The professional sports world appears to be continuing to turn more of its attention to what has been a much-overlooked issue: sleep. This time, it's the National Hockey League that is addressing sleep problems on several fronts.
In response to reports of widespread use, the NHL and the NHL Players' Association are working together to study the use of Ambien by players in the league. The results of the study are expected later this spring, when the league is expected to issue its findings and make recommendations about use of the prescription sleep medication.
The issue of sports-related drug use -- particularly the performance-enhancing kind -- is of course widespread in professional sports these days, and has been for some time. For many years, rightly or wrongly, hockey has been thought of as a sport less riddled with performance-enhancing drugs. But steroids and other performance-enhancing drugs are only part of the drug problem in sports. Prescription drug use -- including excessive or inadvisable use of sleep medications -- is also a problem in the world of competitive athletics.
And the NHL is no exception. The death of NHL player Derek Boogaard is a sad and sobering example: The 27-year-old died of a drug and alcohol overdose in 2011. Investigations into his death revealed that he was in possession of a frightening array of drugs, including a dozen or more prescriptions for Ambien, which he'd received from several different doctors.
Sleep problems are a serious issue for professional athletes, whose intense training, rigorous schedules, and frequent travel across time zones put them at high risk for disrupted and insufficient sleep. Pro athletes crisscrossing the country, often flying overnight before waking up to an early-morning practice or next-day game, share risks for sleep problems with other high-frequency travelers and people who work non-traditional schedules. People in these jobs -- from law enforcement to doctors and nurses to airline personnel and air-traffic controllers -- are at higher risk for sleep disorders such as insomnia and obstructive sleep apnea. They also can be at elevated risk for health problems associated with poor sleep, including obesity, Type 2 diabetes, and cardiovascular disease.
In addition to studying the use of Ambien, the NHL has also taken other steps to address sleep issues among its players. In its most recent agreement with the NHL Players' Association, the NHL made changes to league policies that are intended to provide players with better rest during the season. The new rules include a minimum of four days off per month during the season, and a minimum nine-hour break between flight touchdown and the beginning of the next practice when players are on the road. While these changes may seem modest, they do appear to reflect a growing awareness of the need to protect athletes' ability to sleep. It is my hope that they also reflect an understanding that sleep medication is not the first -- nor always the best -- recourse for improving sleep.
I wrote last fall about the New York Jets' decision to hire sleep specialists to work with players on improving their sleep habits, and the sleep-friendly adjustments made to the team's practice schedule. This is exactly the kind of attention I like to see being put toward improving sleep -- the kind that addresses lifestyle changes in manageable, sustainable ways rather than jumping right to sleep medication as the catch-all solution to sleep problems. I hope we see more of these sorts of strategies implemented by professional sports teams and leagues.
The study of sleep's effects on sports is relatively new, but there is a growing body of evidence to show that sleep can boost athletes' performance on their field of play. There is also research that shows how lack of sleep may have negative consequences for athletes:
- Research at Stanford University's Center for Sleep Sciences and Medicine has shown sleep linked to measurable improvements to performance across a range of sports. From swimming to basketball to football, collegiate players in these studies improved speed, accuracy, and reaction times when they increased their nightly sleep.
- There is also research that indicates sleep may play an important role in post-exercise recovery, which is considered a critical to maintaining athletic performance over the course of a season and a career.
- When professional athletes don't get enough sleep, they may be shortening the overall lengths of their careers. That's the message from a pair of studies that found that low sleep was associated with shorter career spans and more frequent trades, in both professional football and professional baseball.
It's not that sleep medications like Ambien don't have any place in the treatment of disordered sleep. They do. But prescription sleep medications need to be carefully prescribed and monitored, and they are rarely, if ever, the best first step in a treatment plan to improve sleep. This is true for the men and women of professional sports. It's also true for the rest of us, who want to be at the top of our game in our daily lives.
Michael J. Breus, PhD
The Sleep Doctor™
Everything you do, you do better with a good night's sleep™
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