Article Text

Sleep and the athlete: narrative review and 2021 expert consensus recommendations
  1. Neil P Walsh1,
  2. Shona L Halson2,
  3. Charli Sargent3,
  4. Gregory D Roach3,
  5. Mathieu Nédélec4,
  6. Luke Gupta5,
  7. Jonathan Leeder6,
  8. Hugh H Fullagar7,
  9. Aaron J Coutts7,
  10. Ben J Edwards1,
  11. Samuel A Pullinger1,8,
  12. Colin M Robertson9,
  13. Jatin G Burniston1,
  14. Michele Lastella3,
  15. Yann Le Meur4,
  16. Christophe Hausswirth10,
  17. Amy M Bender11,
  18. Michael A Grandner12,
  19. Charles H Samuels13
  1. 1 Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
  2. 2 School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
  3. 3 Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Queensland, Australia
  4. 4 Laboratory Sport, Expertise and Performance (EA 7370), French National Institute of Sport (INSEP), Paris, France
  5. 5 English Institute of Sport, Bisham Abbey National High Performance Centre, Marlow, UK
  6. 6 English Institute of Sport, London, UK
  7. 7 School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
  8. 8 Sports Science Department, Aspire Academy, Doha, Qatar
  9. 9 School for Sport and Exercise Sciences, University of Bolton, Bolton, UK
  10. 10 Laboratory LAMHESS (EA6312), University of Nice Sophia-Antipolis, Nice, France
  11. 11 Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  12. 12 Sleep and Health Research Program, University of Arizona, Tucson, Arizona, USA
  13. 13 Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada
  1. Correspondence to Professor Neil P Walsh, School of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK; n.walsh{at}


Elite athletes are particularly susceptible to sleep inadequacies, characterised by habitual short sleep (<7 hours/night) and poor sleep quality (eg, sleep fragmentation). Athletic performance is reduced by a night or more without sleep, but the influence on performance of partial sleep restriction over 1–3 nights, a more real-world scenario, remains unclear. Studies investigating sleep in athletes often suffer from inadequate experimental control, a lack of females and questions concerning the validity of the chosen sleep assessment tools. Research only scratches the surface on how sleep influences athlete health. Studies in the wider population show that habitually sleeping <7 hours/night increases susceptibility to respiratory infection. Fortunately, much is known about the salient risk factors for sleep inadequacy in athletes, enabling targeted interventions. For example, athlete sleep is influenced by sport-specific factors (relating to training, travel and competition) and non-sport factors (eg, female gender, stress and anxiety). This expert consensus culminates with a sleep toolbox for practitioners (eg, covering sleep education and screening) to mitigate these risk factors and optimise athlete sleep. A one-size-fits-all approach to athlete sleep recommendations (eg, 7–9 hours/night) is unlikely ideal for health and performance. We recommend an individualised approach that should consider the athlete’s perceived sleep needs. Research is needed into the benefits of napping and sleep extension (eg, banking sleep).

  • sleep
  • athlete
  • health
  • performance
  • consensus

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  • Twitter @ProfNeilWalsh, @shonahalson, @CBTmin, @lukegup86, @HughFullagar, @aaronjcoutts, @YLMSportScience, @sleep4sport

  • Contributors All authors have made substantial contributions to the drafting and revision of this consensus statementand have seen and given final approval for the submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AMB and CH have received grant funding from Own the Podium and Mitacs. MAG has received grant funding from Kemin Foods, Nexalin Technology and Jazz Pharmaceuticals; he has performed consulting activities for Fitbit, Natrol, Casper Sleep, Curaegis Technologies, Smartypants, Thrive Global, Pharmavite and Merck.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.