# Association between sleep quality and psychological wellbeing in 175 elite adult athletes: a cross-sectional study

## TL;DR

Poor sleep in elite athletes is linked to worse mood and psychological issues, with fatigue being a key factor.

## Contribution

Identifies psychological predictors of sleep disturbance and highlights gender differences in elite athletes.

## Key findings

- Sleep disturbance is strongly associated with psychological fatigue and mood disturbance.
- Fatigue is the strongest predictor of poor sleep quality in elite athletes.
- Female athletes show stronger mood-sleep correlations and higher depression in sleep disturbance.

## Abstract

This study examined the relationship between sleep quality and mood state and identified psychological predictors of sleep disturbance in elite adult athletes.

A stratified cluster sample of 175 elite adult athletes (67 males, 108 females; age 22.6 ± 3.7 yr) was recruited from Sichuan Province, China. Participants with a Pittsburgh Sleep Quality Index (PSQI) score ≥ 5 were classified as having disturbed sleep (n = 87); those scoring < 5 were assigned to the normal-sleep group (n = 88). Sleep quality was assessed with the PSQI; mood state was evaluated with the Profile of Mood States (POMS).

The disturbed-sleep group scored significantly higher than the normal-sleep group on the PSQI global score and on all seven component scales (p < 0.01). Tension, anger, fatigue, depression, confusion, self-esteem and total mood disturbance (TMD) were also markedly elevated in the disturbed-sleep group (p < 0.01). Pearson correlations revealed positive associations between PSQI global score and both fatigue (R = 0.242) and TMD (R = 0.347) (p < 0.01). Multiple linear regression indicated that fatigue (β = 0.581, p < 0.001) and total mood disturbance (TMD, β = 0.218, p = 0.004) were independent predictors of PSQI global score, explaining 57% of the variance (adjusted R2 = 0.57, F(2,172) = 115.59, p < 0.001). Sex-stratified analysis indicated that the correlations between fatigue, TMD and sleep quality were significantly stronger in female athletes (R = 0.368 for fatigue, R = 0.402 for TMD) than in male athletes (R = 0.286 for fatigue, R = 0.312 for TMD), and depression scores in the disturbed-sleep group were significantly higher in females than in males (p = 0.008).

Sleep disturbance in elite athletes is closely associated with psychological fatigue and overall mood disturbance, with fatigue as the core predictor. Significant gender differences exist: the mood-sleep association is stronger in female athletes, and sleep disturbance has a more prominent impact on their depressive mood, requiring targeted interventions.