1.
Does observance of Ramadan affect sleep in athletes and physically active individuals? A systematic review and meta-analysis.
Trabelsi, K, Ammar, A, Glenn, JM, Boukhris, O, Khacharem, A, Bouaziz, B, Zmijewski, P, Lanteri, P, Garbarino, S, Clark, CCT, et al
Journal of sleep research. 2022;(3):e13503
Abstract
The purpose of this systematic review and meta-analysis is to provide an accurate description of the effect of Ramadan observance on sleep duration, sleep quality, daily nap duration, and daytime sleepiness in athletes and physically active individuals. Five electronic databases (PubMed, Web of Science, Scopus, Wiley, and Taylor and Francis) were used to search for relevant studies conducted with athletes or physically active individuals during Ramadan, published in any language, and available before May 23, 2021. Studies that included assessments of sleep quantity and/or quality, and/or daytime sleepiness, and/or daily naps in athletes and physically active individuals were included. The methodological quality of the studies was assessed using "QualSyst". Of the 18 papers included in this study (298 participants in total), 14 were of strong quality, two were moderate, and the remaining two were rated as weak. Individuals who continued to train during Ramadan experienced a decrease in sleep duration (number of studies, K = 17, number of participants, N = 289, g = -0.766, 95% confidence interval [CI] -1.199 to -0.333, p = 0.001). Additionally, the global score of the Pittsburgh Sleep Quality Index increased from 4.053 (K = 5, N = 65, 95% CI 3.071-5.034) pre-Ramadan, to 5.346 (95% CI 4.362-6.333) during Ramadan, indicating a decrease in sleep quality. The duration of daytime naps increased during compared to pre-Ramadan (K = 2, N = 31, g = 1.020, 95% CI 0.595-1.445, p = 0.000), whereas Epworth Sleepiness Scale scores remained unchanged during versus pre-Ramadan (K = 3, N = 31, g = 0.190, 95% CI -0.139-0.519, p = 0.257). In conclusion, individuals who continued to train during Ramadan experienced a decrease in sleep duration, impairment of sleep quality, and increase in daytime nap duration, with no change in daytime sleepiness levels.
2.
Effects of home confinement on mental health and lifestyle behaviours during the COVID-19 outbreak: insights from the ECLB-COVID19 multicentre study.
Ammar, A, Trabelsi, K, Brach, M, Chtourou, H, Boukhris, O, Masmoudi, L, Bouaziz, B, Bentlage, E, How, D, Ahmed, M, et al
Biology of sport. 2021;38(1):9-21
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Plain language summary
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the respiratory syndrome coronavirus 2 (SARS-CoV-2). To curb the spread of the 2020 pandemic, social distancing, self-isolation and nationwide lockdown measures were put in place. These measures along with hygiene care are recognized as the most effective ways to curb the spread of disease. However; the weakening of social contacts can result in anxiety, frustration, panic attacks, loss or sudden increase of appetite, insomnia, depression, mood swings, delusions, fear, sleep disorders, and suicidal/domestic violence. The purpose of the study is to provide scientific data to help identify risk factors for the psychosocial strain during the COVID-19 outbreak. The study is an international cross-disciplinary online survey and was circulated in April 2020. 1047 replies were analysed from this preliminary phase. The results show a significant difference in all tested parameters and therefore reveal a large burden for mental wellbeing combined with a tendency towards an unhealthy lifestyle during, compared to before, the confinement enforced by the COVID-19 pandemic. These results highlight the importance for policy makers to consider strategies to promote wellbeing during future confinements.
Abstract
Although recognised as effective measures to curb the spread of the COVID-19 outbreak, social distancing and self-isolation have been suggested to generate a burden throughout the population. To provide scientific data to help identify risk factors for the psychosocial strain during the COVID-19 outbreak, an international cross-disciplinary online survey was circulated in April 2020. This report outlines the mental, emotional and behavioural consequences of COVID-19 home confinement. The ECLB-COVID19 electronic survey was designed by a steering group of multidisciplinary scientists, following a structured review of the literature. The survey was uploaded and shared on the Google online survey platform and was promoted by thirty-five research organizations from Europe, North Africa, Western Asia and the Americas. Questions were presented in a differential format with questions related to responses "before" and "during" the confinement period. 1047 replies (54% women) from Western Asia (36%), North Africa (40%), Europe (21%) and other continents (3%) were analysed. The COVID-19 home confinement evoked a negative effect on mental wellbeing and emotional status (P < 0.001; 0.43 ≤ d ≤ 0.65) with a greater proportion of individuals experiencing psychosocial and emotional disorders (+10% to +16.5%). These psychosocial tolls were associated with unhealthy lifestyle behaviours with a greater proportion of individuals experiencing (i) physical (+15.2%) and social (+71.2%) inactivity, (ii) poor sleep quality (+12.8%), (iii) unhealthy diet behaviours (+10%), and (iv) unemployment (6%). Conversely, participants demonstrated a greater use (+15%) of technology during the confinement period. These findings elucidate the risk of psychosocial strain during the COVID-19 home confinement period and provide a clear remit for the urgent implementation of technology-based intervention to foster an Active and Healthy Confinement Lifestyle AHCL).
3.
Practical recommendations to improve sleep during Ramadan observance in healthy practitioners of physical activity.
Trabelsi, K, Ammar, A, Zlitni, S, Boukhris, O, Khacharem, A, El-Abed, K, Khanfir, S, Shephard, RJ, Stannard, SR, Bragazzi, NL, et al
La Tunisie medicale. 2019;(10):1077-1086
Abstract
BACKGROUND During the month of Ramadan, many Muslims continue to exercise and/or to compete in sporting events. However, the combination of Ramadan observance (RO) and physical activity (PA) is likely to be associated with disrupted sleep-wake patterns. OBJECTIVES to (i) evaluate the effects of RO on sleep patterns in practitioners of PA and (ii) provide some evidence-based practical recommendations to improve an active individual's sleep patterns during RO. METHODS The entire content of two databases, PubMed/MEDLINE and Web of Science was searched for relevant articles through March, 25 2019. All accepted articles concerned healthy practitioners of PA and have assessed sleep quantity and/or quality and/or daily naps, whether based on objective or subjective methods. RESULTS Thirteen studies evaluated total sleep time (TST) of active individuals in relation to RO; TST decreased in five studies, increased in one and remained unchanged in seven studies. Sleep quality was self-estimated in five studies, with three noting a decreased quality of sleep and two reporting no change. The duration of daily naps was increased in two studies. Conclusions and practical recommendations: Continuation of PA during RO did not decrease TST. However, no firm conclusions can be drawn regarding sleep quality/characteristic and daily naps durations. Sleep quantity and quality should be evaluated in order to counteract sleep disturbances. Physically active individuals should avoid large late night meal, and if possible take 20- to 30- minute daytime naps. A 10- minute shower at ∼40°C and a self-administered 6-min mindfulness induction video may be helpful immediately before bedtime. Tryptophan (1g/day) or melatonin (5- 8mg) supplements may also improve sleep characteristics.