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Quality in Sport

Pharmacological and Non-Pharmacological Strategies for Enhancing Sleep Quality in Athletes
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  4. Medical Sciences

Pharmacological and Non-Pharmacological Strategies for Enhancing Sleep Quality in Athletes

Authors

  • Paulina Tymińska Medical University of Silesia https://orcid.org/0009-0004-5624-1599
  • Julia Frączek Śląski Uniwersytet Medyczny w Katowicach https://orcid.org/0009-0005-0239-6824
  • Karolina Borówka Śląski Uniwersytet Medyczny w Katowicach https://orcid.org/0009-0001-5669-1491
  • Wiktoria Donocik Śląski Uniwersytet Medyczny w Katowicach https://orcid.org/0009-0003-3801-6729
  • Piotr Górka Śląski Uniwersytet Medyczny w Katowicach https://orcid.org/0009-0002-1044-8952
  • Natalia Kawka Śląski Uniwersytet Medyczny w Katowicach https://orcid.org/0009-0008-8441-7052

DOI:

https://doi.org/10.12775/QS.2025.41.60176

Keywords

insomnia, disrupted sleep, pharmacotherapy, Athletes

Abstract

Sleep is a critical determinant of recovery, performance, and overall well-being in athletes. Despite its importance, sleep disturbances—including insomnia, delayed sleep onset, and circadian rhythm disruption—are common in athletic populations, driven by both primary factors (e.g., overtraining, evening workouts, jet lag) and secondary factors (e.g., stress, injury, metabolic conditions). These disturbances can impair physical restoration, hormonal balance, and cognitive functioning. This review explores the physiological foundations of sleep in athletes, outlines the multifactorial causes of insomnia, and evaluates pharmacological strategies—including melatonin, non-benzodiazepine hypnotics, cannabidiol (CBD), and certain antidepressants—for managing sleep disorders. While pharmacotherapy may provide short-term benefits in select situations, non-pharmacological approaches such as Cognitive Behavioral Therapy for Insomnia (CBT-I) remain the gold standard due to their long-term efficacy and minimal side effects. An integrated, personalized approach that combines behavioral, physiological, and pharmacological strategies offers the greatest potential for optimizing sleep and supporting sustainable athletic performance.

References

Fullagar HH, Skorski S, Duffield R, Hammes D, Coutts AJ, Meyer T. Sleep and athletic performance: the effects of sleep loss on exercise performance, and physiological and cognitive responses to exercise. Sports Med. 2015;45(2):161–86. https://doi.org/10.1007/s40279-014-0260-0

Walsh NP, Halson SL, Sargent C, Roach GD, Nédélec M, Gupta L, et al. Sleep and the athlete: narrative review and 2021 expert consensus recommendations. Br J Sports Med. 2021;55(7):356–68. https://doi.org/10.1136/bjsports-2020-102025

Simpson NS, Gibbs EL, Matheson GO. Optimizing sleep to maximize performance: implications and recommendations for elite athletes. Scand J Med Sci Sports. 2017;27(3):266–74. https://doi.org/10.1111/sms.12703

Gupta L, Morgan K, Gilchrist S. Does elite sport degrade sleep quality? A systematic review. Sports Med. 2017;47(7):1317–33. https://doi.org/10.1007/s40279-016-0650-6

Patel AK, Reddy V, Shumway KR, Araujo JF. Physiology, Sleep Stages. 2024 Jan 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 30252388.

Van Cauter E, Polonsky KS, Scheen AJ. Modulation of glucose regulation and insulin secretion by circadian rhythmicity and sleep. J Clin Invest. 2000;106(5):653–8. https://doi.org/10.1172/JCI10593

Dattilo M, Antunes HK, Medeiros A, Mônico-Neto M, Souza HS, Tufik S, et al. Sleep and muscle recovery: endocrinological and molecular basis for a new and promising hypothesis. Med Hypotheses. 2011;77(2):220–2. https://doi.org/10.1016/j.mehy.2011.04.017

Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M, et al. Sleep drives metabolite clearance from the adult brain. Science. 2013;342(6156):373–7. https://doi.org/10.1126/science.1241224

Walker MP, Stickgold R. Sleep, memory, and plasticity. Annu Rev Psychol. 2006;57:139–66. https://doi.org/10.1146/annurev.psych.56.091103.070307

Rauchs G, Desgranges B, Foret J, Eustache F. Role of hippocampal sleep-related memory consolidation. Neurobiol Learn Mem. 2005;84(1):119–23. https://doi.org/10.1016/j.nlm.2005.04.007

Smith C. Sleep states and memory processes in humans: procedural versus declarative memory systems. Sleep Med Rev. 2001;5(6):491–506. https://doi.org/10.1053/smrv.2001.0164

Mah CD, Mah KE, Kezirian EJ, Dement WC. The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep. 2011;34(7):943–50. https://doi.org/10.5665/SLEEP.1132

Fullagar HH, Skorski S, Duffield R, Hammes D, Coutts AJ, Meyer T. Sleep and athletic performance: the effects of sleep loss on exercise performance, and physiological and cognitive responses to exercise. Sports Med. 2015;45(2):161–86. https://doi.org/10.1007/s40279-014-0260-0

Leeder J, Glaister M, Pizzoferro K, Dawson J, Pedlar C. Sleep duration and quality in elite athletes measured using wristwatch actigraphy. J Sports Sci. 2012;30(6):541–5. https://doi.org/10.1080/02640414.2012.660188

Vitale KC, Owens R, Hopkins SR, Malhotra A. Sleep hygiene for optimizing recovery in athletes: review and recommendations. Int J Sports Med. 2019;40(8):535–43. https://doi.org/10.1055/a-0905-3103

Juliff LE, Halson SL, Peiffer JJ. Understanding sleep disturbance in athletes prior to important competitions. J Sci Med Sport. 2015;18(1):13–8. https://doi.org/10.1016/j.jsams.2014.02.007

Cho U, Im K. Adolescent athletes’ sleep problems and overtraining: A case study. Sports Psychiatry. 2024;3(1):47–50. https://doi.org/10.1024/2674-0052/a000070

Kellmann M. Preventing overtraining in athletes in high-intensity sports and stress/recovery monitoring. Scand J Med Sci Sports. 2010;20 Suppl 2:95–102. https://doi.org/10.1111/j.1600-0838.2010.01192.x

Meeusen R, Duclos M, Foster C, Fry A, Gleeson M, Nieman D, et al. Prevention, diagnosis, and treatment of the overtraining syndrome: Joint consensus statement. Eur J Sport Sci. 2013;13(1):1–24. https://doi.org/10.1080/17461391.2012.730061

Halson SL, Jeukendrup AE. Does overtraining exist? An analysis of overreaching and overtraining research. Sports Med. 2004;34(14):967–81. https://doi.org/10.2165/00007256-200434140-00003

Samuels C. Sleep, recovery, and performance: the new frontier in high-performance athletics. Neurol Clin. 2009;26(1):169–80. https://doi.org/10.1016/j.ncl.2008.08.001

Kreher JB, Schwartz JB. Overtraining syndrome: a practical guide. Sports Health. 2012;4(2):128–38. https://doi.org/10.1177/1941738111434406

Chtourou H, Souissi N. The effect of training at a specific time of day: a review. J Strength Cond Res. 2012;26(7):1984–2005. https://doi.org/10.1519/JSC.0b013e31825770a7

Thomas AG, Dent J, Middleton B, Zisapel N, Herxheimer A, Skene DJ. Effects of evening exercise on sleep in healthy adults: a systematic review and meta-analysis. Sports Med. 2020;50(7):1259–77. https://doi.org/10.1007/s40279-020-01280-0

Zambotti M, Willoughby AR, Fridel KW, Colrain IM, Baker FC. The effects of physical activity on sleep: a meta-analytic review. Health Psychol Rev. 2016;10(1):59–74. https://doi.org/10.1080/17437199.2014.994746

Barger LK, Wright KP Jr, Hughes RJ, Czeisler CA. Effect of circadian preference on sleep and performance of athletes. Chronobiol Int. 2004;21(2):341–56. https://doi.org/10.1081/CBI-120037447

Myllymäki T, Kyröläinen H, Savolainen K, Hokka L, Jakonen R, Juuti T, et al. Effects of vigorous late-night exercise on sleep quality and cardiac autonomic activity. J Sleep Res. 2011;20(1pt2):146–53. https://doi.org/10.1111/j.1365-2869.2010.00874.x

Alnawwar MA, Alraddadi MI, Algethmi RA, Salem GA, Salem MA, Alharbi AA. The effect of physical activity on sleep quality and sleep disorder: a systematic review. Cureus. 2023;15(8):e43595. https://doi.org/10.7759/cureus.43595

Waterhouse J, Reilly T, Edwards B. The stress of travel. J Sports Sci. 2004;22(10):946–65. https://doi.org/10.1080/02640410400000264

Samuels CH. Jet lag and travel fatigue: a comprehensive management plan for sport medicine physicians and high-performance support teams. Clin J Sport Med. 2012;22(3):268–73. https://doi.org/10.1097/JSM.0b013e31824d2eeb

Reilly T, Edwards B. Altered sleep–wake cycles and physical performance in athletes. Physiol Behav. 2007;90(2–3):274–84. https://doi.org/10.1016/j.physbeh.2006.09.017

Burgess HJ, Eastman CI. Human circadian rhythms and jet lag: causes, consequences, and treatments. Minerva Anestesiol. 2005;71(5):289–98.

Fullagar HHK, Duffield R, Skorski S, Coutts AJ, Julian R, Meyer T. Sleep and athletic performance: the effects of sleep loss on exercise performance, and physiological and cognitive responses to exercise. Sports Med. 2016;46(4):517–32. https://doi.org/10.1007/s40279-015-0440-8

Lastella M, Roach GD, Halson SL, Sargent C. Sleep/wake behaviour of elite athletes: a systematic review and meta-analysis. Sports Med. 2015;45(11):1615–31. https://doi.org/10.1007/s40279-015-0377-3

Fowler PM, Knez W, Duffield R. Effects of long-haul transmeridian travel on athlete readiness and performance: a review of current evidence and practical recommendations. Sports Med. 2015;45(4):515–36. https://doi.org/10.1007/s40279-014-0283-z

Sack RL, Auckley D, Auger RR, Carskadon MA, Wright KP Jr, Vitiello MV, et al. Circadian rhythm sleep disorders: part I, basic principles, shift work and jet lag disorders. Sleep. 2007;30(11):1460–83. https://doi.org/10.1093/sleep/30.11.1460

Haack M, Mullington JM. Sustained sleep restriction reduces emotional and physical well-being. Pain. 2005;119(1–3):56–64. https://doi.org/10.1016/j.pain.2005.09.011

Haack M, Simpson N, Sethna N, Kaur S, Mullington J. Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology. 2020;45(1):205–16. https://doi.org/10.1038/s41386-019-0439-z

Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539–52. https://doi.org/10.1016/j.jpain.2013.08.007

Barone MTU, Menna-Barreto L, Franco DR, Minicucci WJ, Cipolla-Neto J, Duarte C, et al. Sleep and glycemic control in type 1 diabetes. Arch Endocrinol Metab. 2015;59(1):71–8. https://doi.org/10.1590/2359-3997000000024

Resnick HE, Redline S, Shahar E, Gilpin A, Newman A, Walter R, et al. Diabetes and sleep disturbances. Diabetes Care. 2003;26(3):702–9. https://doi.org/10.2337/diacare.26.3.702

Vinik AI, Erbas T, Casellini CM. Diabetic neuropathies: clinical manifestations and current treatment options. Nat Clin Pract Neurol. 2006;2(5):269–78. https://doi.org/10.1038/ncpneuro0175

Baschieri F, Cortelli P. Autonomic control of sleep. Front Neurol. 2019;10:440. https://doi.org/10.3389/fneur.2019.00440

Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic function. Lancet. 1999;354(9188):1435–9. https://doi.org/10.1016/S0140-6736(99)01376-8

Ait Abdellah S, Gal C, Guinobert I, Bardot V, Raverot V, Vitacca A, et al. Melatonin bioavailability after oral administration of a new delayed-release form in healthy male volunteers. Drugs R D. 2024;24(3):415–23. https://doi.org/10.1007/s40268-024-00482-6

Poza JJ, Pujol M, Ortega-Albás JJ, Romero O. Melatonin in sleep disorders. Neurologia (Engl Ed). 2022;37(7):575–85. https://doi.org/10.1016/j.nrl.2018.08.002

Gohari F, Mohammadi S, Ramezani N, Soleimani N, Sayehmiri L, Mirmiranpour H. Effect of melatonin supplementation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. J Neurol. 2022;269(1):205–16. https://doi.org/10.1007/s00415-020-10381-w

Nobari H, Azarian S, Saedmocheshi S, Valdés-Badilla P, García Calvo T. Narrative review: the role of circadian rhythm on sports performance, hormonal regulation, immune system function, and injury prevention in athletes. Heliyon. 2023;9(9):e19636. https://doi.org/10.1016/j.heliyon.2023.e19636

Samuels CH. Jet lag and travel fatigue: a comprehensive management plan for sport medicine physicians and high-performance support teams. Clin J Sport Med. 2012;22(3):268–73. https://doi.org/10.1097/JSM.0b013e31824d2eeb

Grigg-Damberger MM, Ianakieva D. Poor quality control of over-the-counter melatonin: what they say is often not what you get. J Clin Sleep Med. 2017;13(2):163–5. https://doi.org/10.5664/jcsm.6434

Walsh NP, Halson SL, Sargent C, Roach GD, Nédélec M, Gupta L, et al. Sleep and the athlete: narrative review and 2021 expert consensus recommendations. Br J Sports Med. 2020 Nov 3:bjsports-2020-102025. https://doi.org/10.1136/bjsports-2020-102025

Jówko E, Gromisz W, Majerczak J, Żychowska M, Słomińska E. Effects of melatonin supplementation on physical performance and biochemical markers of oxidative stress in elite athletes. J Int Soc Sports Nutr. 2018;15:34. https://doi.org/10.1186/s12970-018-0243-2

Krystal AD. A compendium of placebo-controlled trials of the risks/benefits of pharmacologic treatments for insomnia: the empirical basis for U.S. clinical practice. Sleep Med Rev. 2009;13(4):265–74. https://doi.org/10.1016/j.smrv.2008.08.001

Edinoff AN, Wu N, Ghaffar YT, Prejean R, Gremillion R, Cogburn M, et al. Zolpidem: efficacy and side effects for insomnia. Health Psychol Res. 2021;9(1):24927. https://doi.org/10.52965/001c.24927

Caldwell JA, Caldwell JL, Crowley JS, Jones HD. Zolpidem improves performance and alertness in sleep-deprived aviators. Aviat Space Environ Med. 2003;74(7):659–65.

Janse van Rensburg DCC, Fowler P, Racinais S. Practical tips to manage travel fatigue and jet lag in athletes. Br J Sports Med. 2021;55(15):821–2. https://doi.org/10.1136/bjsports-2020-103163

Morin CM, Benca R. Chronic insomnia. Lancet. 2012;379(9821):1129–41. https://doi.org/10.1016/S0140-6736(11)60750-2

Hirschbeck A, Leao DS, Wagner E, Hasan A, Roeh A. Psychiatric medication and physical performance parameters—are there implications for treatment? Front Psychiatry. 2022;13:985983. https://doi.org/10.3389/fpsyt.2022.985983

Shannon S, Lewis N, Lee H. Cannabidiol in anxiety and sleep: a large case series. Perm J. 2019;23:18-041. https://doi.org/10.7812/TPP/18-041

Kaul M, Zee PC, Sahni AS. Effects of cannabinoids on sleep and their therapeutic potential for sleep disorders. Neurotherapeutics. 2021;18(1):217–27. https://doi.org/10.1007/s13311-021-01013-w

McCartney D, Benson MJ, Desbrow B. A narrative review of the effects of cannabidiol on sport and exercise performance. Sports Med. 2020;50(2):249–59. https://doi.org/10.1007/s40279-019-01183-8

Monti JM, Pandi-Perumal SR. Clinical management of sleep and sleep disorders with cannabis and cannabinoids: implications to practicing psychiatrists. Clin Neuropharmacol. 2022;45(2):27–31. https://doi.org/10.1097/WNF.0000000000000494

World Anti-Doping Agency (WADA). Prohibited List 2024. https://www.wada-ama.org

Ranum RM, Whipple MO, Croghan I, Bauer B, Toussaint LL, Vincent A. Use of cannabidiol in the management of insomnia: a systematic review. Cannabis Cannabinoid Res. 2023;8(2):213–29. https://doi.org/10.1089/can.2022.0122

Wichniak A, Wierzbicka A, Jernajczyk W. Sleep and antidepressant treatment. Curr Pharm Des. 2017;23(34):5716–29. https://doi.org/10.2174/1381612823666170714120109

Reardon CL. General approaches to management of mental health in elite athletes: pharmacological treatment. In: Reardon CL, editor. Mental Health Care for Elite Athletes. Cham: Springer; 2022. https://doi.org/10.1007/978-3-031-08364-8_3

Mikutta CA, Wyssen A, Müller TJ. Sleep and sleep disorders in elite athletes. In: Baron D, Wenzel T, Ströhle A, Stull T, editors. Sport and Mental Health. Cham: Springer; 2023. https://doi.org/10.1007/978-3-031-36864-6_5

Riemann D, Baglioni C, Bassetti C, Bjorvatn B, Dolenc Groselj L, Ellis JG, et al. European guideline for the diagnosis and treatment of insomnia. J Sleep Res. 2017;26(6):675–700.

Kokkali M, Pinioti E, Lappas AS, Christodoulou N, Samara MT. Effects of trazodone on sleep: a systematic review and meta-analysis. CNS Drugs. 2024;38(10):753–69. https://doi.org/10.1007/s40263-024-01110-2

Del Rio Verduzco A, Salari A, Haghparast P. Efficacy and safety of pharmacotherapy in chronic insomnia: a review of clinical guidelines and case reports. Ment Health Clin. 2023;13(5):244–54. https://doi.org/10.9740/mhc.2023.10.244

Edinger JD, Means MK. Cognitive-behavioral therapy for primary insomnia. Clin Psychol Rev. 2005;25(5):539–58. https://doi.org/10.1016/j.cpr.2005.04.003

Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D. Cognitive behavioral therapy for chronic insomnia: a systematic review and meta-analysis. Ann Intern Med. 2015;163(3):191–204. https://doi.org/10.7326/M14-2841

Ong JC, Manber R. Combining CBT-I and pharmacotherapy for insomnia: what are the advantages? Sleep Med Rev. 2011;15(1):37–45. https://doi.org/10.1016/j.smrv.2010.06.001

Morin CM, Benca R. Chronic insomnia. Lancet. 2012;379(9821):1129–41. https://doi.org/10.1016/S0140-6736(11)60750-2

Winkelman JW, Buxton OM, Ferber R. When should pharmacological interventions for insomnia be recommended? AMA J Ethics. 2021;23(10):E777–84. https://doi.org/10.1001/amajethics.2021.777

Riemann D, Baglioni C, Bassetti C, et al. European guideline for the diagnosis and treatment of insomnia. J Sleep Res. 2017;26(6):675–700. https://doi.org/10.1111/jsr.12594

Ashton H. The diagnosis and management of benzodiazepine dependence. Curr Opin Psychiatry. 2005;18(3):249–55. https://doi.org/10.1097/01.yco.0000165594.60434.84

Kainz K, Kappel V, Egloff M, Gärtner B, Steinacker JM. Substance use disorders in elite athletes: a narrative review. Sports Med. 2022;52(1):17–31. https://doi.org/10.1007/s40279-021-01537-7

Bahr R, Andersen TE, Løken S, Fossan B, Hansen T, Holme I. Low injury rate strongly correlates with team success in Norwegian professional football. Br J Sports Med. 2008;42(6):384–8. https://doi.org/10.1136/bjsm.2007.044558

McDuff DR, Baron D. Substance use in athletics: a sports psychiatry perspective. Clin Sports Med. 2005;24(2):885–97. https://doi.org/10.1016/j.csm.2005.01.001

Riemann D, Baglioni C, Bassetti C, Bjorvatn B, Dolenc Groselj L, Ellis JG, et al. European guideline for the diagnosis and treatment of insomnia. J Sleep Res. 2017;26(6):675–700. https://doi.org/10.1111/jsr.12594

Quality in Sport

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2025-05-11

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TYMIŃSKA, Paulina, FRĄCZEK , Julia, BORÓWKA, Karolina, DONOCIK, Wiktoria, GÓRKA, Piotr and KAWKA, Natalia. Pharmacological and Non-Pharmacological Strategies for Enhancing Sleep Quality in Athletes. Quality in Sport. Online. 11 May 2025. Vol. 41, p. 60176. [Accessed 28 June 2025]. DOI 10.12775/QS.2025.41.60176.
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Copyright (c) 2025 Paulina Tymińska, Julia Frączek , Karolina Borówka, Wiktoria Donocik, Piotr Górka, Natalia Kawka

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