High cortisol levels as a risk factor for athletes poor sleep quality in training centers

Ni Nyoman Mestri Agustini; A. A. B. N. Nuartha; A. A. A Putri Laksmidewi

doi:10.18203/2320-6012.ijrms20251282

Authors

Ni Nyoman Mestri Agustini Department of Neurology and Medical Rehabilitation, Universitas Pendidikan Ganesha, Bali, Indonesia
A. A. B. N. Nuartha Department of Neurology Universitas Udayana, Bali, Indonesia
A. A. A Putri Laksmidewi Department of Neurology Universitas Udayana, Bali, Indonesia

DOI:

https://doi.org/10.18203/2320-6012.ijrms20251282

Keywords:

Cortisol, Low-level sleep quality, Athletes, HPA axis

Abstract

Background: Intense training in athletes may able to disrupt the HPA axis which leads to increased cortisol levels and low- level quality to sleep. This study investigates whether elevated cortisol levels are a risk factor for low-level sleep quality in athletes.

Methods: This case-control study was conducted from June to November 2017 at a training centre in Denpasar. Subjects included athletes are from athletics, badminton, and bicycle racing who are preparing for a national tournament. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and serum cortisol levels were assessed. Bivariate and multivariate analyses were performed to determine the relationship between cortisol levels and sleep quality.

Results: The study included 64 athletes. Cortisol levels were significantly higher in athletes with low-level sleep quality (270.86±93.43 nmol/l) compared to those with good sleep quality (195.84±61 nmol/l). High cortisol levels were strongly associated with low-level sleep quality (OR 7.67; 95% CI 2.52-23.28; p<0.001). Multivariate analysis confirmed high cortisol levels as an independent risk factor for low-level sleep quality (OR 8.19; 95% CI 2.59–25.89; p<0.001). Elevated cortisol levels are a significant independent risk factor for low-level sleep quality in athletes undergoing intense training.

Conclusions: Elevated cortisol independently predicted poor sleep-in athletes undergoing intense physical training.

Metrics

Metrics Loading ...

References

Charest J, Grandner MA. Sleep and Athletic Performance: Impacts on Physical Performance, Mental Performance, Injury Risk and Recovery, and Mental Health. Sleep Med Clin. 2020;15(1):41–57. DOI: https://doi.org/10.1016/j.jsmc.2019.11.005

Edison BR, Christino MA, Rizzone KH. Athletic Identity in Youth Athletes: A Systematic Review of the Literature. Int J Environ Res Public Health. 2021. DOI: https://doi.org/10.3390/ijerph18147331

Renton T, Petersen B, Kennedy S. Investigating correlates of athletic identity and sport-related injury outcomes: a scoping review. BMJ Open. 2021;11(4):1. DOI: https://doi.org/10.1136/bmjopen-2020-044199

Belval LN, Hosokawa Y, Casa DJ, Adams WM, Armstrong LE, Baker LB, et al. Practical Hydration Solutions for Sports. Nutrients. 2019;11(7):1. DOI: https://doi.org/10.3390/nu11071550

Peeling P, Binnie MJ, Goods PSR, Sim M, Burke LM. Evidence-Based Supplements for the Enhancement of Athletic Performance. Int J Sport Nutr Exerc Metab. 2018;28(2):178–87. DOI: https://doi.org/10.1123/ijsnem.2017-0343

Elia C, de Girolamo L, Clarisse B, Galin M, Rehel S, et al. Effects of sleep disturbances and circadian rhythms modifications on cognition in breast cancer women before and after adjuvant chemotherapy: the ICANSLEEP-1 protocol. BMC Cancer. 2023;23(1):1178. DOI: https://doi.org/10.1186/s12885-023-11664-x

Rothe N, Vogel S, Schmelzer K, Kirschbaum C, Penz M, Wekenborg MK, et al. The moderating effect of cortisol and dehydroepiandrosterone on the relation between sleep and depression or burnout. Compr Psychoneuroendocrinol. 2021;7. DOI: https://doi.org/10.1016/j.cpnec.2021.100051

Pulopulos MM, Hidalgo V, Puig-Perez S, Montoliu, T, Salvador A. Relationship between cortisol changes during the night and subjective and objective sleep quality in healthy older people. Int J Environ Res Public Health. 2020;17(4):1.

Liu Y, Fauth EB, Fleming DJM, Lorenz R. Daily Sleep and Anxious and Depressive Symptoms Among Dementia Caregivers-The Mediation of Cortisol Total Output on High- and Low-Stress Days. J Gerontol B Psychol Sci Soc Sci. 2022;77(8):1406–15. DOI: https://doi.org/10.1093/geronb/gbac074

Pulopulos MM, Hidalgo V, Puig-Perez S, Montoliu T, Salvador A. Relationship between cortisol changes during the night and subjective and objective sleep quality in healthy older people. Int J Environ Res Public Health. 2020;17(4):1. DOI: https://doi.org/10.3390/ijerph17041264

Wells PS, Anderson DR, Rodger M, Forgie M, Kearon C, Dreyer J, et al. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. New England Journal of Medicine. 2003. DOI: https://doi.org/10.1056/NEJMoa023153

Multhoff G, Radons J. Radiation, Inflammation, and Immune Responses in Cancer. Front Oncol. 2012. DOI: https://doi.org/10.3389/fonc.2012.00058

Amalia L, Garyani MD, Lailiyya N. Increasing of Cortisol Level and Neutrophil-Lymphocyte-Ratio are Associated with Severity Level and Sleep Disturbances in Acute Ischemic Stroke. Int J Gen Med. 2023;16:5439–48. DOI: https://doi.org/10.2147/IJGM.S439149

Choshen-Hillel S, Ishqer A, Mahameed F, Reiter J, Gozal D, Gileles-Hillel A, Berger I. Acute and chronic sleep deprivation in residents: Cognition and stress biomarkers. Med Educ. 2021;55(2):1. DOI: https://doi.org/10.1111/medu.14296

Miller M, Thompson S, Hart J. Review of Orthopaedics. 2012.

Zhang X, Dai X, Jiao J, Lee SY. Impact of sleep-wake features on fatigue among female shift work nurses. Annals of Medicin. 2023;55(1):1. DOI: https://doi.org/10.1080/07853890.2023.2210843