Managing Travel Fatigue and Jet Lag in Athletes: A Review and Consensus Statement.

Athletes are increasingly required to travel domestically and internationally, often resulting in travel fatigue and jet lag. Despite considerable agreement that travel fatigue and jet lag can be a real and impactful issue for athletes regarding performance and risk of illness and injury, evidence on optimal assessment and management is lacking. Therefore 26 researchers and/or clinicians with knowledge in travel fatigue, jet lag and sleep in the sports setting, formed an expert panel to formalise a review and consensus document. This manuscript includes definitions of terminology commonly used in the field of circadian physiology, outlines basic information on the human circadian system and how it is affected by time-givers, discusses the causes and consequences of travel fatigue and jet lag, and provides consensus on recommendations for managing travel fatigue and jet lag in athletes. The lack of evidence restricts the strength of recommendations that are possible but the consensus group identified the fundamental principles and interventions to consider for both the assessment and management of travel fatigue and jet lag. These are summarised in travel toolboxes including strategies for pre-flight, during flight and post-flight. The consensus group also outlined specific steps to advance theory and practice in these areas.

Sleep, health, and well-being in elite athletes from different sports, before, during, and after international competition.

Objectives: Limited research has been conducted on sleep problems in elite athletes at international competition, and how this relates to their general health and well-being. Methods: Sixty-five elite international athletes (37 males, 28 females, 21.8 ± 2.1 years) from different sports completed validated sleep (Athlete Sleep Screening Questionnaire), health (Subjective Health Complaints Inventory) and well-being (Sports Profile of Mood States) questionnaires; 1 month pre-competition, at the end of international competition, and 1 month post-competition. Results: Twenty-three percent of the elite athletes were identified as having a moderate or severe clinically significant sleep problem during competition, with 82% reporting less than 8 h of sleep per night. Athletes with a moderate or severe clinically significant sleep problem during competition had significantly greater general health complaints (p = 0.002), mood disturbance (p = 0.001) and poorer sleep hygiene (p = 0.002). Swimmers had more sleep difficulty pre and during competition compared to athletics and soccer (p = 0.009). Conclusion: Sleep disturbance during international competition is common and associated with poorer health and lower mood. Swimmers may be more at risk of sleep difficulty pre and during competition compared to those competing in athletics and soccer. Sleep services may be required to support elite athletes at international competition.

Sleep in elite multi-sport athletes: Implications for athlete health and wellbeing.

OBJECTIVES: To investigate the prevalence of clinically relevant sleep problems in elite multi-sport athletes and their associations with sleep hygiene, general health, mood, chronotype, and injury. DESIGN: Cross-sectional study. SETTING: During the competitive season in athletes' home environment. PARTICIPANTS: Elite multi-sport Irish athletes (n = 58) competing at the 2017 World University Games. MAIN OUTCOME MEASURES: Category of clinical sleep problem (Athlete-Sleep-Screening-Questionnaire), sleep hygiene (Sleep Hygiene Index), general health (Subjective Health Complaints), mood (Sports Profile of Mood States), chronotype (Morningness-Eveningness Questionnaire), and injury (self-reported injury). RESULTS: 43% had no clinical sleep problem, 41% had a mild clinical sleep problem, 16% had a moderate clinical sleep problem, none had a severe clinical sleep problem. Therefore, 84% of athletes did not have a clinically significant sleep problem while 16% had a clinically significant sleep problem. One-way-ANOVA revealed significantly worse sleep hygiene (p = 0.002), more general health complaints (p = 0.001) and greater mood disturbance (p = 0.001) among those with clinically significant sleep disturbances compared to those without. No association was found between having a clinically significant sleep problem and either chronotype or previous recent injury. CONCLUSIONS: Athletes with a clinically significant sleep problem were more likely to report worse sleep hygiene, more general health complaints, and mood disturbance.

An evaluation of two types of exercise classes, containing shoulder exercises or a combination of shoulder and thoracic exercises, for the treatment of nonspecific shoulder pain: A case series.

STUDY DESIGN: A case series was carried out. INTRODUCTION: There is a lack of evidence exploring the effectiveness of group exercise classes for people with nonspecific shoulder pain (NSSP). Also, there is a lack of research that measures potential reductions in thoracic kyphosis after exercise interventions in people with NSSP. PURPOSE OF THE STUDY: To observe changes in shoulder pain, disability, and thoracic kyphosis in 2 groups of people with NSSP, after 2 different types of group exercise classes. METHODS: People with NSSP received a 6-week block of exercises classes containing either shoulder exercises alone (shoulder group, n = 20) or a mixture of shoulder and thoracic extension exercises (thoracic group, n = 19). The Disabilities of the Arm, Shoulder and Hand questionnaire for disability and the Numeric Rating Scale for pain were measured at baseline, 6 weeks, and 6 months. Thoracic kyphosis was measured at baseline and 6 weeks using the manual inclinometer. RESULTS: Significant and clinically meaningful improvements in Numeric Rating Scale and Disabilities of the Arm, Shoulder and Hand were demonstrated in both groups at 6-week and 6-month follow-up (P < .001). Effect sizes ranged from 0.78-1.16 in the shoulder group and 0.85-1.88 in the thoracic group. Thoracic kyphosis did not change beyond measurement error in either group. DISCUSSION/CONCLUSION: Group exercise classes can improve shoulder pain and disability in people with NSSP. Resting thoracic kyphosis did not change after either exercise intervention, which suggests that the treatment effect was not due to a change in static thoracic spine posture.