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Ramadan Observance Exacerbated the Negative Effects of COVID-19 Lockdown on Sleep and Training Behaviors: A International Survey on 1,681 Muslim Athletes

  • Mohamed Romdhani
  • , Achraf Ammar
  • , Khaled Trabelsi
  • , Hamdi Chtourou
  • , Jacopo A. Vitale
  • , Liwa Masmoudi
  • , Mathieu Nédélec
  • , Dale E. Rae
  • , Ramzi A. Al Horani
  • , Helmi Ben Saad
  • , Nicola Bragazzi
  • , Gürhan Dönmez
  • , Ismail Dergaa
  • , Tarak Driss
  • , Abdulaziz Farooq
  • , Omar Hammouda
  • , Nesrine Harroum
  • , Bahar Hassanmirzaei
  • , Karim Khalladi
  • , Syrine Khemila
  • Leonardo Jose Mataruna-Dos-Santos, Imen Moussa-Chamari, Iñigo Mujika, Hussein Muñoz Helú, Amin Norouzi Fashkhami, Laisa Liane Paineiras-Domingos, Mehrshad Rahbari Khaneghah, Yoshitomo Saita, Maher Souabni, Nizar Souissi, Jad Adrian Washif, Johanna Weber, Piotr Zmijewski, Lee Taylor, Sergio Garbarino, Karim Chamari
    • University of Sfax
    • Sport and Health
    • Otto von Guericke University Magdeburg
    • Johannes Gutenberg University Mainz
    • IRCCS Istituto Ortopedico Galeazzi - Milano
    • The French National Institute of Sport (INSEP)
    • University of Cape Town
    • Yarmouk University
    • University of Sousse
    • University of Genoa
    • Faculty of Science
    • Hacettepe University
    • Primary Health Care Corporation
    • Université Paris Nanterre
    • Aspetar Qatar Orthopedic and Sports Medicine Hospital
    • University of Montreal
    • Tehran University of Medical Sciences
    • IFMARC
    • University of Manouba
    • Coventry University
    • College of Education, Qatar University
    • University of the Basque Country
    • Universidad Finis Terrae
    • Universidad Autònoma de Occidente
    • EPC
    • Universidade do Estado do Rio de Janeiro
    • Universidade Federal da Bahia
    • Juntendo University
    • National Sports Institute of Malaysia
    • Bielefeld University
    • Kiel University
    • Jozef Pilsudski University of Physical Education in Warsaw
    • Loughborough University
    • University of Technology Sydney
    • Catholic University of the Sacred Heart

    Research output: Contribution to journalArticlepeer-review

    21 Scopus citations

    Abstract

    Objective: Disrupted sleep and training behaviors in athletes have been reported during the COVID-19 pandemic. We aimed at investigating the combined effects of Ramadan observance and COVID-19 related lockdown in Muslim athletes. Methods: From an international sample of athletes (n = 3,911), 1,681 Muslim athletes (from 44 countries; 25.1 ± 8.7 years, 38% females, 41% elite, 51% team sport athletes) answered a retrospective, cross-sectional questionnaire relating to their behavioral habits pre- and during- COVID-19 lockdown, including: (i) Pittsburgh sleep quality index (PSQI); (ii) insomnia severity index (ISI); (iii) bespoke questions about training, napping, and eating behaviors, and (iv) questions related to training and sleep behaviors during-lockdown and Ramadan compared to lockdown outside of Ramadan. The survey was disseminated predominately through social media, opening 8 July and closing 30 September 2020. Results: The lockdown reduced sleep quality and increased insomnia severity (both p < 0.001). Compared to non-Muslim (n = 2,230), Muslim athletes reported higher PSQI and ISI scores during-lockdown (both p < 0.001), but not pre-lockdown (p > 0.05). Muslim athletes reported longer (p < 0.001; d = 0.29) and later (p < 0.001; d = 0.14) daytime naps, and an increase in late-night meals (p < 0.001; d = 0.49) during- compared to pre-lockdown, associated with lower sleep quality (all p < 0.001). Both sleep quality (χ2 = 222.6; p < 0.001) and training volume (χ2 = 342.4; p < 0.001) were lower during-lockdown and Ramadan compared to lockdown outside of Ramadan in the Muslims athletes. Conclusion: Muslim athletes reported lower sleep quality and higher insomnia severity during- compared to pre-lockdown, and this was exacerbated by Ramadan observance. Therefore, further attention to Muslim athletes is warranted when a circadian disrupter (e.g., lockdown) occurs during Ramadan.

    Original languageEnglish
    Article number925092
    JournalFrontiers in Nutrition
    Volume9
    DOIs
    StatePublished - 30 Jun 2022

    Keywords

    • confinement
    • pandemic
    • religious fasting
    • sleep-wake pattern
    • training load

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