moderate to severe sleep problems international travel and subsequent competition. The Athlete Sleep Screening Questionnaire (ASSQ) was developed as a sleep screening tool to detect clinically significant sleep disturbances and daytime dysfunction in athletes. The purpose of this study was to assess sleep health (sleep disturbances, sleep difficulty and daytime dysfunction) via a sleep screening tool in elite female basketball players during international competition. METHODS Participants were 12 elite female basketball players (New Zealand Women’s Senior National Team, Tall Ferns) competing at the 2021 International Basketball Federation Women’s Asia Cup in Amman Jordan. The Athlete Sleep Screening Questionnaire (16 item) was used to assess sleep health and associated factors during the 7-day tournament to determine the impact of international travel. The ASSQ was scored according to previous validated methods to determine chronotype, sleep difficulty score, clinical sleep problem category (none, mild, moderate, or severe), and potential referral to a sleep physician for assessment due to poor sleep health. Categorical variables were summarised with frequency and percent. The study was approved by the University of Southern Queensland Human Research Ethics Committee (H21REA182). RESULTS Clinical sleep problems, as categorised by sleep difficulty score ≥ 8, were reported in 33% of the athletes, with 25% classified as moderate and 8% classified as severe. Fifty percent of the athletes reported sleep disturbance during travel, while 42% reported daytime dysfunction when travelling for competition. According to chronotype classification, 75% of athletes were categorised into evening type, 33% ‘definitely evening’ type sub-category, with 25% categorised into morning type. In total, 42.0% of athletes (5 players) were identified for further assessment. CONCLUSION This study highlights the effective use of the ASSQ as an easy to administer sleep screening tool to determine sleep health in elite female basketball players. The ASSQ provides a method of accurately identifying athletes that would benefit from sleep hygiene education, sleep travel management and subsequent preventative measures related to clinically significant sleep problems. In this case study, a substantial portion of elite female basketball players appear to suffer from suboptimal sleep and would likely benefit from interventions targeting sleep health. This is an important consideration and provides valuable insights into indicators of sleep health in the management of female athlete sleep health and wellbeing during international competition.

Abstract Introduction Student-athletes face unique demands that heighten vulnerability to both sleep and mental health problems. Circadian preference (CP) describes an individuals’ preferred timing for sleep and wake activity, with this conceived as a continuum between the extremes of morningness and eveningness. CP has been shown to influence both sleep and mental health, with greater eveningness preference generally associating with worse outcomes. However, these relationships are understudied in student-athletes. Thus, this investigation was designed to assess the influence of CP on sleep, depression, and anxiety in Canadian student-athletes. Methods Data were obtained throughout the academic semester from Canadian institutions, with student-athletes completing the Athlete Sleep Screening Questionnaire (ASSQ), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire (PHQ-9). ASSQ captured sleep health characteristics and CP, while GAD-7 and PHQ-9 assessed anxiety and depressive symptoms, respectively. ASSQ CP response options were Definitely-Morning, Morning, Evening, or Definitely-Evening as response options, and was coded on a 0-3 scale, with higher values representing increasing eveningness preference. Linear regression estimated associations of CP with sleep, depression, and anxiety. Adjusted regressions controlled for age, gender, race/ethnicity, and sport type. Results Sample included 559 Canadian student-athletes (Average Age = 18.9 ± 3.21 years; Percentage Women = 53%; Percentage White = 79.1%) from eight different sports. Regarding CP, 11.4% reported Definitely-Morning, 27.0% reported Morning, 41.8% reported Evening, and 19.8% reported Definitely-Evening. Greater eveningness preference significantly associated with worse overall sleep difficulties (padjusted < 0.0001), longer sleep latency (padjusted < 0.0001), reduced sleep satisfaction (padjusted < 0.0001), more prolonged sleep inertia (padjusted < 0.0001), more daytime naps (padjusted = 0.01), and more severe depressive symptomatology (padjusted = 0.0006). Conclusion Greater eveningness in a sample of Canadian student-athletes associated with worse sleep and psychological characteristics, including overall sleep difficulty, sleep latency, sleep satisfaction, sleep inertia, daytime napping, and depressive symptom severity. The results of this study provide compelling evidence that eveningness CP may predict poor mental and sleep health outcomes in student-athletes. Thus, further attention to circadian characteristics of student-athletes is warranted. Additionally, modifications to training schedules and team routines could be considered as preventative strategies for mental and sleep health problems. Support (if any) Mitacs #IT23469

BACKGROUND: Due to the rising concern of inadequate sleep, critical analysis is needed for the presence of sleep problems in diverse popula-tions. Research has shown that college athletes may be one such population at risk for sleep disturbances. Poor sleep may lead to physiological, psychological, and cognitive deficits that can impact college athletes academically and athletically. This investigation was performed to examine the relationship of age, sex, and history of concussion on sleep disturbance in college athletes. METHODS: A total of 191 collegiate athletes between the ages of 18-26 from a single academic NCAA institution in the Rocky Mountain region of the USA, consented to participate in the study. Participants completed a demographic questionnaire and the Athlete Sleep Screening Question-naire (ASSQ). Results were analyzed using SPSS Version 27.RESULTS: Primary results revealed that female athletes reported higher sleep disturbance scores when compared to males (U=3643.0, P=0.016). Self-reported sleep disturbances when traveling for sport were higher for females (x(1) = 23.800, P<0.001). Males were also less likely to report daytime dysfunction when traveling for sport (x(1) =22.988, P<0.001). Sleep disturbance had a significant association with age (x(1) =4.145, P=0.042), with older participants (20+ years of age) reporting greater sleep disturbance. Concussion history did not associate with sleep disturbance in the present study. CONCLUSIONS: Results suggest that sophomore or older female may be at higher risk for sleep disturbances. Clarifying sex-specific sleep health and understanding the role of age and academic class is crucial to enhance and personalize interventions.(Cite this article as: Crutcher BB, Moran RN, Charest J, Leivo JN. Examination of clinical sleep difficulties in college student-athletes. J Sports Med Phys Fitness 2023;63:485-91. DOI: 10.23736/S0022-4707.22.14210-6)

Sleep is an essential human behavior that plays a key role in proper biopsychosocial development as well as short- and long-term biological, physical, psychological, and cognitive health. Sleep plays a key role in athletic performance, influencing an athlete’s ability to train, recover, and perform, as well as their overall wellness. Over the recent decade, the awareness of sleep’s import has penetrated just about every professional sport domain. The purpose of the review was to identify and synthesize the literature published within the past 5 years (2018–2022) that relates to sleep and performance in professional athletes. Literature related to nonprofessional, high-level athletes (e.g., collegiate; Olympic) was omitted as well as those associated with non-traditional professional sports (e.g., eSports). Results from 38 articles were incorporated into this review, which covered (1) the sleep’s role in the training, physical injury prevention and recovery, competitive performance, and mental health of professional athletes, (2) common sleep problems and disorders in professional athletes, and (3) the impact of unique challenges from training, travel, competition, and other factors on sleep health. Additionally, we provide an orientation to utilized strategies and interventions to assist with sleep health in professional athletes, as well as conclude with a commentary on critical steps forward. Sleep plays a critically important role in the training, recovery, performance, and overall wellness of professional athletes. Professional athletes are vulnerable to a variety of sleep-related problems and disorders, due to unique factors related to training, travel, and competition, among other factors. Improved, standardized research methodology and partnerships between professional athletes, coaches, teams, and organizations and researchers are necessary to advance the knowledge of sleep and performance in professional athletes, including identifying sport-specific differences and variation across individual characteristics, as well as developing individualizable, dynamic, and appropriate interventions for improving sleep health among professional athletes.

Sleep improves the cognitive and physical performance of athletes. A detailed questionnaire that detects sleep disruptions is required to identify sleep-deprived athletes. This study evaluates the translated Athlete Sleep Screening Questionnaire (ASSQ), a tool suggested by the International Olympic Committee, among Arabic-speaking athletes. The ASSQ was translated into Arabic and examined for floor or ceiling effects, internal consistency, and validity among Arabic-speaking athletes. The Arabic Pittsburgh Sleep Quality Index (PSQI) was employed to assess convergent validity. Ninety athletes (28.9% women) participated and completed this study's questionnaires. The Cronbach's alpha for the ASSQ-Sleep Difficulty Score (SDS) was 0.435, and that of the ASSQ-chronotype was 0.632. The SDS and chronotype subset of the ASSQ demonstrated excellent test-retest reliability, with intraclass correlation coefficients of 0.84 and 0.938, respectively. The ASSQ-SDS correlated positively with the PSQI (0.734, p = 0.001). The ASSQ-chronotype was inversely associated with the PSQI (p = 0.001). This study's findings can assist clinicians in assessing sleep disorders in sports. The Arabic version of the ASSQ has satisfactory psychometric qualities and can identify clinically relevant sleep problems in athletes.

Abstract Introduction Mental health issues are a leading cause of decreased academic and athletic performances when left untreated. Recently, the International Olympic Committee (IOC) and the National Collegiate Athletic Association (NCAA) have highlighted the fundamental importance of mental health among young athletes. Sleep represents a core feature of mental health, and student-athletes represent a vulnerable population for sleep restriction and disruption due to the demands of their courseload and training schedule. This investigation was performed to identify differences in sleep and mental health across gender, race/ethnicity, and sport type. Methods Data were obtained throughout the academic semester from Canadian institutions, with student-athletes completing the Athlete Sleep Screening Questionnaire (ASSQ), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire (PHQ-9). ASSQ captured sleep and circadian health, while GAD-7 and PHQ-9 assessed anxiety and depressive symptoms, respectively. Linear regression determined gender, race/ethnicity, and sport type differences across ASSQ sleep problems score, ASSQ sleep items, GAD-7 score, PHQ-9 score, and PHQ-9 item #9 (suicidal ideation). Results Final sample (N=559) was 53.0% female, 79.1% white, comprised of young individual (Mean Age = 18.9 ± 3.21), and included student-athletes from basketball, field-hockey, football, ice-hockey, soccer, volleyball, track & field and swimming. Females reported more overall sleep difficulties (p=0.01), medication use (p=0.04) and WASO (p=0.001) compared to males. Females also reported higher anxiety (p < 0.0001), depression (p< 0.0001), and suicidal ideation (p=0.03). Significant variance in total sleep time (TST) (p=0.001) and sleep satisfaction (p=0.04) was observed across race/ethnicity, with student-athletes identifying as Black or African American reporting the lowest TST, while Asian or Pacific Islander student-athletes reported the lowest sleep satisfaction. Significant variance in sleep difficulties score (p< 0.0001), TST (p < 0.0001), and satisfaction (p< 0.0001), as well as anxiety (p < 0.0001) and depression (p< 0.0001) was observed across sport type. Football student-athletes reported the highest sleep difficulties score, and lowest TST satisfaction. Field-hockey student-athletes reported the highest anxiety and depression. Conclusion Results suggest that sleep and mental health challenges present differently across gender, race/ethnicity, and sport type. Clarifying these unique and specific challenges to student-athlete sleep and mental health is necessary to enhance and personalize interventions. Support (if any) Mitacs #IT23469

Despite sleep health being critically important for athlete performance and well-being, sleep health in marathoners is understudied. This foundational study explored relations between sleep health, individual characteristics, lifestyle factors, and marathon completion time. Data were obtained from the 2016 London Marathon participants. Participants completed the Athlete Sleep Screening Questionnaire (ASSQ) along with a brief survey capturing individual characteristics and lifestyle factors. Sleep health focused on the ASSQ sleep difficulty score (SDS) and its components. Linear regression computed relations among sleep, individual, lifestyle, and marathon variables. The analytic sample (N = 943) was mostly male (64.5%) and young adults (66.5%). A total of 23.5% of the sample reported sleep difficulties (SDS ≥ 8) at a severity warranting follow-up with a trained sleep provider. Middle-aged adults generally reported significantly worse sleep health characteristics, relative to young adults, except young adults reported significantly longer sleep onset latency (SOL). Sleep tracker users reported worse sleep satisfaction. Pre-bedtime electronic device use was associated with longer SOL and longer marathon completion time, while increasing SOL was also associated with longer marathon completion. Our results suggest a deleterious influence of pre-bedtime electronic device use and sleep tracker use on sleep health in marathoners. Orthosomnia may be a relevant factor in the relationship between sleep tracking and sleep health for marathoners.

Abstract Introduction Frequent travel across time zones and travelling long distances interferes with healthy sleep and disrupts the circadian system, often degrading athletic performance. National Basketball Association (NBA) players face a demanding travel schedule often requiring multiple games per week, with games spanning the continental United States. This investigation aimed to clarify the influence of circadian factors and travel distance on NBA performance using a dataset from the 2014-2018 seasons. Methods NBA (2014-2018) game data were acquired from an open-access source: (https://www.kaggle.com/ionaskel/nba-games-stats-from-2014-to-2018). Circadian variables of time zone change (TZ∆) and adjusted jet lag (AJL) were formulated, with quadratic versions utilized across analyses. TZ∆ captured circadian delay/advance based on travel for a game, with each TZ going eastward and westward reflected by -1 and +1, respectively. AJL advances TZ∆ by allowing acclimation to a novel TZ, with each day resulting in a 1-unit change towards circadian neutral. AJL is a season-long rolling summation, which was computed using two different travel approaches: Approach1 (AJL1) assumes travel the day before each game, whereas Approach2 (AJL2) was designed to prioritize being home. A standardized flight tracker determined travel distance for each game (GameDistance). Team ability differences, characterized as difference in season win percentages (SeasonWinPerDiff), served as an analytic covariate. Game point differential (PointDiff), defined as a team’s score minus their opponent’s score, and a team’s free throw percentage (FreeThrowPer) served as outcome variables. Linear mixed-effects modeling assessed univariate and multivariate associations, with games nested within both team and year. Results AJL2 (β = -0.63; p = .01) and GameDistance (β = -0.73; p<0.0001) significantly associated with PointDiff. TZ∆ (β = -0.002; p = .03), AJL1 (β = -0.002; p =.04) and GameDistance (β = -0.003; p = 0.007) significantly associated with FreeThrowPer. AJL2 and GameDistance maintained significant relationship with PointDiff in fully adjusted model that included AJL2, GameDistance, and SeasonWinPerDiff. Conclusion Results suggest that both circadian delay/advance and greater distance traveled for games negatively influence NBA performance, even when controlling for differences in team ability. Season travel and flight plans could be constructed to reduce the effects of circadian misalignment and travel distance. Support (If Any) None

Sleep health is an important consideration for athletic performance. Athletes are at high risk of insufficient sleep duration, poor sleep quality, daytime sleepiness and fatigue, suboptimal sleep schedules, irregular sleep schedules, and sleep and circadian disorders. These issues likely have an impact on athletic performance via several domains. Sleep loss and/or poor sleep quality can impair muscular strength, speed, and other aspects of physical performance. Sleep issues can also increase risk of concussions and other injuries and impair recovery after injury. Cognitive performance is also impacted in several domains, including vigilance, learning and memory, decision making, and creativity.

Background: Sleep is considered an essential component related to physiological and psychological recovery in athletes and particularly in basketball, given the impact of condensed travel and game schedules on player health and performance. Objective: The aim of this systematic review is to examine studies published to date on sleep and basketball performance. Methodology: All scientific articles that reported a relationship between sleep and its possible impact on performance in basketball are included. The research processes followed the PRISMA criteria, and the relevant articles were extracted (PubMed, WOS, Scopus) as of December 31, 2021. Results: Twenty-eight articles were selected for inclusion and data extraction, with 27 demonstrating that sleep is a vital component in the recovery of basketball players and their corresponding on-court performance. Three central themes that we identified: (1) the quality and extension of sleep (the better quality and more extension of sleep, better performance and lower probability of injury); (2) influence of the players circadian rhythm (travel and game scheduling do not currently facilitate or take this into account); and (3) higher training loads and/or increased stress may jeopardize a subsequent good night’s sleep, which should be taken into account when scheduling practices and workouts. Conclusion: The current systematic review regarding sleep and basketball performance and highlights that there is a strong relationship between both variables. Collectively, the evidence supports the critical influence of sleep on player recovery and basketball performance and risk for injury.

Objectives: Many studies have investigated the role that travel plays in athletic performance. However, these studies lacked a holistic representation of travel. For instance, they do not consider travel distance and uniquely focuses on travel direction.Design: An open source (www.evolving-hockey.com) provided NHL (2013-2020) game data. In total, this re-sulted in 17,088 regular season games.Methods: Linear and quadratic versions of time zone change (TZA) and adjusted jet lag (AJL) were formulated. TZA captured circadian delay/advance based on travel for a game, with each TZ going eastward and westward reflected by -1 and +1, respectively. AJL advances TZA by allowing TZ acclimation, with each day resulting in a 1-unit change towards circadian neutral. AJL is a season-long rolling summation, which was computed using two different travel approaches: Approach A (AJL_A) assumes travel the day before each game, whereas Ap-proach B (AJL_B) was designed to prioritize being home. A standardized flight tracker determined travel distance for each game. Team ability differences, characterized as difference in total season points, served as an analytic covariate. Outcome variables included goal differential, difference between actual and expected Fenwick save percentage (dFSv%), and goals saved above average (GSAA).Results: GameDistance (beta = -0.14, p = 0.0007), AJL_B2 (beta = -0.15, p = 0.0006), and their interaction (p = 0.0004) associated with GoalDifferential. GameDistance (beta = -0.18, p = 0.02) and AJL_B2 (beta = 0.12, p = 0.03) associated with dFSv%, whereas only AJL_B2 (beta = 0.03, p = 0.05) associated with GSAA.Conclusions: Results suggest that circadian change, in both direction, and greater traveled distance can negatively im-pact NHL athletes.(c) 2022 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Introduction: Several studies have highlighted the glaring lack of sleep among student-athletes. Finding an intervention which will alleviate sleep difficulties is thus important. This study explores the impact of a transcranial direct stimulation current (tDCS) stimulation and the depth of sleep with the Odds Ratio Product (ORP) sleep scoring method among a sample of student-athletes with subclinical sleep issues. Methods: Thirty student-athletes (15 females, 15 males, age 21.1 ± 2.1 years) were recruited. All participants underwent a series of questions to rule out depressive and anxiety disorders or any specific tDCS exclusion criteria. All participants were advised to maintain their usual sleep schedule during the course of the study. Each participant underwent five nights of either tDCS or placebo stimulation. While subjective sleep was scored through a sleep diary, PSG was scored according to the ORP method. Results: Analyses indicated a marginal improvement after experimental tDCS on subjective total sleep time for both men and women and a general gender difference. However, tDCS did not appear to significantly impact the Odds Ratio Product computed from the polysomnographic data. Discussion: Individualized tDCS setting should be further explored because of the observed difference in total sleep time estimation between males and females.

This investigation aimed to clarify the influence of circadian change and travel distance on National Basketball Association (NBA) team performance using a dataset from the 2014-2018 seasons. Data from 9,840 games were acquired from an open-access source. Game point differential and team free-throw percentage served as outcome variables. Time zone change (TZΔ) captured raw circadian delay/advance based on travel for a game and adjusted TZΔ (AdjTZΔ) evolved TZΔ by allowing acclimation to a novel TZ. We also further categorized AdjTZΔ into AdjTZΔ_A, which assumed travel the day before each game and AdjTZΔ_B, which assumed teams spent as many days in their home city as possible. Travel distance for each game was calculated. Linear mixed-effects modeling estimated associations, with games nested within team and year. Adjusted associations accounted for differences in team ability, whether the game was home or away, and whether the game occurred on the second half of a back-to-back game sequence. Greater circadian misalignment, regardless of delay or advance, and increasing travel distance negatively influenced NBA game performance. Yet, results suggest that performance outcomes may be more influenced by travel distance than circadian misalignment. Moreover, circadian misalignment and travel distance interacted to significantly influence game point differential. Furthermore, differences in results across analyses were observed between AdjTZΔ_A and AdjTZΔ_B, which suggests that subtle differences in constructed travel schedules can have notable impact on NBA performance outcomes. Lastly, playing on the second half of a back-to-back sequence emerged as a robust predictor of performance disadvantage, which corroborates the existing literature and provides further support for NBA schedule changes purposed to enhance competitive equity by reducing the number of back-to-back games across a season. These findings can help guide NBA teams on key strategies for reducing travel-related disadvantages and inform schedule makers on critical factors to prioritize across future schedules to attenuate competitive inequity from travel. Furthermore, they can help direct teams towards scenarios that are best to target for load management purposes due to the cumulative disadvantage arising from travel-related factors, opponent quality, game location, and game sequence.

Sleep is recognized as an essential component to optimize health and human performance, and as such the topic is of increasing interest to athletes. Yet, the sleep of athletes is affected by multiple sports-specific, and societal factors. Hence the recent emergence of the important role of sleep science in athlete health and performance. This review focuses on the fundamentals of sleep physiology and elaborates on the affects sleep has on athlete health and performance. Despite sports practitioners recognizing the importance of sleep on health and performance, findings report that insufficient sleep, and poor sleep quality are prevalent among athletic populations. This paper will describe sleep in athletes, define sleep characteristics, discuss the impact of sleep restriction following travel and competition, and strategies to mitigate sleep difficulties. Sleep is arguably the most undervalued pillar of health and performance. (C) 2022 Elsevier Inc. All rights reserved.

Previous research has shown that student athletes are more likely to be involved in a physical altercation or be a victim of verbal, physical and/or sexual abuse than student non-athletes, which can have long-lasting negative effects on mood, behavior and quality of life. In addition, among college students, sleep difficulties are ubiquitous and may deteriorate the unique life experience that university represents. The influences of poor sleep quality, mood and alcohol consumption related to these events are examined here between student athletes and student non-athletes. A series of hierarchical logistic regressions explored the relationship between verbal, physical and sexual assault risk factors. Results suggest that poor sleep, alcohol consumption and mood are all associated with exposure to a physical altercation or episode of abuse, irrespective of athlete status. Results also show that variables targeting self-reported difficulty sleeping and experiences of verbal, physical and sexual assault were positively associated. However, given the cross-sectional nature of the study, it is impossible to establish the direction of these relationships.

A significant consideration by the performance staff heading into the NBA Bubble was the potential accumulative increase in player stress and anxiety associated with adhering to the daily NBA Coronavirus disease (COVID-19) protocols, environmental transition into the Bubble (quarantine and isolation), coupled with training and competition demands. The impact of such cumulative stress and anxiety negatively affects players mental health, resulting in significant sleep-related issues6 with detrimental effects on player health, recovery and performance. The National Basketball Players Association highlighted that the uncertainty of the situation the impact of COVID-19 on the players and staff, likely to result in a range of emotions such as “anxiety, fear, uncertainty, confusion, hypervigilance, depression, an increased sense of vulnerability, boredom, and a heightened awareness of the needs for self-care”. In response, the NBA expanded their mental health guidelines by adopting new rules that required all teams to have at least one mental health professional on their full-time staff for 2019-2020 season.