Wake up call for collegiate athlete sleep: narrative review and consensus recommendations from the NCAA Interassociation Task Force on Sleep and Wellness

Correspondence to Dr Emily Kroshus; [email protected], [email protected]

What is already known

• Sleep is an important determinant of collegiate athlete health, well-being and performance.

• Collegiate athletes often neglect sleep because of academic, athletic and social demands.

What are the new findings

• College athletic departments can take steps to promote collegiate athlete well-being and performance through sleep by:

  • Conducting an annual time demands survey.

  • Incorporating sleep screening into the preparticipation exam.

  • Providing evidence-based sleep education to collegiate athletes and coaches.

Introduction

Sleep is critical for overall health and well-being. The Healthy People 2020 objectives, a set of 10-year national objectives for the health of all Americans, prioritised sleep and set out objectives to increase sufficient sleep, increase diagnosis and treatment of obstructive sleep apnea and prevent accidents due to drowsy driving.¹ Poor sleep disproportionately negatively impacts those in late adolescence through their early 20s (emerging adults).² The relationship between sleep duration and cardiometabolic risk and neurocognitive dysfunction is especially pronounced among young adults.³ Although fewer studies have focused on collegiate athletes, the documented outcomes of insufficient sleep duration, poor sleep quality (restorative sleep) or both include many critically important domains, spanning physical and academic performance, cognitive function, recovery from athletic exertion and injury, mental health and cardiometabolic health. Collegiate athletes’ social and physical environments are often not conducive to obtaining restorative sleep. Furthermore, their academic and athletic schedules may vary due to travel, practice and game schedules, different meal schedules, mandatory team meetings or other factors, all of which can prevent consistent bed and rise times.

Good sleep hygiene practices are summarised in box 1.⁴ A 2015 survey of National Collegiate Athletic Association (NCAA) collegiate athletes found that they spend 27–41 hours per week on athletics.⁵ After allowing time for academics, other extracurricular activities and relaxation or socialising, few have sufficient time left for restorative sleep.⁵ In addition, collegiate athletes often practice poor sleep hygiene habits. Caffeine, alcohol, marijuana and other illicit drugs and non-medical use of prescription drugs such as stimulants all can interfere with neurochemical control of sleep.⁶ Evening use of electronic devices suppresses melatonin levels and increases alertness, both of which delay sleep onset and contribute to sleep deprivation.⁶ These behaviours are compounded by student...