Sleep in Elite Athletes and Nutritional Interventions to Enhance Sleep

Beskriver forskjellige måter søvn påvirker atleter, og hvordan søv påvirkes av mat. Nevner at høykarbo mat må inntaes minimum 1t før leggetid.

The same research group also increased the sleep time of swimmers from their usual sleep amount to 10 h per night for 6–7 weeks. Following this period, 15 m sprint, reaction time, turn time, and mood all improved [30].

Waterhouse et al. [31] investigated the effects of a lunchtime nap on sprint performance following partial sleep deprivation (4 h of sleep). Following a 30-min nap, 20 m sprint performance was increased, alertness was increased, and sleepiness was decreased when compared with the no-nap trial. In terms of cognitive performance, sleep supplementation in the form of napping has been shown to have a positive influence on cognitive tasks following a night of sleep deprivation (2 h) [32]. Naps can markedly reduce sleepiness and can be beneficial when learning skills, strategy or tactics [32]. Napping may also be beneficial for athletes who have to wake early routinely for training or competition and those who are experiencing sleep deprivation [32].

Pain Perception

It is well accepted that individuals with chronic pain frequently report disturbed sleep (changes in continuity of sleep as well as sleep architecture). However, there is also recent evidence suggesting that sleep deprivation may cause or modulate acute and chronic pain [36]. Sleep deprivation may thus enhance or cause pain, and pain may disturb sleep by inducing arousals during sleep. A cycle may then eventuate, starting with either pain or sleep deprivation, with these two issues maintaining or augmenting each other [36].

Athletes may experience pain as a result of training, competition and/or injury. Evidence, although minimal at this stage, suggests that athletes may also have lower sleep quality and quantity than the general population [16]. Therefore, appropriate pain management as well as adequate sleep is likely to be very important for athletes from both a pain and sleep perspective.

A small number of studies have investigated the effects of carbohydrate ingestion on indices of sleep quality and quantity. Porter and Horne [52] provided six male subjects with a high-carbohydrate meal (130 g), a low-carbohydrate meal (47 g), or a meal containing no carbohydrate, 45 min before bedtime. The high-carbohydrate meal resulted in increased REM sleep, decreased light sleep, and wakefulness [52].

Practical Applications

In the first instance, athletes should focus on utilizing good sleep hygiene to maximize sleep quality and quantity. While research is minimal and somewhat inconclusive, several practical recommendations may be suggested:

  • High GI foods such as white rice, pasta, bread, and potatoes may promote sleep; however, they should be consumed more than 1 h before bedtime.
  • Diets high in carbohydrate may result in shorter sleep latencies.
  • Diets high in protein may result in improved sleep quality.
  • Diets high in fat may negatively influence total sleep time.
  • When total caloric intake is decreased, sleep quality may be disturbed.
  • Small doses of tryptophan (1 g) may improve both sleep latency and sleep quality. This can be achieved by consuming approximately 300 g of turkey or approximately 200 g of pumpkin seeds.
  • The hormone melatonin and foods that have a high melatonin concentration may decrease sleep onset time.
  • Subjective sleep quality may be improved with the ingestion of the herb valerian; however, as with all supplements, athletes should be aware of potential contaminants as well as the inadvertent risk of a positive drug test.

Elevated Inflammatory Markers in Response to Prolonged Sleep Restriction Are Associated With Increased Pain Experience in Healthy Volunteers

Denne nevner at 10 dager med redusert søvn (4 timer) øker betennelsesfaktorer i kroppen. 4 timers søvn er svært lite og de fleste sover nok mer enn dette, men studien nevner at 25% reduksjon (6 timer) også gir en økning i betennelsesfaktorer, dog ikke like kraftig.

Den nederste grafen viser hvordan ubehag i kroppen henger sammen med økning i betennelsesfaktorer.


Insufficient sleep quantity may facilitate and/or exacerbate pain through elevations of IL-6. In disorders where sleep disturbances are common, insufficient sleep quantity itself may establish and maintain its co-occurrence with pain and increased inflammation.

Acute sleep loss of up to 3 nights15,17,18 as well as more commonly experienced forms of sleep loss, i.e., sleep reduced by 25%-50% across consecutive days,18,19 have been shown to induce an increase of interleukin-6 (IL-6) and C-reactive Protein (CRP) levels. In addition, increased levels of IL-6 have been found in patients suffering from primary insomnia.20,21

Pain is a hallmark of inflammatory processes. Prostaglandins, in particular PGE2, are classical pain mediators, but in the last decade a variety of novel pain modulators have been identified. For example, proinflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) have been found to be potent pain-inducing and pain-facilitating agents, able to sensitize primary sensory neurons.26

Ten days of sleep restriction to 50% of the habitual time led to an IL-6 increase of 1.16 pg/mL in the current study. Sleep restriction to approximately 25% of usual sleep time over one week has been found to lead to a slightly smaller IL-6 increase of 0.75 pg/mL compared to the present result.19 This may suggest a dose-response relationship between chronicity/severity of sleep restriction and elevation of IL-6 levels, and warrants further investigation.

Pain Sensitivity and Recovery From Mild Chronic Sleep Loss

Denne viser at økt søvnmengde reduserer smerte. Ved å øke antall timer søvn fra (under) 8 timer til 10 timer ble deltakerene mindre sensitive for smertestimuli. Den nevner også at vi sover mindre nå enn vi gjorde på 60-tallet. Nå er vi nede i 6 timer eller mindre, mens på 60-tallet sov vi 8 timer eller mindre. Den nevner også vi vi får 24%-31% mindre smertetåleranse om vi får 50% dårligere søvn 1 enkelt natt.

Studien beskriver at 4 dager med 10 timers søvn reduserer smertesensitivitet med 25%.


Study Objectives:

To determine whether an extended bedtime in sleepy and otherwise healthy volunteers would increase alertness and thereby also reduce pain sensitivity.


Outpatient with sleep laboratory assessments.

Participants and Interventions:

Healthy volunteers (n = 18), defined as having an average daily sleep latency on the Multiple Sleep Latency Test (MSLT) < 8 min, were randomized to 4 nights of extended bedtime (10 hr) (EXT) or 4 nights of their diary-reported habitual bedtimes (HAB). On day 1 and day 4 they received a standard MSLT (10:00, 12:00, 14:00, and 16:00 hr) and finger withdrawal latency pain testing to a radiant heat stimulus (10:30 and 14:30 hr).


During the four experimental nights the EXT group slept 1.8 hr per night more than the HAB group and average daily sleep latency on the MSLT increased in the EXT group, but not the HAB group. Similarly, finger withdrawal latency was increased (pain sensitivity was reduced) in the EXT group but not the HAB group. The nightly increase in sleep time during the four experimental nights was correlated with the improvement in MSLT, which in turn was correlated with reduced pain sensitivity.


These are the first data to show that an extended bedtime in mildly sleepy healthy adults, which resulted in increased sleep time and reduced sleepiness, reduces pain sensitivity.

In the 1960s sleep duration was estimated to be approximately 8 hr per 24-hr period, whereas by 2005 it was reported that sleep duration was 7 hr or less.3 A national survey reported that 21% of the population obtains 6 hr or less of sleep per 24-hr period.4

Partial deprivation, the reduction of bedtime by 50% for one night, reduced finger withdrawal latency (increased pain sensitivity) to a radiant heat stimulus by 24%.7

In the EXT group of the current study finger withdrawal latency was increased by 25%, which reflects a reduction in pain sensitivity.

Exploring the associations between sleep problems and chronic musculoskeletal pain in adolescents: A prospective cohort study

Denne nevner at søvnproblemer i ungdommen gir utgangspunkt for smerteproblemer senere i livet. Det er vanlig å tro at smerteproblemer gir søvnproblemer, men denne viser at søvnproblemer ofte kommer før smerteproblemer.



The prevalence of musculoskeletal chronic pain in adolescents is estimated to be approximately 4% to 40%. The development of musculoskeletal pain during teenage years could have a marked impact on physical, psychological and social well-being.


To examine whether sleep problems during adolescence are associated with musculoskeletal pain, particularly chronic regional pain and chronic widespread pain.


Using data from the Avon Longitudinal Study of Children, the relationship between sleep problems at 15 years of age and the presence of chronic regional and widespread pain at 17 years of age was explored. Pain data were not available at 15 years of age. A total of 2493 participants with complete data were identified. Relationships among sleep problems and musculoskeletal pain were examined using logistic regression. ORs were calculated after adjusting for sex, ethnicity, socioeconomic position and depression (15 years of age).


Sleep disturbance (usually wakes up more than two or three times), difficulties with hypersomnolence and poor subjective sleep perception were associated with the presence of both musculoskeletal regional and widespread pain. Finally, using ordered logistic regression, poor subjective sleep perception was also found to be associated with greater pain severity in participants with chronic musculoskeletal regional and widespread pain.


The results of the present study suggest an association between sleep problems during adolescence and the presence of musculoskeletal pain at a later stage. These findings are consistent with adult literature suggesting a link between sleep problems and musculoskeletal pain. Given these associations, sleep problems in adolescence may be an important risk factor for musculoskeletal pain.

Efficacy of paced breathing for insomnia: Enhances vagal activity and improves sleep quality.

Nevner at 0,1 Hz pust (5x minuttet) styrker vagusnerven slik at søvnen blir bedre for de som har insomnia. Her gjorde de det i 20 minutter før de la seg til å sove.


Fourteen self-reported insomniacs (SRI) and 14 good sleepers (GS) had their cardiac neuronal activity assessed by heart rate variability (HRV) under controlled respiration at a slow frequency rate of 0.1 Hz, and a forced rate of 0.2 Hz during daytime rest. Nighttime sleep was measured by polysomnography. The SRI showed depressed high frequency power of HRV compared to the GS. An increased total power of HRV was observed among the SRI during slow, paced breathing compared with spontaneous breathing and 0.2 Hz. Sleep onset latency, number of awakenings, and awakening time during sleep were decreased and sleep efficiency was increased if SRI practiced slow, paced breathing exercises for 20 min before going to sleep. Our results indicate that there is autonomic dysfunction among insomniacs, especially in relation to vagal activity; however, this decreased vagal activity can be facilitated by practicing slow, paced breathing, thereby improving sleep quality.