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By: AAST Editor on March 1st, 2018

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Sports & Sleep: An Interview with Amy M. Bender, MS, PhD

Sleep Disorders | sleep technologist

Amy Bender Headshot.jpgProfessional athletes put their bodies through a lot. High-intensity competition, grueling travel schedules, late games — all of this makes good sleep hygiene crucial. A well-rested and recovered athlete plays better than a sleep-deprived one, and professional teams are starting to understand how the sleep health of their athletes impacts wins and losses.

In the first installment of our Sports & Sleep series, we spoke with Amy Bender, MS, PhD., the clinical program director of athlete services at the Centre for Sleep & Human Performance.

Tell me about your work in sports medicine and sleep technology.

I got really lucky and started off in the sleep field as a sleep technologist at a research lab at Washington State University. I received training from world-renowned sleep researchers Drs. Belenky and Van Dongen who were studying the effects of sleep deprivation on cognitive performance. I scored the sleep studies, trained research assistants, kept participants awake, and I also worked at a sleep disorders clinic a few times a month. I got my RPSGT and worked as a sleep technologist for four years, and then I decided to go to graduate school while still working at Washington State University. I got my masters and Ph.D. in Experimental Psychology, and being an athlete myself, I knew that I wanted to get into working with athletes.

After my Ph.D., I did a Mitacs post-doctoral fellowship with the University of Calgary and Centre for Sleep and Human Performance, which is one of only a handful of places specializing in sleep with athletes. Now I am working full time as the Clinical Program Director of Athlete Services. We work with athletes at any level from Professional, Olympic, all the way down to developmental athletes. Our main focus is on sleep optimization which starts with sleep screening using the Athlete Sleep Screening Questionnaire which we developed at the Centre for Sleep and Human Performance. The tool helps identify athletes who need further help from a sleep specialist and is the only sleep screening tool that has been validated in athletes. We want to make sure that the athletes don’t have any underlying sleep problems, so our sleep optimization strategies will help.   

What sports did you play?

I played multiple sports growing up but settled on basketball. I played at the community college level in Spokane where I was inducted into the Hall of Fame, and then I also played at Cal State University – San Bernardino. After college, I did some mountaineering and completed an Ironman in 2009. Currently I am running around chasing my three young children. 

What’s the reaction from the players you work with? Do you have to work with any skepticism?

It’s pretty mixed. There are a lot of athletes who are gung-ho; they want to really find ways to optimize their sleep. They understand how sleep is important and how it can affect their performance. They’re keen to do whatever they can to get better sleep quality and quantity. But there are also some athletes who know what they should be doing but poor habits get in the way. An example of this would be to put electronic devices away an hour before bedtime. We know this is important because of the negative impact of blue light on our circadian rhythms and being able to relax before bedtime to prepare the brain and body for sleep. But our research shows about 90 percent of athletes still use electronics before bedtime. They have the same temptations as all of us. We then need to use the research to inform our advice. So, in the case of electronic devices, we still want to preach to put them away but then also potentially supplement with blue light blocking glasses to help mitigate the effect of the blue light exposure.

What has surprised you the most working with these sports team and their sleep habits?

What we see in the research is around 50 percent of athletes are being flagged as having sleep problems. Intuitively, we knew that wasn’t right. The Athlete Sleep Screening Questionnaire was developed, and we found that it’s probably more around 25 percent. We think it’s a more accurate representation of the sleep problems that are occurring.

Is there a correlation with the type of sport you play and how much sleep you get or need?

This is a good question to explore. It still needs to be answered definitively, but what we find is athletes who are in endurance sports, such as cross-country skiing or long-distance running would need more sleep versus a more cognitively demanding sport such as golf or curling. It is likely the more physically demanding, the more recovery sleep you need.

Why do you think sleep consulting doesn’t get as much attention as it deserves in sports?

It’s hard for coaches and trainers to control that aspect of their athletes’ lives. They’re really focused on what they can control. They can control what type of practice plan they’re going to have, what type of strength program to implement, even nutrition in a way by providing meals for the team. But sleep is something that they can’t necessarily control. Players leave the facility and they are on their own. Despite this, teams and athletes are becoming aware of how important sleep is and an increasing number of teams are hiring sleep specialists to optimize recovery and to help with travel management.

What are you excited to look more into in the future?

Shifting circadian rhythms to align with competition times is something I think could make a huge impact on performance. We know that certain physiological processes peak at certain times of day, so can we manipulate that for the timing of the competition? There’s a little bit of research showing that athletes who are morning types perform better earlier compared to evening types who perform better later. Given competition times are fixed, can we use light to shift the athlete in a direction so they are performing at a peak level internally regardless of the competition time. If we take a ski jumper as an example, their competition time at the Olympics started at 10 pm. This is when melatonin is starting to ramp up and this is not good thing for performance. So, could we shift them to a later phase in order to optimize performance. This is an exciting area to explore.   

Anything else?

Napping is really important, and many athletes don’t take advantage of this performance booster. We found in our research that about 80% of Canadian National Team athletes only nap 1-2 times per week with one-third of athletes not napping at all. Napping does two things, it provides an alertness and mood boost which is going to help you compete harder, but it also helps to erase some of the sleep debt accruing across the week. For most of our athletes, we would recommend about a 20-30-minute nap on important training or competition days so they aren’t waking up in the deeper stages of sleep, and more of a longer 90-minute nap on their days off. However, those athletes who have early morning training sessions may have to take longer naps every day to make up for some of the lost sleep at night. Coaches need to consider building in a nap opportunity into athletes’ schedules.