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August 28, 2024

How sleep impacts athletes’ performance

Sleep Health Patient stories

This content has been medically reviewed by Florent Lavergne, Director of Clinical Research, Medical Affairs at Resmed.

It’s been an action-packed summer of sport all over the world. Watching elite athletes going for gold is always inspiring – so if you feel like following in your sporting heroes’ footsteps you may be surprised to learn that, for many of them, enhancing performance doesn’t start in the gym or at the training ground, but in the bedroom…

Waking up to the power of sleep

That’s because the sporting world is waking up to the power of sleep, with coaches and competitors alike employing all sorts of tactics to harness it – some of which us mere mortals can benefit from too.

So join us for a look at how sleep affects athletic performance, with a little help from Josh Piper, Sleep Clinician at our London Sleep Clinic.

As well as helping people with sleep disorders such as sleep apnoea (more on this later) during his day job, Josh also visits local football clubs – all the way from amateur to semi-pro level – to offer advice on incorporating good sleep into their training regimes.

Does sleep really affect athletic performance?

“The quick answer is yes!” says Josh. “But first, let’s start by going back to basics and examining sleep’s effect on the very rhythm of our lives, and how athletes can use this to their advantage…”

Our sleep and wake cycles across 24 hours are governed by our internal ‘body clock’, otherwise known as a circadian rhythm.

How does circadian rhythm work?

Circadian rhythm is influenced by external time cues such as the light-dark cycle, which is why we generally wake as the sun rises and feel sleepy at night, something that – like many functions in our bodies – is largely governed by hormones:

  • Cortisol: Often called the ‘stress hormone’, your body releases cortisol during high-pressure situations – whether that’s taking a penalty in the Euros or facing a tough job interview – essentially putting you on ‘red alert’ for action. It’s also released in the morning, helping us feel more focused and ready for the day ahead1.
  • Melatonin: At the opposite end of the spectrum, your body starts producing this hormone around two to three hours before bedtime – coinciding with when it starts getting dark – making you feel sleepy. Your levels of melatonin lower again during the day, helping you stay awake1.

So far, so simple. However, everyone’s rhythm is different – you’ll know whether you’re usually up with the lark and work best in the morning, a night owl who’s more active in the evening, or something in between.

In athletes, even small variations in rhythm can make a big difference to performance, as Josh explains: “We perhaps see this when some sports teams seem to win more midday performances than they do evening ones (or vice-versa), depending on whether the team consists of larks or owls!”.

Capitalising on circadian rhythm

What’s more, research has shown that athletic performance can vary by up to 26% during the day based on circadian rhythm2. So, for athletes, knowing whether they’re a morning person or a night owl is key.

Here are some ways athletes use this knowledge to optimise their performance:

  • Training: Studies show that certain times of day correlate with higher strength, flexibility, and endurance levels3. By choosing to train at these times, athletes can aim to be at their peak when it counts.
  • Travelling: If flying long-haul, some athletes try to adjust their sleep patterns by exposing themselves to artificial light in a controlled way to help regulate circadian rhythm4, or taking melatonin tablets to help their body clocks adapt to the new time zone5 – but beware, neither of these are things to attempt yourself without guidance from your doctor.
  • Eating and drinking: Some athletes also time their meals and snacks in line with their circadian rhythm in a bid to optimise their intake of nutrients and boost energy levels.
  • Sleeping: Last but certainly not least, ensuring athletes get adequate, high-quality sleep is crucial for both overall performance and recovery – and we’ll look at why this is in the rest of this article…
What does this mean for me?

While it’s unlikely you’ll be flying all over the world to participate in international sports tournaments, you can still think about tailoring your exercise plan to suit your sleep habits. So if you’re a morning person, you may enjoy an early jog more than an evening aerobics class, for example – and consequently feel more inclined to keep it up!

How physical activity affects athletes’ sleep

Not only does sleep affect physical activity, but physical activity has an effect on sleep – and more specifically, the stages of sleep you experience during the night.

The stages of sleep

We typically experience four stages of sleep:

  1. Sleep onset, when you drift into sleep
  2. Light sleep, when you’re asleep but still relatively easy to rouse
  3. Deep sleep, when your muscles relax, blood pressure drops, and breathing slows
  4. Rapid eye movement (REM) sleep, when your brain activity is comparable to waking hours and you start dreaming

These four stages repeat in cycles, lasting between 90 and 120 minutes each6. “What makes for good-quality sleep is the balance between these stages,” says Josh. “While it may seem like not much is happening during deep sleep, quite the opposite is true! Your body is busy repairing your tissues, bones and muscles7.”

This is why it’s really important that people, and especially athletes, get enough stage 3 sleep.

 

How much sleep do elite athletes need?

Healthy adults need around seven to nine hours of sleep a night8 – although some experts believe elite athletes may need more than this due to the extra demands they place on their bodies9.

One way to help get good-quality sleep is through exercise itself, as Josh explains: “Moderate to vigorous activity during the day can yield more consolidated periods of deep sleep than without.” Put simply, the more active you are, the better you should sleep.

However, in spite of this, some research has shown that athletes tend to sleep less on average than your typical couch potato10, and their quality of sleep seems to be lower than that of their less-sporty peers11. Why might this be?

“Athletes may be missing out on sleep for sorts of reasons, ” says Josh. “As discussed above, experiencing jetlag when travelling across time zones, having to get up early to train, or being nervous before a big game and not sleeping well, can all knock an athlete’s circadian rhythm out of balance .”

Even more reason for athletes to stay in tune with their sleep patterns!

 

What does this mean for me?

You don’t need to do anything as strenuous as running marathon or swimming the Chanel to enjoy physical activity’s positive effect on sleep (phew!). In fact, studies have shown that as little as 10 minutes of aerobic exercise a day can help you sleep better12. And if you do happen to be an early riser, it’s also been shown that people who do moderate-intensity workouts before 7am have improved overall sleep quality13.

Why is sleep important for athletes?

We’ve already seen that getting plenty of good-quality sleep – and especially deep sleep – helps the body rest and repair. Here are some other ways sleep can benefit athletes:

Sleep reduces injury risk

“Sleep has been shown to actually help prevent injuries occurring in the first place,” says Josh. Multiple studies have found lack of sleep is associated with an increased risk of sports injury14 – with one finding that adolescents who slept less than six hours a night had a 70% higher risk of injury, compared to those who slept for nine hours or more15.

And of course, if an athlete is feeling sleepy or has impaired concentration due to lack of sleep, this makes accidents and injuries more likely.

Sleep can also prevent athletes from picking up cough or cold bugs, since during sleep the body releases proteins called cytokines, which help direct the immune system’s response to infection or injury16.

Sleep helps recovery

If an athlete does get injured, sleep can help them recover more quickly. This is because sleep – and especially sleeping for longer periods than usual (known as sleep extension) – increases production of the growth hormones17 vital for bodily repair. Adequate sleep also helps control inflammation, which can also promote muscle recovery17, and can even reduce sensitivity to pain17!

Sleep restores energy

Energy from the food we eat is stored in the body as a substance called glycogen. Sleep tops up these glycogen stores18 – which should be music to athletes’ ears, since having plenty of glycogen ‘in the tank’ can fuel intense workouts and help them exercise for longer periods before feeling tired.

Sleep improves focus

Whether it’s aiming for a goal, throwing a javelin, or serving an ace, athletes need sharp mental skills. Quality sleep improves mental health, concentration, reaction times, and overall brain function8,19.

A black male athlete draped in a Union Jack flag running and feeling good about how sleep has impacted his athletic performance.
What does this mean for me?

The key takeaway is that it’s quality of sleep, as well as quantity that counts. So if you’re getting a full night’s sleep but still feel tired in the morning, it could be that a sleep disorder such as obstructive sleep apnoea (OSA) is stopping you from getting the deep sleep you need. Taking our free online sleep assessment can help you know whether you’re at risk of sleep apnoea, or another condition such as insomnia. You can then speak to your doctor about the results and start sorting your sleep!

Can sleep disorders also affect athletes?

If you are eventually diagnosed with obstructive sleep apnoea, you’re not alone. This condition can affect anyone, regardless of age, weight, size or fitness level – including sports stars such as legendary US basketball player Shaquille O’Neal – so there’s nothing to feel embarrassed about.

In fact, the physical characteristics of certain types of sportspeople may actually predispose them to having OSA. Take rugby players for example. A study of 42 elite athletes from the Japanese rugby team saw 64.3% of them diagnosed with the condition20.

Why might this be? Obstructive sleep apnoea is caused by a blockage (or obstruction) in the airways, leading to temporary pauses in breathing during sleep. One of the things that can contribute to the blocking of the airway is having a wide neck circumference21, which can be seen in professional rugby players.

Sleep apnoea symptoms and signs in athletes

So do athletes experience OSA any differently to non-athletes? Not really, says Josh: “Realistically, the symptoms of sleep apnoea in athletes are exactly the same as any other person on this planet. Athletes aren’t exempt from snoring or experiencing daytime sleepiness in the same way the average Joe or Jolene might.”

However, some of the symptoms of sleep apnoea can be particularly problematic for athletes who need to be at their best when training and competing, such as:

  • Poor memory22
  • Fatigue22
  • Morning headaches22
  • Feeling apathetic22

And that’s not all… OSA is also associated with some serious health conditions, such as heart disease, stroke, diabetes and high blood pressure23, which nobody wants, regardless of whether they’re an athlete or not.

Treatment for sleep apnoea

The good news for athletes (and anyone with OSA!) is that sleep apnoea can be successfully treated. There are several options available, depending on the severity of the condition, but the ‘gold standard’ treatment is continuous positive airway pressure, or CPAP therapy21.

During this treatment, a CPAP device delivers a continuous, steady stream of pressurised air to a mask, which you wear over your nose and mouth, or just your nose, when you sleep. This air helps to keep your airways open to help avoid the pauses in breathing that we mentioned above.

The benefits of treating sleep apnoea for athletes20

Once athletes with sleep apnoea are on CPAP therapy they should start enjoying the benefits of getting good-quality sleep again pretty soon – some people report feeling better after the first night of treatment! And with better sleep comes all the benefits for athletic performance that we’ve discussed so far.

One example of this is professional surfer Dani Garcia, who says that starting CPAP therapy for his sleep apnoea has changed his life for the better. His only regret, it seems, is not starting the treatment sooner: “One thing that struck me is how many championships I could have won out of those I lost, if only I could have rested better,” he says. How many other athletes may not be reaching their full potential due to undiagnosed sleep disorders?

If you need further convincing of the transformative effects CPAP therapy can have on people from all walks of life, take a look at our inspiring patient stories !

What does this mean for me?

It’s not just elite athletes who can benefit from treating sleep apnoea with CPAP therapy. As well as helping you feel better mentally and physically thanks to reduced sleepiness24, improved brain function25 and mood25 (in people who had depression alongside OSA), starting and sticking to CPAP therapy can also lead to a 64% reduced risk of cardiovascular disease26.

So – there’s a brighter future ahead! Talking of which…

What’s the future of sleep science in sport?

Does Josh think sleep will become a bigger part of athletes’ training, prep and performance in years to come? “We’re already seeing it!” he says. “Premier League football clubs, Team Sky cycling and Team GB are all taking notice of the power of sleep and using things like ‘sleep kits’, which are effectively sets of mattresses and other paraphernalia (such as eye masks) that help travelling athletes maintain a consistent sleeping environment.”

Team GB recently went a step further by investing in ‘Sleep Pods’ for their athletes – complete with sound-proofing, ambient lighting and a safe box for phones to minimise distractions. The aim was to help athletes optimise the quality and quantity of their sleep and give them somewhere to nap if needed.

Strategies based on studies

On the subject of napping, there’s also evidence to suggest it can enhance mood and improve mental and physical performance even in people who typically get enough sleep27. “This is why some athletes and coaches are starting to use evidence-based technique such as planned naps and ‘sleep banking’8 (where athletes gradually extend their sleep by one or two hours per night in the run-up to a competition) – all with a view to ensure athletes aren’t ‘behind’ on their sleep,” says Josh.

Monitoring sleep and performance

Josh also thinks the ever-increasing ways of tracking activity and sleep will continue to come into play: “In the same way we monitor an athlete’s performance while they are awake, I think there’ll be an overlap with analysing sleep by monitoring it as well. Athletes now are driven by such marginal gains; sleep looks to be one of the last, somewhat untapped, mines of improvement that can be had.”

What does this mean for me?

You don’t need to be an elite athlete to benefit from monitoring and tracking your sleep and activity levels. These days wearable tech like smart watches mean practically anyone can have this sort of information quite literally at their fingertips.

If you have a condition like sleep apnoea there are apps available that can track both your CPAP therapy and sleep, so you can follow your progress. Some even allow you to share your activity data with them so you can get a more complete idea of your overall wellbeing.

And while you may not have a sports science team or professional coach at your disposal, CPAP therapy apps can also offer you tailored tips and advice – as well as encouragement!

Of course, we’re here to help too – so check out our page on good habits for healthy sleep and explore our blog for more ideas on how to sleep better and feel better. Who knows? You may even find you’re able to improve your 5K time or score an extra goal next time you have a kickabout in the park… Enjoy!

This blog post contains general information about medical conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such. You must not rely on the information on this website as an alternative to medical advice from your doctor or other professional healthcare provider.

If you have any specific questions about any medical matter, you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition, you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website. The views expressed on this blog and website have no relation to those of any academic, hospital, practice, or other institution with which the authors are affiliated and do not directly reflect the views of Resmed or any of its subsidiaries or affiliates.

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