Although its true function remains unclear, sleep is considered critical to human physiological and cognitive function. Equally, since sleep loss is a common occurrence prior to competition in athletes, this could significantly impact upon their athletic performance. Much of the previous research has reported that exercise performance is negatively affected following sleep loss; however, conflicting findings mean that the extent, influence, and mechanisms of sleep loss affecting exercise performance remain uncertain. For instance, research indicates some maximal physical efforts and gross motor performances can be maintained. In comparison, the few published studies investigating the effect of sleep loss on performance in athletes report a reduction in sport-specific performance. The effects of sleep loss on physiological responses to exercise also remain equivocal; however, it appears a reduction in sleep quality and quantity could result in an autonomic nervous system imbalance, simulating symptoms of the overtraining syndrome. Additionally, increases in pro-inflammatory cytokines following sleep loss could promote immune system dysfunction. Of further concern, numerous studies investigating the effects of sleep loss on cognitive function report slower and less accurate cognitive performance. Based on this context, this review aims to evaluate the importance and prevalence of sleep in athletes and summarises the effects of sleep loss (restriction and deprivation) on exercise performance, and physiological and cognitive responses to exercise. Given the equivocal understanding of sleep and athletic performance outcomes, further research and consideration is required to obtain a greater knowledge of the interaction between sleep and performance.

Sleep and athletic performance: the effects of sleep loss on exercise performance, and physiological and cognitive responses to exercise.

Altered sleep–wake cycles and physical performance in athletes

We tested the hypothesis that key endocrine responses to semistarvation would be attenuated by changing only the food intake in a multistressor environment that also included sustained workload, inadequate sleep, and thermal strain. Serum hormones were compared within and between two groups of healthy young male volunteers participating in the 8-wk US Army Ranger course, with four repeated cycles of restricted energy intakes and refeeding: group 1 (n = 49) and group 2 (n = 48); energy deficits averaged 1,200 and 1,000 kcal/day, respectively. After 8 wk, most of group 1 achieved a minimum body fat, serum 3,5,3'-triiodothyronine (T(3)) was below normal (78 +/- 20 ng/dl), testosterone (T) approached castrate levels (4.5 +/- 3.9 nmol/l), insulin-like growth factor I (IGF-I) declined by one-half (75 +/- 25 microg/l), and cholesterol rose from 158 +/- 31 to 217 +/- 39 mg/dl. Bioavailable T(3) and T were further reduced by increases in their specific binding proteins in response to declining insulin. Refeeding, even with continuation of the other stressors, produced prompt recovery of T(3), T, and IGF-I. Higher energy intakes in group 2 attenuated the subclinical hypothyroidism and hypercholesterolemia, whereas consistent luteinizing hormone suppression indicated centrally mediated threshold effects on gonadal hormone suppression. We conclude that low T, T(3), and IGF-I remained reliable markers of acute energy deficits in the presence of other stressors; elevated cholesterol and cortisol provided information about chronic status, corresponding to diminishing body fat stores.

Endocrine markers of semistarvation in healthy lean men in a multistressor environment.

Purpose: Soldiers are expected to maintain a high degree of physical readiness as operational demands can severely degrade performance capabilities. This study examined the physiological consequences of U.S. Army Ranger training on strength, power, body composition, and somatotrophic hormones.

Methods: In an intensive 8-wk military training course that included an average daily energy deficit of 1000 kcal·d-1, lower-body power output, maximal lifting strength, body composition, and serum concentrations of several somatotrophic hormones were measured in 50 male soldiers (24.6 ± 4.4 y; 176.1 ± 7.8 cm; 78.4 ± 8.7 kg; 14.7 ± 4.2% body fat) before and after the course.

Results: Vertical jump height (-16%), explosive power output (-21%), maximal lifting strength. (-20%), body mass (-13%), fat-free mass (-6%), and fat mass (-50%) declined (P < 0.05) after the training course. Circulating total testosterone and insulin-like growth factor-I (IGF-I) experienced significant (P < 0.05) declines, and cortisol was significantly increased. Lower-body power output, but not maximal lifting strength, correlated with changes in fat-free mass. IGF-I and cortisol, but not total testosterone, were correlated with losses of tissue mass.

Conclusion: Lower-body power output, estimated from vertical jump height and body mass, is a sensitive and field expedient measure that can be used to assess the influence of caloric deficit on physical performance after 8 wk of U.S. Army Ranger training. With severe weight loss (=13% of body mass), IGF-I and cortisol correlate more closely with soft-tissue tissue adaptations than does testosterone.

Physiological consequences of U.S. Army Ranger training.

NINDL, B. C., C. D. LEONE, W. THARION, R. F. JOHNSON, J. CASTELLANI, J. F. PATTON, and S. J. MONTAIN. Physical performance responses during 72 h of military operational stress. Med. Sci. Sports Exerc., Vol. 34, No. 11, pp. 1814–1822, 2002.PurposeTo characterize the impact of prolonged work, underfee

Physical performance responses during 72 h of military operational stress

The purpose of this study was to evaluate the effects on physical performance of three levels of energy intake during a 5-day period of prolonged physical exercise and relative sleep deprivation. A group of 27 male soldiers were randomly assigned to three groups receiving either 1800 kcal · 24 h−1 (7560 kJ, LC), 3200 kcal · 24h−1 (13440 kJ, MC) or 4200 kcal-24h−1 (17640 kJ, HC). They took part in a 5-day combat course (CC) of heavy and continuous physical activities, with less than 4 h sleep per day. Performance capacity was tested just before and at the end of CC. Maximal oxygen uptake (
 
$$\dot V$$

 O2max) was determined during an exhausting incremental exercise test on a cycle ergometer. Anaerobic performance was measured from the time during which exercise could be maintained at supra maximal loads on a cycle ergometer. After CC, the subjects receiving LC exhibited a 14% decrease in power output at exhaustion in the incremental exercise test [from 325 (SEM 8) to 278 (SEM 9) W,P < 0.001] and a significant decrease in
 
$$\dot V$$

 O2max of 8% [from 3.74 (SEM 0.06) to 3.45 (SEM 0.05) l · min−1,P<0.05]. The remaining two experimental groups demonstrated the same mechanical and metabolic performances on days 1 and 5. Anaerobic performance was not influenced by energy intake and the field course. Blood samples were obtained at rest on days 1 and 5. At the end of CC, the data demonstrated a significant decrease in blood glucose concentrated ion (P<0.01) for LC diet only. Plasma free fatty acid, blood glycerol and β-OH butyrate were significantly increased in all groups, from day 1, but the values observed for LC were higher than those for the MC and HC diets. The concentrations of the anabolic hormones, insulin and testosterone, decreased in the three groups, the lowest values being observed in the LG group (P < 0.05). In conclusion, we found that only a severe energy deficit decreased physical performance during submaximal exercise. A moderate deficit between energy intake and expenditure did not affect performance. Supramaximal exercise did not appear to be influenced by energy intake and CC.

Physical performance and metabolic changes induced by combined prolonged exercise and different energy intakes in humans.

The effects of two levels of protein intake on muscle performance and energy metabolism were studied in humans submitted to repeated daily sessions of prolonged exercise at moderate altitude. For this purpose, 29 healthy males, were exposed to seven successive stages of ski-mountaineering at altitudes between 2500 and 3 800 m, and to an isocaloric diet (4000 kcal·day−1, 16760 kJ·day−1) with either 1.5g·kg−1·day−1 (C group,n =14), or 2.5 g·kg−1·day−1 (PR group,n =15) protein intake. Measurements made after the ski-mountaineering programme did not show any change in body mass. The peak torque during maximal isometric voluntary contraction (MVC) of the quadriceps muscle was unaffected by the repeated exercises, whereas the endurance time at 50% MVC was decreased in PR subjects (−26.8%,P<0.001). Increased levels of both free fatty acids (+147%,P<0.001) and glycerol (+170%,P<0.001) observed in C subjects would suggest that lipolysis was enhanced after the repeated exercise. The plasma amino acid pattern was altered after completion of the ski-mountaineering programme; the plasma concentration of the three branched-chain amino acids (BCAA) was significantly decreased in C subjects, whereas the higher level of protein intake (PR group) greatly minimized the exercise-induced decrease in serum BCAA.

P. Satabin

Papers

Physical performance and metabolic changes induced by combined prolonged exercise and different energy intakes in humans.

Effects of protein supplementation during prolonged exercise at moderate altitude on performance and plasma amino acid pattern