Article
Sleep Score Overview
Benjamin T. House, Andy J. Galpin, Dan Garner, Vince Kreipke, and Thomas R. Wood

What is The Sleep Score:

Sleep quality and quantity are essential to physical and mental health, yet up to 60% of athletes may be at risk for poor sleep, especially during periods of high training/competitions [1, 2]. Poor sleep can lead to decreases in speed, power, endurance, repeat sprint ability, cognitive performance, and sport‑specific fine motor skills [3, 4]. The Sleep Score aggregates all of the biomarkers that can be negatively affected by poor sleep into one integrated value.

Keywords: Sleep, Performance, Recovery

Associated Biomarkers

Female Biomarkers Male Biomarkers
hsCRP* hsCRP
Neutrophil:Lymphocyte Neutrophil:Lymphocyte Ratio
HbA1c HbA1c
C-Peptide C-Peptide
Insulin Insulin
Triglycerides Triglycerides
IGF-1 IGF-1
Total Testosterone Total Testosterone

Experienced Physiological Effects:

  • Tiredness/ Fatigue
  • Poor mood
  • Low Focus
  • Increased anxiety or easily agitated

Physiology Deep Dive:

Decreased sleep quantity or quality can reduce both testosterone [5, 6] and IGF-1 [7-10], while sleep extension (more total sleep time) can increase these values [11]. Sleep loss is also known to upregulate systemic inflammation [12], as well as decrease insulin sensitivity and overall metabolic health [13, 14]. Chronically impaired sleep reliably increases hunger, blunts satiety signaling, and augments the drive for hyperpalatable foods and larger portion sizes [15, 16]. All of these deleterious effects can lead to negative body composition changes including increased rates of muscle loss, impaired muscle protein synthesis, and elevated visceral fat deposition [15, 17-20]. Poor sleep can also disrupt the immune system leading to increased susceptibility to illness, which can reduce training time and availability, as well as limit the ability to maintain a higher protective chronic workload [21-25]. Reduced sleep can also increase the risk of musculoskeletal injuries in athletes and impair recoverability [4, 26-28]. The sleep score only tells us that sleep may be compromised, however, it does not allow us to differentiate the source, which is typically one of these five main areas: Duration, Timing, Consistency, Quality, and Pathology.

Constraint Zones:

Dark Green:

An increased likelihood of poor sleep quantity or quality was not detected from known blood biomarkers; however, this does not necessarily rule out a sleep-related issue. Prioritizing recovery and sleep are still strongly encouraged.

Green:

Blood results indicate the potential for poor sleep, which could be from inconsistent sleep schedules, misaligned circadian rhythm, insufficient sleep quality, low total sleep time, or possibly the presence of a clinical sleep disorder. Prioritizing recovery and sleep are strongly encouraged.

Yellow:

Blood results indicate an increased likelihood of poor sleep, which could be from inconsistent sleep schedules, misaligned circadian rhythm, insufficient sleep quality, low total sleep time, or possibly the presence of a clinical sleep disorder. Further sleep testing may be warranted.

Red:

Blood results indicate an elevated risk of poor sleep, which could be from inconsistent sleep schedules, misaligned circadian rhythm, insufficient sleep quality, low total sleep time, or possibly the presence of a clinical sleep disorder. Further sleep testing may be warranted

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