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Sleep Quality in Elite Athletes: Normative Values, Reliability and Understanding Contributors to Poor Sleep

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Abstract

Background

The aims of this retrospective study were to (i) provide a description of sleep quality in elite athletes as measured by the Pittsburgh Sleep Quality Index (PSQI), (ii) provide normative PSQI data, (iii) identify differences across sex and sport, (iv) identify components that contribute to high PSQI scores and (v) assess PSQI test–retest reliability.

Methods

The PSQI was completed by 479 athletes (371 female and 108 male) across 20 Olympic team and individual sports. For ordinal and categorical variables, the Wilcoxon rank sum test and Chi Squared tests were used, respectively. A random forest regression was built to determine the importance of each PSQI component. Test–retest reliability was assessed using two-way mixed effects intraclass correlation coefficients.

Results

Fifty-two percent of athletes had a global PSQI score ≥ 5. Team sport athletes reported significantly longer sleep onset latency times but longer sleep durations compared with individual sport athletes. Sleep onset latency and sleep quality made the greatest contribution to the global PSQI scores. The PSQI demonstrated variability over periods of 2 months or more, with a minimal detectable change of 3 arbitrary units (AU).

Conclusion

Long sleep onset latency and poor perceived sleep quality made the greatest contribution to the high PSQI scores observed in approximately half of elite athletes investigated. The PSQI should be administered at regular intervals due to variability within individuals over periods of 2 months or more. Individual questionnaire items or component scores of the PSQI may be useful for practitioners in guiding decision-making regarding sleep interventions in athletes.

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Acknowledgements

All data presented is part of the ‘Stay Healthy’ project, an initiative that supports Australia’s elite athletes. The remaining data was collected in routine periodic health evaluations. We would like to warmly thank the contributions of the National Sporting Organisation of the participating athletes, the staff who facilitated the data collection and of course the athletes themselves for donating their time to participate.

Author information

Authors and Affiliations

  1. School of Behavioural and Health Sciences, Australian Catholic University, McAuley at Banyo, Brisbane, Australia

    Shona L. Halson & Rich D. Johnston

  2. Carnegie Applied Rugby Research Centre, Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK

    Rich D. Johnston

  3. Australian Institute of Sport, Bruce, Australia

    Renee N. Appaneal, Margot A. Rogers, Liam A. Toohey & Michael K. Drew

  4. University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, Australia

    Renee N. Appaneal, Margot A. Rogers & Michael K. Drew

  5. Appleton Institute for Behavioural Science, Central Queensland University, Wayville, Australia

    Charli Sargent & Gregory D. Roach

Authors
  1. Shona L. Halson
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  2. Rich D. Johnston
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  3. Renee N. Appaneal
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  4. Margot A. Rogers
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  5. Liam A. Toohey
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  6. Michael K. Drew
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  7. Charli Sargent
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  8. Gregory D. Roach
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Corresponding author

Correspondence to Shona L. Halson.

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Funding

This work was supported by the Australian Institute of Sport High Performance Research Fund, the Athlete Availability Program at the Australian Institute of Sport, the Queensland Academy of Sport Centre of Excellence for Applied Sport Science Research (Grant number CoE056), and Griffith University (Internal Grant). The authors also acknowledge the in-kind contributions from the University of Canberra Research Institute for Sport and Exercise.

Conflict of interest

The authors have no conflicts of interest to declare.

Availability of data and material

The authors are willing to discuss data sharing under collaborative agreements. Please contact the corresponding author.

Code availability

Not applicable.

Authors' contributions

SLH conceived of the study, participated in its design and coordination and drafted the manuscript; RDJ performed the statistical analysis, creating figures and drafting the manuscript; RNA, MAD, LAT, MKD were involved in data collection, CS and GDR participated in its design and drafting the manuscript. All authors have read and approved the final version of the manuscript and agree with the order of presentation of the authors.

Ethics approval

This study was approved by the Australian Institute of Sport Ethics Committee (approval number 20200203).

Consent to participate

Athletes were recruited through their relevant National Sporting Organisation, which provided organisational consent.

Consent for publication

Not applicable.

Electronic supplementary material

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Supplementary file1 (DOCX 42 kb)

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Halson, S.L., Johnston, R.D., Appaneal, R.N. et al. Sleep Quality in Elite Athletes: Normative Values, Reliability and Understanding Contributors to Poor Sleep. Sports Med 52, 417–426 (2022). https://doi.org/10.1007/s40279-021-01555-1

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  • DOI: https://doi.org/10.1007/s40279-021-01555-1

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