No stop signs/Speed limit/Nobody’s gonna slow me down/Like a wheel/Gonna spin it//I’m on the highway to hell/Highway to hell. (AC/DC, 1979)
We read with great interest the case study by Gattoni et al1 on a novel and experimental intervention called sleep deprivation (SD) training, consisting of a weekly night of SD during 6 weeks prior an ultraendurance competition (ie, a 6-d running race). The topic is of high interest! SD is a major component of ultrarunning performance on distance >100 miles2 and has important health consequences on multiday ultramarathon since it induces an important decrease in velocity throughout the race, leading to a very low intensity in the final part of the race, that likely partly prevents cardiac and neuromuscular fatigue,3 compared with shorter events; in other words, the increasing sleepiness level has indirectly a “protective” effect by impacting the athlete’s pacing and consequently by limiting the load-induced physiological alterations during this type of event.
It is well known that adenosinergic mechanisms modulate individual vulnerability to the detrimental effects of SD, and there is also evidence that sleep regulation is under genetic control4 with evidence that trait vulnerability could not be trained. However, SD poses safety risks in all modes of transportation, particularly in a challenging environment,5 and mountain ultramarathons are among these challenging conditions. Concomitant decreased sleepiness and vigilance may lead to inadequate velocity and to fatal accidents, especially during downhill sections; for example, 32% of the deaths that occurred during mountain running competitions in Western Europe between 2008 and 2019 were due to falls.6
Finally, it is beyond the content of the present letter to comment on the well-identified health consequences (ie, depressed immunity, increased prevalence of metabolic and/or cardiovascular diseases …) of chronic SD. But it raises the point that SD training is at risk for both short (ie, during the ultraendurance event) and long term (ie, if systematized over years by the athlete).
To conclude, because it is ineffective and dangerous, we strongly discourage athletes from practicing SD training. Instead we recommend decreasing sleep propensity and sustaining stability of waking neurobehavioral functions prior to a multiday running race involving sleep loss.2
References
- 1.↑
Gattoni C, Girardi M, O’Neill BV, Maria Marcora S. Sleep deprivation training to reduce the negative effects of sleep loss on endurance performance: a single case study. Int J Sports Physiol Perform. 2021;17(3):499–503. PubMed ID: 34911035 doi:10.1123/ijspp.2021-0230
- 2.↑
Hurdiel R, Riedy SM, Millet GP, et al. Cognitive performance and self-reported sleepiness are modulated by time-of-day during a mountain ultramarathon. Res Sports Med. 2018;26(4):482–489. PubMed ID: 29973086 doi:10.1080/15438627.2018.1492401
- 3.↑
Saugy J, Place N, Millet GY, Degache F, Schena F, Millet GP. Alterations of neuromuscular function after the world’s most challenging mountain ultra-marathon. PLoS One. 2013;8(6):e65596. PubMed ID: 23840345 doi:10.1371/journal.pone.0065596
- 4.↑
Rusterholz T, Tarokh L, Van Dongen HP, Achermann P. Interindividual differences in the dynamics of the homeostatic process are trait-like and distinct for sleep versus wakefulness. J Sleep Res. 2017;26(2):171–178. PubMed ID: 28019041 doi:10.1111/jsr.12483
- 5.↑
Goel N, Rao H, Durmer JS, Dinges DF. Neurocognitive consequences of sleep deprivation. Semin Neurol. 2009;29(4):320–339. PubMed ID: 19742409 doi:10.1055/s-0029-1237117
- 6.↑
Roi GS. Fatal events related to running competitions in the mountains. Wilderness Environ Med. 2021;32(2):176–180. PubMed ID: 33744107 doi:10.1016/j.wem.2020.12.001
