Sleep-Deprived Triathletes Face an Uphill Battle

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When I was an internal medicine intern, my friends used to tell me I was nuts. Back then I would work and work and then work some more, often on no sleep. A typical call day would start at 6 a.m. and end at 5 p.m. the following day. If I slept for an hour during that time I considered myself lucky.

After my shift, I would head to the pool, go for a run or get on my bike for a workout. Sleep became a luxury (not a priority) as I tried to fit everything into my hectic schedule.

Despite the long hours at work, I was determined to stay in shape and keep competing in triathlon. Often I would feel dizzy or lightheaded during these workouts, but trudged through them regardless. Sometimes when I was spinning at the gym I would close my eyes and take one-minute naps. This ludicrous behavior finally ended when I fell asleep and drove off the road returning home from the pool. After that, sleep grew as a priority.

Sleep Isn’t Negotiable

Does this behavior sound similar to your own? As triathletes, we may also wear many other hats in our lives: parent, spouse, busy professional, student or community leader. Juggling it all and finding time to train for triathlon can be difficult.

As a result, triathlon tends to attract disciplined individuals who are successful at multi-tasking behavior, but sometimes it also attracts those who simply take on too many tasks. As we strive to fit in more and more commitments each day, something ultimately gets sacrificed. That something is often our commitment to sleep.

But sleep is not negotiable, and an accumulated sleep deficit can lead to serious consequences both for our health and our performance. In addition, it’s estimated that sleep deprivation and sleep disorders cost this country over $100 billion annually in lost productivity, medical expenses, sick leave and property and environmental damage.

So what about the guy in the office who brags he only needs five hours of sleep a night to function? Well, here is what else he may not be telling you.

Before adulthood we slept all the time, and adequate sleep was essential for growth and development as an infant, child and adolescent. Remember the good old days when we had naptime? Then in early adulthood, we accumulated sleep debt from partying all night or studying late for exams. However we made up for it: we slept late on weekends, took afternoon naps and slept through class in college.

Later, in adulthood, life’s daily tasks increased in number to include career, marriage, children and myriad extracurricular activities. Sleep suddenly became something we did less and less of as the complexity of our lives increased.

But do we really need sleep? The short answer is yes. Sleep is part of an innate biological rhythm that alternates with wakefulness. Controlled by the hypothalamus in the brain, this endogenous rhythm persists even in the absence of time cues, light or dark. During sleep, the heart rate slows, the blood pressure drops and we progress from non-REM sleep to REM (Rapid Eye Movement) sleep. It’s during REM sleep that we dream.

Sleep allows the body to slow down, repair itself and recover. It’s as important as eating, drinking or exercise. For athletes, it’s also an essential part of training, yet for many it’s thoroughly overlooked.

Chronic Sleep Deprivation

The National Sleep Foundation, in their annual review in 2005, estimated that 71 percent of those surveyed slept fewer than eight hours a night, with 16 percent sleeping fewer than six hours. In addition, on average men slept less than women, 6.2 versus 6.8 hours respectively.

And since 1998, the problem seems to be worsening. It’s estimated that more than half of the country’s young adults wake up feeling tired. Those reporting they’re not getting a good night’s sleep also reported more errors at work and daytime sleepiness.

Perpetual sleep loss or deprivation can also be detrimental to our health. Sleep is essential for proper immune function, and chronic sleep deficits can decrease immune cell number and function and increase susceptibility to infections. Accumulating sleep debt can impair motor function and delay visual and auditory reaction times, increasing the risk for motor-vehicle

By Dr. Krishna R. Polu
Triathlete magazine

In addition, chronic sleep loss can diminish mental function, raise blood pressure and precipitate mood disorders such as depression. Sleep-deprived individuals can experience reduced cardiovascular performance and reduced endurance. For the triathlete, the impact on performance may also be profound.

The Tri-angle

In a study published in the medical journal The Lancet, athletes who experienced six successive nights of sleep deprivation (four hours of sleep a night) demonstrated an impaired ability to use glucose. This will not only impair athletic performance but can also hinder recovery and affect the body’s ability to build glucose stores for future use.

In addition, the study showed that sleep-deprived athletes also had elevated levels of the hormone cortisol when compared to controls. Prolonged elevations in cortisol may impair tissue growth and repair and, if the cortisol level persists, may increase the risk for the development of dementia and insulin resistance (i.e., diabetes) in the future. The good news is that these metabolic changes can be reversed when adequate amounts of sleep are achieved in recovery.

Additional studies have shown that extreme sleep deprivation can reduce the time to the point of exhaustion when exercising and increase perceived exertion. There’s controversy over whether sleep deprivation affects heart rate during aerobic exercise, but some studies have suggested a connection between sleep deficits and an inability to achieve maximum heart rates with progressively higher workloads.

However, the evidence is largely inconclusive on whether sleep deprivation affects respiratory gas exchange, VO2 max, lactate production and anaerobic strength. Regardless of what the scientific studies show, however, I tell my patients–athlete or non-athlete–that sleep and adequate rest are essential to their health.

For some, however, avoiding sleep to train or work is not the problem, but rather they have problems sleeping. In many cases, there are medical issues that surround these sleep disorders. The National Institute of Health estimates that up to 40 million Americans have chronic sleep disorders. Individuals who have concerns about their ability to sleep at night or who have problems with daytime sleepiness should see their physician to assist in the diagnosis and treatment of a sleep disorder.

How Much Sleep do we Need?

So how much sleep should we get? The simple answer is as much as we need to feel rested; however, sometimes even this may not be enough. For those triathletes training three to four hours a day, the common adage of eight hours of sleep a night may not be enough for recovery.

However for most triathletes, eight to nine hours is probably ideal. In the modern age, the reality is that this probably doesn’t and won’t happen. Coming from a profession that has created an army of sleep-deprived individuals, I can tell you personally that I crave and love sleep, yet seldom do I get adequate amounts.

Anecdotally, my best workouts and races have always occurred during breaks in my training as a physician when I’ve been well rested. My mood is always better during these times, I find it easier to concentrate on tasks and I find life more manageable.

Training and competing in triathlon has always been an outlet for me in a sea of complex responsibilities. However, when it comes at the sacrifice of sleep, it becomes stressful and less enjoyable.

Unfortunately, sleeping has become equated with laziness and fails to find its way onto our list of priorities. This perception is skewed in a society that is preoccupied with doing too many things at once. Adequate sleep is part of that balance, and in triathlon it may be the most important choice in our preparation for the next race.