It Is Time to Consider Sleep in Female Athletes: Assessment and Tailored Sleep Intervention

Purpose: Optimal sleep is essential for supporting athletes' health, performance and facilitating recovery. However, athletes' sleep is impaired in both quality and quantity. Previous research has shown athletes' sleep quality and quantity to be improved using sleep interventions, however very few studies have evaluated sleep and investigated it among female athletes. Therefore, this exploratory study aimed to evaluate the sleep of adult female team-sport athletes over a match week in an ecological context and to assess the effects of a one-to-one sleep intervention (comprising both educational and practical components). Methods: Nine female rugby players completed a two-week protocol including a sleep evaluation (PRE week) and an intervention (POST week). The first week was dedicated to sleep assessment via both actigraphy and self-report questionnaires, and during the second week, players received educational and practical sleep interventions. Results: During the PRE week, 88.9% of the participants were classified as poor sleepers, compared to only 44% during the POST week. A significant positive effect of sleep interventions was particularly found on subjective sleep (from 10.3 +/- 1.1 to 8.8 +/- 1.8, p = 0.03, n2 = 0.38) and psychological state (from 3.7 +/- 0.6 to 2.9 +/- 0.9, p = 0.002, n2 = 0.55). Conclusion: These positive effects highlight the need for sleep among female athletes and the potential benefits of targeted sleep interventions, though confirmation in larger samples of athletic women is needed. This feasible and tailored approach could be effectively implemented among female team-sport athletes over the competitive season.

There is little research investigating relationships between the Functional Movement Screen (FMS) and athletic performance in female athletes. This study analyzed the relationships between FMS (deep squat; hurdle step [HS]; in-line lunge [ILL]; shoulder mobility; active straight-leg raise [ASLR]; trunk stability push-up; rotary stability) scores, and performance tests (bilateral and unilateral sit-and-reach [flexibility]; 20-m sprint [linear speed]; 505 with turns from each leg; modified T-test with movement to left and right [change-of-direction speed]; bilateral and unilateral vertical and standing broad jumps; lateral jumps [leg power]). Nine healthy female recreational team sport athletes (age = 22.67 ± 5.12 years; height = 1.66 ± 0.05 m; body mass = 64.22 ± 4.44 kilograms) were screened in the FMS and completed the afore-mentioned tests. Percentage between-leg differences in unilateral sit-and-reach, 505 turns and the jumps, and difference between the T-test conditions, were also calculated. Spearman's correlations (p ≤ 0.05) examined relationships between the FMS and performance tests. Stepwise multiple regressions (p ≤ 0.05) were conducted for the performance tests to determine FMS predictors. Unilateral sit-and-reach positive correlated with the left-leg ASLR (r = 0.704-0.725). However, higher-scoring HS, ILL, and ASLR related to poorer 505 and T-test performance (r = 0.722-0.829). A higher-scored left-leg ASLR related to a poorer unilateral vertical and standing broad jump, which were the only significant relationships for jump performance. Predictive data tended to confirm the correlations. The results suggest limitations in using the FMS to identify movement deficiencies that could negatively impact athletic performance in female team sport athletes.

BackgroundHip and groin (HAG) problems are common among team-sport athletes. However, very few studies have focused in female athletes and used the clinical entity approach to describe the origin of...

Objective To evaluate the differences in subjective sleep quality, quantity, and behaviors among male and female elite rugby union athletes through two common sleep questionnaires.Materials and Methods A sample of 38 male and 27 female elite rugby union athletes filled out the Athlete Sleep Behavior Questionnaire (ASBQ) and the Pittsburgh Sleep Quality Index (PSQI). Global scores and individual items for each questionnaire were compared to assess differences between sexes.Results Male athletes reported significantly longer sleep duration (7 h 50 m ± 50 m versus 7h 12 m ± 58 m respectively;p≤ 0.01;d = 0.70) and higher habitual sleep efficiency (88% versus 83% respectively;p < 0.05;d = 0.54) when compared with female athletes. Individual items of the ASBQ revealed significant differences between male and female athletes for five questions. Male athletes displayed higher instances of taking stimulants before training or competition and consuming alcohol within 4 hours of going to bed. Conversely, female athletes expressed greater thought or worry while in bed and a higher instance of training late at night.Discussion Male athletes displayed better self-reported sleep quality and quantity than female athletes; however, the present study highlighted that male and female elite rugby union athletes face specific challenges that differ. It appears that the differences observed between male and female elite rugby union athletes may be due to differing levels of professionalism or differences in training or competition schedules.

Hip and groin problems are common among team-sport athletes. However, few studies have been conducted in female athletes that have used the Doha Agreement classification system to categorize these problems. The purpose of this study was to examine the preseason point prevalence of hip and groin problems in elite female team-sport athletes. Secondary aims were to categorize the groin problems according to the Doha Agreement classification system and to explore the association between hip muscle strength and self-reported hip and groin function. Cross-sectional study. Female athletes who participated in various sports underwent preseason assessment of isometric hip adduction and abduction strength, with pain levels recorded during respective contractions, and self-reported function on the Copenhagen Hip and groin Outcome Score (HAGOS). If any athlete reported current hip and groin problems during this screening assessment, a full, standardized clinical hip and groin examination was undertaken. These hip and groin problems were then categorized according to the Doha Agreement classification system. Comparisons between the participants with vs without hip and groin problems were made, and correlational statistics were used to examine relationships between strength and HAGOS scores. Ninety-one elite female athletes from six different sports were included in the study. Thirteen athletes reported current hip and groin problems, with an overall prevalence rate of 14.3%. Iliopsoas-related groin pain was the most common category diagnosed, accounting for 58.8% of cases, followed by hip-related groin pain (17.6%), adductor-related (11.8%), and inguinal- and pubic-related pain (both 5.9%). No association was found between strength and function. The hip and groin point prevalence in female athletes documented during preseason appears to be similar to those reported in male athletes. Iliopsoas-related groin pain was the most common clinical entity reported in female athletes in this study. There was no association between hip muscle strength and self-reported hip and groin function. 3b.

Subjective and objective sleep differ in male and female collegiate athletes

Nutrition knowledge influences adequate dietary intake in athletes. Inadequate dietary intakes can result in low energy availability (LEA) which can lead to relative energy deficiency in sport (RED-S). To date, there is little information on the relationship between nutrition knowledge and the risk of LEA in female team sport athletes. This study investigates if general and sports nutrition knowledge are associated with the risk of LEA in female team athletes. A cross-sectional design was used. Female athletes (>16 years) who participate in team sports in New Zealand were asked to complete an online questionnaire. The LEA in Females Questionnaire and the Abridged Sport Nutrition Knowledge Questionnaire were included. LEA risk and general/sports nutrition knowledge were assessed. The relationship between LEA risk and knowledge was analyzed using the Kruskal-Wallis Test of independent variables and χ2 tests. Among 100 female athletes, 53% were at-risk for LEA, and 70% (N.=67) had poor nutrition knowledge. Athletes who were "at-risk" for LEA and those who were "not at-risk" for LEA did not differ statistically in terms of age (P=0.350) or BMI (P=0.576). Of those "not at risk" 54% had an A-NSK score between 50 and 60% (i.e., average knowledge), whereas 54% of the athletes who were "at risk" for LEA had poor nutrition knowledge. There was no statistical difference between the groups (P=0.273). The poor nutrition knowledge and the high rates of those "at risk" of LEA among team sports athletes indicates the need for more nutrition education in this population.

Female athletes with menstrual abnormalities have poor sleep quality. However, whether female athletes with poor sleep quality based on subjective assessment have distinctive changes in objective measures of sleep in association with menses remains unclear. This study aimed to compare changes in objective sleep measurements during and following menses between collegiate female athletes with and without poor subjective sleep quality. Female collegiate athletes (age range/mean ± standard deviation: 18-22/ 22.2±1.1) with regular menstrual cycles were recruited. The participants underwent home electroencephalogram monitoring during the first and second nights after the onset of menses and one night between the seventh and 10th nights after menses onset (mid-follicular phase). The Pittsburgh Sleep Quality Index (PSQI) was used to assess the subjective sleep quality. Interactions between the presence of poor subjective sleep quality (ie, PSQI ≥6) and changes in objective measures of sleep in association with menses were analyzed. Data of 45 athletes, including 13 with poor subjective sleep quality, showed that changes in arousal index in athletes with poor subjective sleep quality were distinctive from those in athletes without poor subjective sleep quality (p = 0.036 for interaction). In athletes with poor subjective sleep quality, the arousal index was significantly increased in menses (p for analysis of variance, 0.015), especially on the first night after the onset of menses compared with during the mid-follicular phase (p = 0.016). Collegiate female athletes with regular menstrual cycles are likely to have poor subjective sleep quality in association with more frequent arousal during the first night after the onset of menses than during the mid-follicular phase.

Objectives The purpose of this prospective cohort study was to assess the associations between lower limb injuries in female team-sport athletes and a number of factors. The potential risk factors explored included (1) lower limb strength, (2) history of life-event stress, (3) family history of ACL injuries, (4) menstrual history, and (5) history of oral contraception use. Methods One hundred and thirty-five female athletes aged between 14 and 31 years (mean: 18.8 ± 3.6 years) from rugby union (n = 47), soccer (n = 72), and netball (n = 16) volunteered to participate in this study. Demographics, history of life-event stress, injury history and baseline data were obtained prior to the competitive season. The following strength measures were collected: isometric hip adductor and abductor strength, eccentric knee flexor strength and single leg jumping kinetics. Athletes were then followed for 12 months, and all lower limb injuries sustained were recorded. Results One hundred and nine athletes provided one-year follow-up injury data, of whom, 44 suffered at least one lower limb injury. All athletes who reported high scores for negative life-event stress sustained lower limb injuries. Non-contact lower limb injury was positively associated with weak hip adductor strength (OR: 0.88; 95%CI: 0.78–0.98; p = 0.017), and between-limb adductor (OR: 5.65; 95%CI: 1.61–19.7.; p = 0.007) and abductor (OR: 1.95; 95%CI: 1.03–3.71; p = 0.039) strength asymmetries. Conclusion History of life event stress, hip adductor strength, and between-limb adductor and abductor strength asymmetries offer potential novel avenues for investigating injury risk factors in female athletes.

PURPOSE: To determine if a field-based neuromuscular test (Counter Movement Jump (CMJ)) could accurately detect EIMD-related performance decrements incurred by repeated sprinting in female team sport athletes. METHODS: 10 female athletes (Age: 21.7 ± 2.5y) performed an eccentrically-biased, repeated sprint protocol consisting of 5 sets of 8 maximal sprint (MS) trials (20m in length, 5m deceleration zones). Participants then immediately performed three CMJs on a force plate (FD4000, NMP ForceDecks Ltd, UK) to assess fatigue before beginning the next set of 8 sprints. Blood lactate and RPE were assessed following the completion of the sprint protocol. After 24-48h, participants returned to complete soreness ratings, 3 CMJs and 3 MSs. This process was completed 4 times (each “Trial” = 1 repeated sprint protocol visit + 1 24-28h follow up visit). RESULTS: A number of CMJ metrics were significantly lower (p<0.05) when measured during the 24-48h follow up visits, however the only one that was consistently lower across all 4 trials was concentric RFD (N/s/kg) (Pre v 24-48h post: Trial 1 = 36.03 ± 16.81 v 20.64 ± 13.49; Trial 2 = 49.37 ± 32.29 v 29.44 ± 21.87; Trial 3 = 50.45 ± 40.86 v 27.59 ± 24.43; Trial 4 = 43.87 ±32.37 v 31.01 ± 29.41). No significant differences (p>0.05) were found for peak or average velocity during the MSs across any trial. Lower body soreness was significantly greater (p<0.05) during the 24-48h follow up visits as assessed via a 0-10 visual analogue scale. The sprint protocol induced a high internal physiological load, evidenced by significantly elevated post-exercise blood lactate levels (pre: 1.51±0.50 vs post: 5.6±2.53). CONCLUSION: Concentric RFD determined using a CMJ was the best metric for detecting performance impairments, as it consistently declined 24-48h after completing a repeated sprint protocol. The other CMJ metrics, as well as MS performance did not decrease across all trials. A CMJ test that assesses concentric RFD may be a useful tool for coaches to determine readiness to train in female athletes. Future research should seek to replicate this protocol using higher sprinting volumes, to determine whether concentric RFD declines in a predictable dose-response manner. Limitations of this study were the small sample size and the lack of control for external damaging activity (i.e. rugby training).

Background: Studies assessing post-activation potentiation (PAP) responses comparing male and female athletes are conflicting. Objectives: This study investigated whether differences exist in the duration for optimal post-preload stimulus measures on performance in male and female team sport athletes. Methods: Twenty-four participants (12 males and 12 females) participated in the study. Two familiarization sessions were conducted with each participant. Then, three experimental conditions were implemented, incorporating a standardized warm-up, followed by back squats (conditioning exercises) and varying passive recovery times of 4 min (PAP4), 8 min (PAP8), or 12 min (PAP12). Following the recovery, players performed three physical performance measures related to team sports: A countermovement jump, a modified agility t-test, and a 20-m linear sprint. The significance level was set at P &lt; 0.05. Results: All performance measures were significantly greater in PAP12 than in PAP4 and PAP8 conditions in both males (1.50 to 2.95%) and females (1.09 to 5.79%) (P &lt; 0.05). The PAP12 condition also had significantly lower values for HR (3.18 to 5.15 beats.min-1; P &lt; 0.0005) and ratings of perceived exertion (RPE) (0.63 to 1.02; P &lt; 0.05) than PAP8 and PAP4. Males performed better on all the performance tests (19.33 to 26.34%) compared to their female counterparts (P &lt; 0.0005). Conclusions: A pre-load stimulus consisting of one set of 5 repetitions of back squat at 85% one-repetition maximum can elicit a PAP response. A 12-min passive rest after the pre-load stimulus was most beneficial in improving physical performance measures in both male and female team-sport athletes.

Research has been equivocal with respect to sex differences in communication. Although the bulk of the literature suggests that any differences are small to moderate, several characteristics of sport teams suggest that male and female athletes may communicate differently. A sample of 299 athletes (150 female and 148 male) completed the Scale for Effective Communication in Team Sports. Multivariate Analyses of Variance revealed no significant differences between male and female athletes. The researcher concluded that there are no differences between male and female athletes with respect to the frequency of communication of these sports‐specific resources. Considering that the sample and operational definition were selected to maximize the probability of sex differences in communication, this study further supports that males and females communicate similarly.

Long, JW, Gonzalez, M, Farrell, J, Carmargo, ME, and Cheever, K. Sleep duration and sleep quality as season-long predictors of ratings of perceived exertion and psychological well-being in female soccer athletes. J Strength Cond Res 39(9): 973-981, 2025-Sleep's effect on physiologic and psychological well-being has been examined through cross-sectional studies, but research is limited on the longitudinal impact sleep has on well-being in collegiate athletes. Thus, the purpose of this study was to explore daily fluctuations in subjective measures of psychological wellness and physiologic stress (soreness, rating of perceived exertion [RPE]) across a competitive soccer season, and the extent to which sleep duration and quality modify daily measures of wellness. Twenty female collegiate soccer players underwent daily measures of psychological well-being (mental stress, mental fatigue, anxiety, and depression), physical stress (active time, total distance, GPS load, soreness, and RPE), and sleep (duration and quality) across a 120-day competitive season. Generalized linear mixed-effects models with a zero-inflation component were used to examine the effects of sleep duration and quality on measures of physiologic and psychological stress. Sleep duration was a predictor of RPE and anxiety, and there was an interaction between sleep duration and the day of the soccer season affecting RPE, anxiety, and soreness ( p < 0.05). Sleep quality was a predictor of anxiety, mental stress, and RPE ( p < 0.05). Significant interactions were observed between sleep quality and the day of the soccer season affecting soreness, anxiety, mental fatigue, and mental stress (all p < 0.05). Findings suggest sleep duration and sleep quality are protective of measures of psychological well-being, with increasingly protective effects across a competitive soccer season. These findings have utility in helping to maximize both student athlete performance and wellness.

The present study determined metabolic and performance responses to repeated sprint exercise under hypoxia among female team-sport athletes. Fifteen female athletes (age, 20.7±0.2 years; height, 159.6±1.7 cm; body weight, 55.3±1.4 kg) performed two exercise trials under either a hypoxic [HYPO; fraction of inspired oxygen (FiO2), 14.5%] or normoxic (NOR; FiO2, 20.9%) condition. The exercise consisted of two sets of 8×6-s maximal sprint (pedaling). The average power output was not significantly different between trials for set 1 (P=0.89), but tended to be higher in the NOR trial for set 2 (P=0.05). The post-exercise blood lactate concentrations were significantly higher in the HYPO trial than that in the NOR trial (P<0.05). Exercise significantly increased serum growth hormone (GH) and cortisol concentrations (P<0.01 for both hormones), with no difference between the trials. In conclusion, repeated short-duration sprints interspaced with 30-s recovery periods in moderate hypoxia caused further increase in blood lactate compared with the same exercise under normoxic conditions among female team-sport athletes. However, exercise-induced GH and cortisol elevations or power output during exercise were not markedly different regardless of the different levels of inspired oxygen.

This study examined the effects of a personalized sleep or nutrition intervention on sleep in shift-workers. Fifty-seven healthy male workers on 12-hour shifts received the sleep intervention (n=25), nutrition intervention (n=22), or control (n=10). The sleep intervention aimed to improve sleep duration and quality through adjustments in sleep timing and sleep education. The nutrition intervention targeted circadian alignment by structuring meal timing and macronutrient distribution. Interventions were personalized using baseline sleep, diet, and physiological markers. Subjective sleep was assessed with the Insomnia Severity Index at baseline, last weeks of the intervention, and 8-month follow-up. Objective sleep outcomes (total sleep time, sleep efficiency, fragmentation index, and wake after sleep onset) were assessed through actigraphy at baseline, first and last weeks of the intervention. Mixed-effects models analyzed changes in subjective and objective sleep outcomes, adjusting for age, chronotype and household composition. The sleep intervention group had significantly higher insomnia scores at baseline, which improved to control levels post-intervention and remained so at follow-up. However, no significant changes in objective sleep were observed. The nutrition intervention group showed no significant effects on subjective or objective sleep outcomes. These findings suggest personalized sleep strategies may improve perceived sleep without detectable changes in objective measures.