Changes in the Objective Measures of Sleep in Association with Menses Among Female Athletes with Poor Subjective Sleep Quality: Female Athletes with Poor Subjective Sleep Quality Have More Sleep Arousals During Menses

Nat Sci Sleep. 2024 Apr 16:16:381-388. doi: 10.2147/NSS.S449305. eCollection 2024.

Abstract

Purpose: Female athletes with menstrual abnormalities have poor sleep quality. However, whether female athletes with poor sleep quality based on subjective assessment have distinctive changes in objective measures of sleep in association with menses remains unclear. This study aimed to compare changes in objective sleep measurements during and following menses between collegiate female athletes with and without poor subjective sleep quality.

Patients and methods: Female collegiate athletes (age range/mean ± standard deviation: 18-22/ 22.2±1.1) with regular menstrual cycles were recruited. The participants underwent home electroencephalogram monitoring during the first and second nights after the onset of menses and one night between the seventh and 10th nights after menses onset (mid-follicular phase). The Pittsburgh Sleep Quality Index (PSQI) was used to assess the subjective sleep quality. Interactions between the presence of poor subjective sleep quality (ie, PSQI ≥6) and changes in objective measures of sleep in association with menses were analyzed.

Results: Data of 45 athletes, including 13 with poor subjective sleep quality, showed that changes in arousal index in athletes with poor subjective sleep quality were distinctive from those in athletes without poor subjective sleep quality (p = 0.036 for interaction). In athletes with poor subjective sleep quality, the arousal index was significantly increased in menses (p for analysis of variance, 0.015), especially on the first night after the onset of menses compared with during the mid-follicular phase (p = 0.016).

Conclusion: Collegiate female athletes with regular menstrual cycles are likely to have poor subjective sleep quality in association with more frequent arousal during the first night after the onset of menses than during the mid-follicular phase.

Keywords: Pittsburgh sleep quality index; electroencephalogram; menstruation; sports; women.

Grants and funding

This study was supported by the MEXT*-Supported Program for the Strategic Research Foundation at Private Universities, 2014–2018 (*Ministry of Education, Culture, Sports, Science and Technology); Japanese Center for Research on Women in Sport, Juntendo University; Project for Fostering, Survey research for the strategic strengthening of female athletes 2017–2018 by the Japan Sports Agency; the Juntendo University Young Investigator Joint Project Award 2015 (K1517), a Grant-in-Aid for Scientific Research (Grant Number, 26507010); JSPS KAKENHI (Grant Number, JP17K09527; JP18K15904; JP21K08116; JP21K16034; JP21K17604); and a grant to The Intractable Respiratory Diseases and Pulmonary Hypertension Research Group from the Ministry of Health, Labor and Welfare (20FC1027). These funding sources do not have any other roles in this study.