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J Sports Med Phys Fitness. 2018 Jun 7. doi: 10.23736/S0022-4707.18.08498-0. [Epub ahead of print]

Risk factors for precompetitive sleep behavior in elite female athletes.

Silva MR1,2,3,4, Paiva T5,6.

Author information

Institute of Molecular Medicine, Medical Faculty of Lisbon, Lisbon, Portugal -
Faculty of Health Sciences, University Fernando Pessoa, Oporto, Portugal -
Research Centre for Anthropology and Health, University of Coimbra, Coimbra, Portugal -
Scientific Commission of the National School of Gymnastics, Gymnastics Federation of Portugal, Lisbon, Portugal -
Institute of Molecular Medicine, Medical Faculty of Lisbon, Lisbon, Portugal.
CENC, Sleep Medicine Center, Lisbon, Portugal.



Sleep is of major importance for the athletes' short and long-term health, performance and recovery; however, published studies on athletes' sleep and even fewer before competition are scarce. This study evaluated the risk factors of sleep in young female gymnasts before an international competition.


Sixty-seven rhythmic gymnasts (M=18.7,SD=2.9yrs.) of high performance (M=36.6,SD=7.6h/week) were evaluated regarding training and sport practice, body composition, sleep duration, daytime sleepiness by the Epworth Sleepiness Scale, sleep quality by the Pittsburgh Sleep Quality Index, precompetitive anxiety by the Sport Competition Anxiety Test form A, and detailed dietary intake just prior to a world competition.


The majority of the participants (83.6%) presented reduced body fat levels (M=9.1,SD=2.1%) and low energy availability (M=31.5,SD=11.9kcal/kgFFM/day). They slept 8h10±1h30/night on weekdays and 8h40±00h40/night on weekends, 67% suffered from mild daytime sleepiness and 78% had a reduced sleep quality. Precompetitive anxiety was on average moderate (M=22.7,SD=3.2). The risk factors for short sleep duration were: 1.92 for a training volume>30hours/week (95%CI 0.84-4.39), 4.57 for menstruation (95%CI 1.17- 17.77), 6.62 for bedtime≥11:00PM (95%CI 1.74-25.10), 1.40 for BF<12%(95%CI 1.03- 1.92), 2.19 for FFM<30kg (95%IC 0.94-4.94), 2.37 for BMR<1100kcal/day (95%CI 1.06- 5.32), 1.90 for EEE≥700kcal (95%CI 0.92-3.93) and 3.17 for EA<45kcal/kgFFM/day (95%CI 0.84-6.59). Age, performance, sleep duration on weekdays and precompetitive stress were also predictors for a reduced sleep quality and/or abnormal daytime sleepiness.


Age, training regime, menstruation, individual preferences for bedtime, body composition and energy were important predictors of gymnasts' precompetitive sleep with consequences upon their sleep duration, SQ and DS.

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