Sleep habits and strategies of ultramarathon runners.

Among factors impacting performance during an ultramarathon, sleep is an underappreciated factor that has received little attention. The aims of this study were to characterize habitual sleep behaviors in ultramarathon runners and to examine strategies they use to manage sleep before and during ultramarathons. Responses from 636 participants to a questionnaire were considered. This population was found to sleep more on weekends and holidays (7-8 h to 8-9 h) than during weekdays (6-7 h to 7-8 h; p < 0.001). Work was a mediator of napping habits since 19-25% reported napping on work days and 37-56% on non-work days. There were 24.5% of the participants reporting sleep disorders, with more women (38.9%) reporting sleep problems than men (22.0%; p < 0.005). Mean (±SD) sleepiness score on the Epworth Sleepiness Scale was 8.9 ± 4.3 with 37.6% of respondents scoring higher than 10, reflecting excessive daytime sleepiness. Most of the study participants (73.9%) had a strategy to manage sleep preceding an ultramarathon, with 54.7% trying to increase their opportunities for sleep. Only 21% of participants reported that they had a strategy to manage sleep during ultramarathons, with micronaps being the most common strategy specified. Sub-analyses from 221 responses indicated that sleep duration during an ultramarathon was correlated with finish time for races lasting 36-60 h (r = 0.48; p < 0.01) or > 60 h (r = 0.44; p < 0.001). We conclude that sleep duration among ultramarathon runners was comparable to the general population and other athletic populations, yet they reported a lower prevalence of sleep disorders. Daytime sleepiness was among the lowest rates encountered in athletic populations, which may be related to the high percentage of nappers in our population. Sleep extension, by increasing sleep time at night and daytime napping, was the main sleep strategy to prepare for ultramarathons.