Effect of Perceived Stress on Sleep Quality and Nutritional Status in Professional Female Basketball Players

Abstract

Athletes face not only physical strength but also intense psychological stress that leads to sleep problems. It is known that one way to manage stress is to make changes in food intake. This study examined the relationship between perceived stress levels, sleep quality, and nutritional status in professional women basketball players. Eighty adult professional women basketball players (age ≥ 19) in the competitive season competing in the Women's Basketball Super League and the lower league Women's Basketball League affiliated with the Turkish Basketball Federation participated in the study. The survey included player characteristics, anthropometric measurements, food consumption frequency, Perceived Stress Scale (PSS-10), and Pittsburgh Sleep Quality Index (PSQI) sections. The mean score of the basketball players participating in the survey from PSS-10 was 19.3±6.66. The perceived stress level and perception of stress discomfort were significantly higher in the women's league (p <0.05). The mean PSQI total score of the basketball players was 5.9±2.91. In this study, 43.75% of basketball players were found to have good sleep quality, and 56.25% had poor sleep quality. This study's findings showed that the relationship between basketball players’ low self-efficacy scores and average daily fiber intake was negative, and sleep quality worsened as perceived stress levels increased (p <0.05). Athletes are affected by stress, sleep quality, and dietary choices, all of which significantly affect their performance. It is essential to monitor individual athletes' energy and nutrient intake. Understanding the impact of stress on sleep disorders and nutritional factors is crucial for assessment and management.

Keywords

• Athletes
• Basketball
• Diet
• Perceived Stress Scale
• Sleep quality

References

1. Ağargün, M.Y., Kara, H., & Anlar, Ö. (1996). Pittsburgh Uyku Kalitesi İndeksi’nin geçerliliği ve güvenirliliği [Validity and reliability of the Pittsburgh Sleep Quality Index]. Türk Psikiyatri Dergisi, 7(2), 107-115. ISSN:1300-2163
2. Akgün, H., Biçer, M., & Vural, M. (2021). Investigation of mental health of amateur and professional football players in the COVID–19 pandemic period. European Journal of Physical Education and Sport Science, 7(2). https://doi.org/10.46827/ejpe.v7i2.3782
3. Alex, M. L. (2018). Relationship Between Stress, Dietary Intake, and Perception of Performance Amongst Female Long-Distance Runners (Master's thesis, Kent State University).
4. Aydın, G. (2017). Su topu sporcularının stres düzeyi ve problem çözme becerilerinin incelenmesi [Examining the stress level and problem-solving skills of water polo athletes] [Undergraduate thesis, Dumlupınar University].
5. Barbadoro, P., Annino, I., Ponzio, E., Romanelli, R. M., D'Errico, M. M., Prospero, E., & Minelli, A. (2013). Fish oil supplementation reduces cortisol basal levels and perceived stress: a randomized, placebo-controlled trial in abstinent alcoholics. Molecular nutrition & food research, 57(6), 1110–1114. https://doi.org/10.1002/mnfr.201200676
6. Berg Schmidt, J., Johanneson Bertolt, C., Sjödin, A., Ackermann, F., Vibeke Schmedes, A., Lynge Thomsen, H., Marie Juncher, A., & Hjorth, M. F. (2018). Does stress affect food preferences? - a randomized controlled trial investigating the effect of examination stress on measures of food preferences and obesogenic behavior. Stress (Amsterdam, Netherlands), 21(6), 556–563. https://doi.org/10.1080/10253890.2018.1494149
7. Bonnet, M. H., & Arand, D. L. (2010). Hyperarousal and insomnia: State of the science. Sleep Medicine Reviews, 14(1), 9-15. https://doi.org/10.1016/j.smrv.2009.05.002
8. Brandt, R., Bevilacqua, G. G., & Andrade, A. (2017). Perceived sleep quality, mood states, and their relationship with performance among Brazilian elite athletes during a competitive period. Journal of Strength and Conditioning Research, 31(4), 1033-1039. https://doi.org/10.1519/JSC.0000000000001551

9. Buckley, T. M., & Schatzberg, A. F. (2005). On the interactions of the hypothalamic-pituitary-adrenal (HPA) axis and sleep: Normal HPA axis activity and circadian rhythm, exemplary sleep disorders. Journal of Clinical Endocrinology & Metabolism, 90(5), 3106-3114. https://doi.org/10.1210/jc.2004-1056
10. Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193-213. https://doi.org/10.1016/0165-1781(89)90047-4
11. Charest, J., & Grandner, M. A. (2022). Sleep and athletic performance: Impacts on physical performance, mental performance, injury risk and recovery, and mental health: An update. Sleep Medicine Clinics, 17(2), 263-282. https://doi.org/10.1016/j.jsmc.2022.03.006
12. Charmandari, E., Tsigos, C., & Chrousos, G. (2005). Endocrinology of the stress response. Annual Review of Physiology, 67, 259-284. https://doi.org/10.1146/annurev.physiol.67.040403.120816
13. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396. https://doi.org/10.2307/2136404
14. Condo, D., Lastella, M., Aisbett, B., Stevens, A., & Roberts, S. (2022). Sleep duration and quality are associated with nutrient intake in elite female athletes. Journal of Science and Medicine in Sport, 25(4), 345-350. https://doi.org/10.1016/j.jsams.2021.11.045
15. Cutler, B. A., & Dwyer, B. (2020). Student-athlete perceptions of stress, support, and seeking mental health services. Journal of Issues in Intercollegiate Athletics, 13(1), 16.
16. Davenne, D. (2009). Sleep of athletes–problems and possible solutions. Biological Rhythm Research, 40(1), 45-52.
17. de la Cruz Marcos, S., Redondo del Río, M. P., & de Mateo Silleras, B. (2021). Applications of Bioelectrical Impedance Vector Analysis (BIVA) in the Study of Body Composition in Athletes. Applied Sciences, 11(21), 9781. https://doi.org/10.3390/app11219781
18. Eskin, M., Harlak, H., Demirkıran, F., & Dereboy, Ç. (2013). Algılanan stres ölçeğinin Türkçeye uyarlanması: Güvenirlik ve geçerlik analizi [Adaptation of the Perceived Stress Scale into Turkish: Reliability and validity analysis]. Yeni Symposium, 51(3), 132-140.
19. Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191. https://doi.org/10.3758/BF03193146
20. Gunes, F. E., Imeryuz, N., Akalin, A., Bekiroglu, N., Alphan, E., Oguz, A., & Dehghan, M. (2015). Development and validation of a semi-quantitative food frequency questionnaire to assess dietary intake in Turkish adults. JPMA. The Journal of the Pakistan Medical Association, 65(7), 756–763.
21. Güvendi, B., Keskin, N., Altıncı, E. E., & Türksoy, A. (2016). Perceived stress, mood states associated with optimal performance and decision making styles in elite female basketball players. International Refereed Academic Journal of Sports Health and Medical Sciences, 21, 27-38. https://doi.org/10.17363/SSTB.20162124013 Halson, S. L., Johnston, R. D., Appaneal, R. N., Rogers, M. A., Toohey, L. A., Drew, M. K., Sargent, C., & Roach, G. D. (2022). Sleep Quality in Elite Athletes: Normative Values, Reliability and Understanding Contributors to Poor Sleep. Sports medicine (Auckland, N.Z.), 52(2), 417–426. https://doi.org/10.1007/s40279-021-01555-1
22. Hamlin, M. J., Deuchrass, R. W., Olsen, P. D., Choukri, M. A., Marshall, H. C., Lizamore, C. A., Leong, C., & Elliot, C. A. (2021). The Effect of Sleep Quality and Quantity on Athlete's Health and Perceived Training Quality. Frontiers in sports and active living, 3, 705650. https://doi.org/10.3389/fspor.2021.705650
23. Heaton, L. E., Davis, J. K., Rawson, E. S., Nuccio, R. P., Witard, O. C., Stein, K. W., Baar, K., Carter, J. M., & Baker, L. B. (2017). Selected In-Season Nutritional Strategies to Enhance Recovery for Team Sport Athletes: A Practical Overview. Sports medicine (Auckland, N.Z.), 47(11), 2201–2218. https://doi.org/10.1007/s40279-017-0759-2
24. Horner, K. C. (2003). The emotional ear in stress. Neuroscience & Biobehavioral Reviews, 27(5), 437-446. https://doi.org/10.1016/s0149-7634(03)00071-x
25. Hoshino, F., Inaba, H., Edama, M., Natsui, S., Maruyama, S., & Omori, G. (2022). Sleep Quality and Nutrient Intake in Japanese Female University Student-Athletes: A Cross-Sectional Study. Healthcare (Basel, Switzerland), 10(4), 663. https://doi.org/10.3390/healthcare10040663
26. Hyatt, H. W., & Kavazis, A. N. (2019). Body Composition and Perceived Stress through a Calendar Year in NCAA I Female Volleyball Players. International journal of exercise science, 12(5), 433–443.
27. İmamoğlu Kaya, M., Çiçek, G., & İmamoğlu, M. (2020). Kadın Futbolcularda Algılanan Stres, Sporda Güdülenme, Sürekli Öfke ve Öfke Tarzı Düzeyleri. [Perceived Stress, Motivation in Sports, Trait Anger and Anger Style Levels in Female Football Players]. Journal Of International Social Research, 13(74).
28. Kandiah, J., Yake, M., Jones, J., & Meyer, M. (2006). Stress influences appetite and comfort food preferences in college women. Nutrition Research, 26(3), 118-123. https://doi.org/10.1016/j.nutres.2005.11.010
29. Kawasaki, Y., Kasai, T., Koikawa, N., Hanazato, N., Suda, S., Murata, A., Ozaki, R., Nagai, S., Matsumura, Y., Kaneko, H., Kubo, M., Osawa, A., Nojiri, S., Ogasawara, E., Sakuraba, K., Daida, H., Kitade, M., & Itakura, A. (2020). Sex differences in factors associated with poor subjective sleep quality in athletes. The Journal of sports medicine and physical fitness, 60(1), 140–151. https://doi.org/10.23736/S0022-4707.19.09875-X
30. Klerman, E. B., & Hilaire, M. S. (2007). On mathematical modeling of circadian rhythms, performance, and alertness. Journal of Biological Rhythms, 22(2), 91-102. https://doi.org/10.1177/0748730407299200
31. Knufinke, M., Nieuwenhuys, A., Geurts, S. A. E., Coenen, A. M. L., & Kompier, M. A. J. (2018). Self-reported sleep quantity, quality and sleep hygiene in elite athletes. Journal of Sleep Research, 27(1), 78-85. https://doi.org/10.1111/jsr.12509
32. Lim, E. X., Sim, A. Y., Forde, C. G., & Cheon, B. K. (2018). The role of perceived stress and gender on portion selection patterns. Physiology & Behavior, 194, 205-211. https://doi.org/10.1016/j.physbeh.2018.05.031
33. Mancha-Triguero, D., García-Rubio, J., Calleja-González, J., & Ibáñez, S. J. (2019). Physical fitness in basketball players: A systematic review. Journal of Sports Medicine and Physical Fitness, 59(10), 1513-1525. https://doi.org/10.23736/S0022-4707.19.09180-1
34. Mikolajczyk, R. T., El Ansari, W., & Maxwell, A. E. (2009). Food consumption frequency and perceived stress and depressive symptoms among students in three European countries. Nutrition Journal, 8, 31. https://doi.org/10.1186/1475-2891-8-31
35. Mutsuzaki, H., Tsunoda, K., Hotta, K., Yozu, A., Shimizu, Y., & Wadano, Y. (2018). Comparison of sleep status among three Japanese national wheelchair basketball teams. Journal of Physical Therapy Science, 30(1), 63-66. https://doi.org/10.1589/jpts.30.63
36. Nedelec, M., Halson, S., Delecroix, B., Abaidia, A. E., Ahmaidi, S., & Dupont, G. (2015). Sleep hygiene and recovery strategies in elite soccer players. Sports Medicine, 45(11), 1547-1559. https://doi.org/10.1007/s40279-015-0377-9
37. O’Donnell, S., Beaven, C. M., & Driller, M. (2018). Sleep/wake behavior prior to and following competition in elite female netball athletes. Sport Sciences for Health, 14(2), 289-295. https://doi.org/10.1007/s11332-017-0425-y
38. Ohayon, M., Wickwire, E. M., Hirshkowitz, M., Albert, S. M., Avidan, A., Daly, F. J., Dauvilliers, Y., Ferri, R., Fung, C., Gozal, D., Hazen, N., Krystal, A., Lichstein, K., Mallampalli, M., Plazzi, G., Rawding, R., Scheer, F. A., Somers, V., & Vitiello, M. V. (2017). National Sleep Foundation's sleep quality recommendations: first report. Sleep health, 3(1), 6–19. https://doi.org/10.1016/j.sleh.2016.11.006
39. Oliver, G., Wardle, J., & Gibson, E. L. (2000). Stress and food choice: A laboratory study. Psychosomatic Medicine, 62(6), 853-865. https://doi.org/10.1097/00006842-200011000-00016
40. Otter, R. T., Brink, M. S., van der Does, H. T., & Lemmink, K. A. (2016). Monitoring perceived stress and recovery in relation to cycling performance in female athletes. International Journal of Sports Medicine, 37(1), 12-18. https://doi.org/10.1055/s-0035-1555779
41. Öz, H. (2018). Türkiye kadın basketbol süper liginde oynayan basketbolcuların 8 haftalık bireysel kuvvet ve kondisyon programı sonrası antropometrik ve motorik gelişimlerinin değerlendirilmesi [Evaluation of anthropometric and motoric development of basketball players playing in the Turkish women’s basketball super league after an 8-week individual strength and conditioning program] [Master’s thesis, Gelişim University].
42. Parlak, E., & Kırşan, H. (2024). Elit Basketbolcularda Akdeniz Diyeti Uyum Ölçeği ile Uyku Kalitesi Arasındaki İlişkinin İncelenmesi. [Examination of the Relationship Between Mediterranean Diet Compliance Scale and Sleep Quality in Elite Basketball Players]. Osmaniye Korkut Ata Üniversitesi Fen Bilimleri Enstitüsü Dergisi, 7(5), 2158-2172. https://doi.org/10.47495/okufbed.1435102
43. Pascoe, M., Pankowiak, A., Woessner, M., Brockett, C. L., Hanlon, C., Spaaij, R., S. Robertson, S. McLachlan, & Parker, A. (2022). Gender-specific psychosocial stressors influencing mental health among women elite and semielite athletes: a narrative review. British Journal of Sports Medicine, 56(23), 1381-1387. https://doi.org/10.1136/bjsports-2022-105540
44. Power, C. J., Fox, J. L., Teramoto, M., & Scanlan, A. T. (2023). Sleep Patterns Fluctuate Following Training and Games across the Season in a Semi-Professional, Female Basketball Team. Brain sciences, 13(2), 238. https://doi.org/10.3390/brainsci13020238
45. Randell, R. K., Anderson, R., Carter, J. M., & Rollo, I. (2021). Self-reported current sleep behaviors of adult athletes from different competitive levels and sports. Sleep Science, 14(1), 1-7. https://doi.org/10.5935/1984-0063.20200044
46. Richardson, G. S. (2005). The human circadian system in normal and disordered sleep. Journal of Clinical Psychiatry, 66(suppl 9), 42.
47. Richmond, S. R., & Godard, M. P. (2004). The effects of varied rest periods between sets to failure using the bench press in recreationally trained men. Journal of Strength and Conditioning Research, 18(4), 846-849. https://doi.org/10.1519/14833.1
48. Roberts, S. S. H., Main, L. C., Condo, D., Carr, A., Jardine, W., Urwin, C., Convit, L., Rahman, S. S., & Snipe, R. M. J. (2022). Sex differences among endurance athletes in the pre-race relationships between sleep, and perceived stress and recovery. Journal of sports sciences, 40(14), 1542–1551. https://doi.org/10.1080/02640414.2022.2091345
49. Roberts, S. S. H., Teo, W. P., & Warmington, S. A. (2019). Effects of training and competition on the sleep of elite athletes: A systematic review and meta-analysis. British Journal of Sports Medicine, 53(8), 513-522. https://doi.org/10.1136/bjsports-2018-099322
50. Ruiz-Esteban, C., Olmedilla, A., Méndez, I., & Tobal, J. J. (2020). Female soccer players’ psychological profile: Differences between professional and amateur players. International Journal of Environmental Research and Public Health, 17(12), 4357. https://doi.org/10.3390/ijerph17124357
51. Saghafian, F., Sharif, N., Saneei, P., Keshteli, A. H., Hosseinzadeh-Attar, M. J., Afshar, H., Esmaillzadeh, A., Adibi, P. (2021). Consumption of dietary fiber in relation to psychological disorders in adults. Frontiers in psychiatry, 12, 587468. https://doi.org/10.3389/fpsyt.2021.587468
52. Salleh, R. M., Kuan, G., Aziz, M. N. A., Rahim, M. R. A., Rahayu, T., Sulaiman, S., Kusuma, D. W. Y., Adikari, A. M. G. C. P., Razam, M. S. M., Radhakrishnan, A. K., & Appukutty, M. (2021). Effects of Probiotics on Anxiety, Stress, Mood and Fitness of Badminton Players. Nutrients, 13(6), 1783. https://doi.org/10.3390/nu13061783
53. Silva, M. G., & Paiva, T. (2019). Sleep, energy disturbances and pre-competitive stress in female traveller athletes. Sleep Science, 12(4), 279-286. https://doi.org/10.5935/1984-0063.20190093
54. Swinbourne, R., Gill, N., Vaile, J., & Smart, D. (2016). Prevalence of poor sleep quality, sleepiness and obstructive sleep apnoea risk factors in athletes. European Journal of Sport Science, 16(7), 850-858. https://doi.org/10.1080/17461391.2015.1120781
55. Taheri, M., Irandoust, K., Reynoso-Sánchez, L. F., Muñoz-Helú, H., Cruz-Morales, K. N., Torres-Ramírez, R., ... & Nobari, H. (2023). Effects of home confinement on physical activity, nutrition, and sleep quality during the COVID-19 outbreak in amateur and elite athletes. Frontiers in nutrition, 10, 1143340. ttps://doi.org/10.3389/fnut.2023.1143340
56. Tanaka, E., Yatsuya, H., Uemura, M., Murata, C., Otsuka, R., Toyoshima, H., Tamakoshi, K., Sasaki, S., Kawaguchi, L., & Aoyama, A. (2013). Associations of protein, fat, and carbohydrate intakes with insomnia symptoms among middle-aged Japanese workers. Journal of epidemiology, 23(2), 132–138. https://doi.org/10.2188/jea.je20120101
57. Terry, P. C., Galambos, S. A., West, J., & Iizuka, C. A. (2007). Psychological correlates of training load among athletes. In Proceedings of the 42nd Australian Psychological Society Annual Conference: Psychology Making an Impact (pp. 1-5).
58. Thomas, D. T., Erdman, K. A., & Burke, L. M. (2016). American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance. Medicine and science in sports and exercise, 48(3), 543–568. https://doi.org/10.1249/MSS.0000000000000852
59. Uğurlu, F. M. Kadın Basketbolcularda Algılanan Stres Nedenleri Ve Stresle Başa Çıkma Yaklaşımları [Causes of Perceived Stress in Female Basketball Players and Approaches to Coping with Stress]. Journal of History School (JOHS), 2018; 36; 149- 159. http://dx.doi.org/10.14225/Joh1422
60. Wörner, T., Kauppinen, S., & Eek, F. (2024). Same game, different worlds? General conditions, perceived stress, and associations between stress and past season injuries in elite female and male ice hockey players. BMC Sports Science, Medicine and Rehabilitation, 16(1), 69. https://doi.org/10.1186/s13102-024-00862-0
61. Yardımcı, F. B., & Kulunkoglu, B. (2022). Tokyo 2020 paralimpik oyunlarına hazırlanan sporcuların anksiyete, depresyon ve stres düzeylerinin incelenmesi [Examination of anxiety, depression and stress levels of athletes preparing for the 2020 Paralympic Games]. Gazi Journal of Physical Education and Sports Sciences, 27(2), 89-100. https://doi.org/10.53434/gbesbd.987452
62. Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar, A. (2017). The impact of stress on body function: A review. EXCLI Journal, 16, 1057-1072. https://doi.org/10.17179/excli2017-480
63. Yüksel, A. (2021). COVID-19 Pandemi Döneminde Elit Sporcuların Uyku Kalitesi ile Beslenme Durumunun Değerlendirilmesi. OPUS International Journal of Society Researches, 17(Pandemi Özel Sayısı), 3918-3942. https://doi.org/10.26466/opus.909434
64. Zhang, Y., Xun, P., Wang, R., Mao, L., & He, K. (2017). Can magnesium enhance exercise performance? Nutrients, 9(9), 946. https://doi.org/10.3390/nu9090946
65. Zhao, J., Tian, Y., Nie, J., Xu, J., & Liu, D. (2012). Red light and the sleep quality and endurance performance of Chinese female basketball players. Journal of athletic training, 47(6), 673–678. https://doi.org/10.4085/1062-6050-47.6.08
66. Zhao, M., Tuo, H., Wang, S., & Zhao, L. (2020). The effects of dietary nutrition on sleep and sleep disorders. Mediators of Inflammation, 2020, 3142874. https://doi.org/10.1155/2020/3142874