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Sleep is part of everyone’s daily routine, some more than others, but is often how we spend one-third of our existence on this planet. It’s been reported through the years that sleep is closely related to physical and mental health, cognitive processes and metabolic functions (Samuels, 2008).

For the athlete population, sleep serves as one of the most significant factors to ensure the appropriate sleepamount of recovery from training sessions and games. Research indicates athletes generally sleep less than non-athletes and often have difficulty sleeping (Walters, 2002). Sleep serves multiple purposes. It has been emphasized that sleep helps with physical and psychological restoration and recovery, conservation of energy, memory consolidation, discharge of emotions, brain growth and maintenance of the immune system (Samuels, 2008). Sleep loss or a lack of sleep could lead to a general decline in athletic performance.

In professional sports, athletes and staff can expect to spend half of the team’s regular season games on the road. A constant struggle with east to west or west to east travel is athletes and staff tend to battle fatigue during and after the long journeys. This more than likely is due to the cramped conditions; dehydration as a result of the low humidity on board the airplane; turbulence; reduced barometric pressure; vibration; noise; flight anxiety and body stiffness due to relative inactivity while traveling (Reilly et al., 2005).

The rapid transition across time zones leads to the appearance of a number of undesirable side effects, collectively known as jet lag.  Jet lag is the psychophysiological impairment of wellbeing and performance. It occurs when the athletes’ circadian rhythms are disturbed by trans meridian travel because the time in the new environment no longer matches the body’s internal circadian rhythm (Reilly et al., 2005).  Jet lag symptoms include but are not limited to an inability to sleep at the local time, bowel irregularities, increased incidence of headaches, irritability and moodiness, fatigue, reduced cognitive skills and poor psychomotor coordination (Brooks et al., 2005). The severity of jet lag is directly related to the direction of flight (it can be worse after flying east compared to west) and the number of time zones crossed. The general rate of adjustment is traditionally seen as one day for each time zone crossed (Reilly et al., 2005).

Contrary to the other professional sports in the US, teams within Major League Soccer travel commercially for all road games throughout the entire regular season. Each club deals with the headaches everyone else tends to have when traveling domestically, including weather delays, long lines at security, aircraft mechanical issues, the middle seat saga, lost baggage and the general negative mood level of some airline personnel. Arriving into the new city can be a hectic experience.  As the medical staff looking after athletes, it is imperative we have protocols in place to ensure each individual is able to maximize their recovery from the flight and activity from the day. Athletes are normally expected to be fully prepared to participate at a high level in less than 24 hours after travel. Listed below are some strategies taken to allow athletes to get to sleep in order to promote recovery and ultimately achieve maximum performance with a minimal amount of travel side effects.

Behavioral

  • Nap on the flight. A 20-minute nap about 8 hours after nocturnal sleep has positive effects on performance (Postolache et al., 2005).
  • Recommend that athletes get 9 to 10 hours of sleep per day, with 80-90% of it during the night (Bompa & Haff, 2009).
  • Encourage a bedtime ritual to develop a winding down routine to serve as a cue to the mind and body to get ready for sleep.
  • Researchers recommend flight schedules be arranged to allow athletes to arrive at their destination as close to their recommended sleep time as possible. East-bound flights should be made during daylight hours with an earlier start for the longer flights. West-bound flights should be late in the day to arrive as close to the athlete’s sleep time as possible (Brooks et al., 2005).

Environmental

  • Try to keep the temperature of the room as close to what is normal and most comfortable for the athlete. Research suggests that the ideal temperature for males to promote deep sleep is 680 and for females it is 730 (Pan et al., 2012).
  • Keep the lights low or off in the hotel room when preparing to fall asleep, usually starting an hour before going to sleep. The alteration of light and darkness is seen as the most important factor that can be used to reset the body clock (Arendt, 2009).
  • Avoid using electronics (phone, TV, etc.) prior to going to bed to maximize the darkness in the hotel room.
  • Massage prior to bed to allow the body to calm down and relieve any tension built up in the musculature.

Diet

  • Drink water on the flight and upon arrival in the new city, as dehydration makes it difficult to adjust to a new circadian rhythm.
  • Consume food sources containing tryptophan for dinner. Such foods include nuts, seeds, tofu, cheese, red meat, chicken, turkey, fish, oats, beans, lentils and eggs. Tryptophan serves as a precursor for the rest-inducing hormones serotonin and melatonin and ultimately leads to the synthesis of melatonin in the brain (Peuhkuri, 2012).
  • Minimize spicy and acidic foods at dinner which can increase the risk of heartburn.
  • Drink chamomile tea after dinner. Chamomile has been valued as a digestive relaxant and has been used to treat various GI disturbances including flatulence, indigestion, diarrhea, motion sickness, nausea and vomiting (Srivastava et al., 2010).
  • Consume a snack before bed that contains carbohydrate. Carbohydrate can elevate plasma tryptophan levels, promoting the synthesis and release of serotonin, a precursor of melatonin (Reilly et al., 2005). Research indicates that certain fruits such as tart cherries or kiwi fruits promote sleep (Peuhkuri, 2012).
  • Drink a glass of chocolate milk before bed. Melatonin is a natural compound in cow’s milk (Peuhkuri, 2012)
  • Avoid drinking caffeine or alcohol before going to bed.
  • Take a night-time supplement with magnesium and zinc (ZMA pills). Magnesium is an essential mineral that can improve length and quality of sleep. Magnesium supplementation close to bed has been shown to improve brain activity readings associated with deep sleep and lower late-night cortisol levels (Held et al., 2002). Zinc, particularly in combination with magnesium and possibly melatonin, can promote better sleep, particularly for people who struggle with insomnia (Rondanelli et al., 2011).
  • Ingest oral melatonin 30 minutes prior to going to bed. Melatonin is known to decrease the time taken to fall asleep, and is thought to promote more restful sleep based on its circadian rhythm functions (Macchi & Bruce, 2004). Research shows that daily doses between 0.5 and 5mg were similar in effectiveness, except that on the higher dose people fell asleep more quickly. High-dose melatonin prompts sleep induction and decreases the fatigue the next day more than low-dose melatonin (Herxheimer & Petrie, 2001).

Resources

  1. Arendt, J. (2009). Managing jet lag: Some of the problems and possible new solutions. Sleep Medicine Reviews, 13: 249-256.
  2. Bompa, T.O. & Haff, G.G. (2009). Periodization: Theory and methodology of training (5th). Champaign, IL: Human Kinetics.
  3. Brooks, G.A., Fahey, T.P., & Baldwin, K.M. (2005). Exercise physiology: Human bioenergetics and its applications. (4th) New York, NY: McGraw Hill.
  4. Held, K., Antonijevic, I. A., Kunzel, H., Uhr, M., Wetter, T.C., Golly, I.C. … & Murck, H. (2002). Oral Mg (2+) supplementation reverses age related neuroendocrine and sleep EEG changes in humans. Pharmacopsychiatry, 35(4), 135-143.
  5. Herxheimer, A. & Petrie, K.J. (2001). Melatonin for preventing and treating jet lag. Therapeutics, 6: 186.
  6. Macchi, M., & Bruce, J.N. (2004). Human pineal physiology and functional significance of melatonin. Frontiers in Neuroendocrinology, 25(3): 177-195.
  7. Pan, L., Lian, Z., & Lan, L. (2012). Investigation of gender differences in sleeping comfort at different environmental temperatures. Indoor and Built Environment, 21(6): 811-820.
  8. Peuhkuri, K., Sihvola, N., & Korpela, R. (2012). Diet promotes sleep duration and quality. Nutrition Research, 32: 309-319.
  9. Postolache, T.T., Hung, T.M., Rosenthal, R.N., Soriano, J.J., Montes, F., & Stiller, J.W. (2005). Sport chronobiology consultation: From the lab to the arena. Clinics in Sports Medicine, 24(2): 415-456.
  10. Reily, T., Waterhouse, J., & Edwards, B. (2005). Jet lag and air travel: Implications for performance. Clinics in Sports Medicine, 24(2): 367-380.
  11. Rondanelli, M., Opizzi, A., Monteferrario, F., Antoniello, N., Manni, R., & Klersy, C. (2011). The effect of melatonin, magnesium, and zinc on primary insomnia in long term care facility residents in Italy: A double blind, placebo controlled clinical trial. Journal of the American Geriatrics Society, 59(1): 82-90.
  12. Samuels, C. (2008). Sleep, recovery and performance. The new frontier in high performance athletics. Neurologic Clinics, 26: 169-180.
  13. Srivasta, J.K., Shankar, E., & Gupta, S. (2010). Chamomile: A herbal medicine of the past with bright future. Mol Med Report, 3(6): 895-901.
  14. Walters, P.H. (2002). Sleep, the athlete, and performance. National Strength and Conditioning Association, 24(2): 17-24.

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Kurt Andrews, MS, ATC, PES, CES is in his fifth year as an assistant Athletic Trainer for the Major League Soccer (MLS) club LA Galaxy

 

 

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