INCREASED HOURS OF TRAINING PER WEEK IS ASSOCIATED WITH DECREASED SLEEP IN PEDIATRIC & ADOLESCENT ATHLETES

Matthew D. Milewski; Caitlin M. McCracken; Bill Meehan; Andrea Stracciolini

摘要

BACKGROUND Sleep duration and sport specialization have been shown to affect injury profile in young athletes. The interplay between training hours per week, and, multiple versus single sports participation on sleep hours in young athletes is unknown. Purpose/Objective To investigate associations between single sport participation and training volume, with sleep hours, in pediatric and adolescent athletes. METHODS Study design: Cross-sectional epidemiological study was conducted using electronic questionnaire data from an injury prevention evaluation (IPE) at a sports injury prevention center affiliated with a tertiary level pediatric medical center between April 2013 and February 2018. Data analysis included sports participation, previous injury history, training regimen, and sleeping habits. For each sport selected, athletes were asked about average number of practice hours for each sport and number of seasons training for the sport during the year. All athletes aged 11-18 years were included in the study. Main outcome measures include sleep duration, single sport, and training hours/seasons. Single sport athletes were defined as those athletes who listed participation in only one sport year-round. Binary measures were created to indicate 1)any participant that listed practicing & 10 hour/week for any sport during a season and 2) any participant that trains three or more seasons for any sport in which they participate. Multivariate regression models (M1, M2, M3) were created for soccer athletes to control for sport training differences while testing the independent effect of gender, age and sport training. Based on the results univariate linear regression of hours of sleep was stratified by age and gender and regressed by self-reported hours of practice per week, identification as single sport athlete, training three or more seasons for soccer. RESULTS There were 756 athletes, 11-18 years old, included (mean age 13.5±2.5 years; 56% female (N=426)). For female athletes, figure skating (46%, 11/24), dance (42%, 28/67), and gymnastics (25%, 12/47) lead the list for single sport athletes. In comparison, for male athletes, swimming (26%, 5/19), tennis (19%, 5/26) and soccer (13%, 16/120) lead the list. The overwhelming majority of gymnasts, dancers, and figure skaters (88% (38/43), 83% (54/66) and 83%, (20/24)) train = 3 seasons of the year. In comparison, for male athletes, tennis athletes (62%, 16/25) seem to train = 3 seasons of the year followed by soccer (41%, 49/119) and swimming (39%, 7/18). (Tables 1 and 2) Table 3 presents multivariate linear regression coefficient of weeknight hours slept by practice hours, gender, age and sport characteristics for soccer participants using three different models (M1, M2, M3). Younger athletes, ages 11-14 years, slept nearly an hour more than participants aged 15-18 years across all training types. Only female soccer athletes training = 3 seasons slept significantly less (? -0.24, SE 0.12, 95%) than their male counterparts. Participants that practiced soccer & 10 hours/week slept significantly, and substantively, less than their peers practicing =3 or less hours/week (? -0.61, SE 0.17, 95%). Table 4 presents all participants and sport type stratified by age and sex. Practicing more than 10 hours/week was significant in males ages 11-14 years. Middle school aged males, practicing & 10 hours/week for any sport in which they participate over the course of the year, slept over half an hour less than their peers that practiced fewer hours (? -0.65, SE 0.2, 95%). CONCLUSIONS/SIGNIFICANCE Training volume appears to affect sleep in young athletes. Middle school male athletes practicing greater than 10 hours/week appear to sleep less than their peers. Anticipatory guidance surrounding training may help to improve sleep hygiene in pediatric and adolescent athletes. Table 1. Female Participants Age, Sleep and Practice by Sport. N Participant Age M(SD) Weeknight Hrs. Slept M(SD) Practice (Week/hours) MD(IQR) Train 3 or more seasons n/N(%) Single Sport n/N(%) Dance 67 13 (3) 7.8 (14) 6 (7) 54/66(83) 28/67(42) Field Hockey 36 14.5 (2) 7.9(1.2) 8(7) 8/36(22) 3/33(8) Figure Skating 24 13(3) 8.2(1.4) 2(4) 20/24(83) 11/24(46) Cross Country 23 14(1.5) 7.2(1.1) 4(5) 1/23(4) 0 Swimming 47 13(2) 8.3 (1.3) 5.5(6) 16.45(36) 3/47(6) Softball 45 13(2.5) 8.2(1.4) 4(5) 10/45(22) 3/42(7) Lacrosse Women 96 13.5(2) 8.2 ( 1.0 ) 3(5) 24/95(25) 0 Tennis 32 12.5(2) 8.7(10) 2(6) 10/31(32) 3/32(9) Track - running 51 15(2) 7.3 (1.0) 6(6) 5/51(10) 1/51(2) Track - field 18 16(1.5) 7.0(10) 6(3) 2/18(11) 0 Soccer 203 13(2) 8-2(1.2) 7(6) 113/201(56) 23/203(11) Ice Hockey 31 13(2.5) 8-2(1.1) 5(4) 17/30(57) 2/31(6) Gymnastics 47 11(3) 8.8(1.2) 12(10) 38/43(88) 12/47(25) Volleyball 19 15(2) 7.7(1.0) 8(11) 1/19(5) 0 Basketball 111 13.5(2) 8.02(1.2) 7(6) 31/111(28) 6/111(5) Note: Sports with 15 participants included. Table 2. Male Participants Age, Sleep and Practice by Sport. N Participant A

机译：背景技术睡眠时间和运动专业化已显示出影响年轻运动员的伤害状况。未知每周训练时间与年轻运动员的睡眠时间之间进行多次与单次运动之间的相互作用。目的/目的调查儿童和青少年运动员的单项运动参与和训练量与睡眠时间之间的关联。方法研究设计：横断面流行病学研究是在2013年4月至2018年2月之间，使用电子问卷调查数据从伤害预防评估（IPE）处的伤害预防评估中心（附属于三级儿科医学中心）进行的。数据分析包括运动参与，以前的受伤史，训练方案和睡眠习惯。对于每项选定的运动，向运动员询问一年中每种运动的平均练习时数和赛季训练的次数。所有年龄在11-18岁之间的运动员都包括在研究中。主要结果指标包括睡眠时间，单项运动和训练时数/季节。单身运动运动员的定义是那些只参加一年运动的运动员。创建了二进制度量以指示1）任何列出了练习＆一个赛季中任何一项运动每周10个小时，以及2）任何参加了为其参加的任何一项运动训练三个或更多季节的参与者。为足球运动员创建了多元回归模型（M1，M2，M3），以控制运动训练差异，同时测试性别，年龄和运动训练的独立影响。根据结果，睡眠时间的单变量线性回归按年龄和性别进行分层，并根据每周自我报告的练习时间进行回归，确定为单身运动运动员，训练三个或三个以上的足球赛季。结果包括756名11-18岁的运动员（平均年龄13.5±2.5岁; 56％的女性（N = 426））。对于女运动员，花样滑冰（46％，11/24），舞蹈（42％，28/67）和体操（25％，12/47）居单身运动运动员榜首。相比之下，男性运动员中，游泳（26％，5/19），网球（19％，5/26）和足球（13％，16/120）位居榜首。绝大多数的体操运动员，舞者和花样滑冰运动员（88％（38/43），83％（54/66）和83％（20/24））训练=一年的三个季节。相比之下，对于男性运动员，网球运动员（62％，16/25）似乎训练=一年中的3个季节，其次是足球（41％，49/119）和游泳（39％，7/18）。（表1和表2）表3给出了使用三种不同模型（M1，M2，M3）的足球参与者在工作时间，性别，年龄和运动特征上所睡着的工作时间，睡眠时间的多元线性回归系数。在所有训练类型中，年龄11至14岁的年轻运动员比年龄15至18岁的参与者多睡了一个小时。仅训练了3个季节的女足球运动员的睡眠水平显着低于男性足球运动员（？-0.24，SE 0.12，95％）。参加过足球的参加者＆每周10个小时的睡眠时间显着，实质上比他们的同龄人每周3个小时或更少的睡眠时间少（？-0.61，SE 0.17，95％）。表4列出了按年龄和性别分类的所有参与者和运动类型。在11-14岁的男性中，每周练习10个小时以上很重要。中等年龄的男性，正在练习＆他们一年中参加的任何运动每周10个小时，比同等运动时间更少的同龄人睡了半小时以上（？-0.65，SE 0.2，95％）。结论/意义训练量似乎影响年轻运动员的睡眠。每周练习超过10个小时的中学男运动员的睡眠时间似乎少于同龄人。围绕训练的预期指导可能有助于改善小儿和青少年运动员的睡眠卫生。表1.女性参与者的年龄，睡眠和体育锻炼。 N参与者年龄M（SD）周末睡眠M（SD）练习（周/小时）MD（IQR）训练3个或更多季节n / N（％）单项运动n / N（％）舞蹈67 13（3）7.8（14）6（7）54 / 66（83）28/67（42）曲棍球36 14.5（2）7.9（1.2）8（7）8/36（22）3/33（8）花样滑冰24 13（3）8.2（1.4）2（ 4）20/24（83）11/24（46）越野23 14（1.5）7.2（1.1）4（5）1/23（4）0游泳47 13（2）8.3（1.3）5.5（6） 16.45（36）3/47（6）垒球45 13（2.5）8.2（1.4）4（5）10/45（22）3/42（7）曲棍网兜球女士96 13.5（2）8.2（1.0）3（5 ）24/95（25）0网球32 12.5（2）8.7（10）2（6）10/31（32）3/32（9）跑道51 15（2）7.3（1.0）6（6） 5/51（10）1/51（2）田径场18 16（1.5）7.0（10）6（3）2/18（11）0足球203 13（2）8-2（1.2）7（6 ）113/201（56）23/203（11）冰上曲棍球31 13（2.5）8-2（1.1）5（4）17/30（57）2/31（6）体操47 11（3）8.8（ 1.2）12（10）38/43（88）12/47（25）排球19 15（2）7.7（1.0）8（11）1/19（5）0篮球111 13.5（2）8.02（1.2）7 （6）31/111（28）6/111（5）注意：包括15名参与者的运动。表2.男性参与者的年龄，睡眠和体育锻炼。 N参加者A

INCREASED HOURS OF TRAINING PER WEEK IS ASSOCIATED WITH DECREASED SLEEP IN PEDIATRIC & ADOLESCENT ATHLETES

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