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

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Romdhani, Mohamed | Ammar, Achraf | Trabelsi, Khaled | Chtourou, Hamdi | Vitale, Jacopo | Masmoudi, Liwa | Nedelec, Mathieu | Rae, Dale | Al Horani, Ramzi | Ben Saad, Helmi | Hammouda, Omar | Bragazzi, Nicola | Dönmez, Gürhan | Dergaa, Ismail | Driss, Tarak | Farooq, Abdulaziz | Harroum, Nesrine | Hassanmirzaei, Bahar | Khalladi, Karim | Khemila, Syrine | Mataruna-Dos-Santos, Leonardo Jose | Moussa-Chamari, Imen | Mujika, Iñigo | Muñoz Helú, Hussein | Norouzi Fashkhami, Amin | Paineiras-Domingos, Laisa Liane | Souabni, Maher | Khaneghah, Mehrshad Rahbari | Souissi, Nizar | Saita, Yoshitomo | Washif, Jad Adrian | Weber, Johanna | Garbarino, Sergio | Zmijewski, Piotr | Taylor, Lee | Chamari, Karim

Edité par CCSD ; Frontiers Media S.A. -

International audience. 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.

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