Frontiers in Nutrition (Jun 2022)

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

DOI
https://doi.org/10.3389/fnut.2022.925092
Journal volume & issue
Vol. 9

Abstract

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ObjectiveDisrupted 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.MethodsFrom 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.ResultsThe 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.ConclusionMuslim 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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