The association of sleep with subjective wellbeing and performance in female athletes: a systematic review

Sleep and athletic performance have been investigated in previous research, showing sleep to be important for cognitive function, mood, and recovery. Inferior sleep has been reported in female athletes compared to male athletes; however, no systematic reviews have examined the association of sleep with performance and subjective wellbeing in female athletes. Three electronic databases (SPORTDiscus, PubMed, and Web of Science) were searched with no date restrictions in June 2024. Studies had to contain primary data and examine any association between sleep and performance in female athletes over the age of 18 years, with their level of competition described. Performance and subjective wellbeing were categorised as sport-specific performance; cognitive performance; physical performance, readiness, and availability; and mood and subjective wellbeing. From 2565 records, 38 studies remained for review. Most studies examined physical performance, readiness, and availability, whereas cognitive performance was the least studied aspect of performance. The majority of studies included in this review supported the general conclusion that positive sleep outcomes were associated with positive performance and subjective wellbeing outcomes (89% of sport-specific performance; 50% of cognitive performance; 38% of physical performance, readiness, and availability; and 21% of mood and subjective wellbeing studies), while negative sleep outcomes were associated with negative performance and subjective wellbeing outcomes (50% of cognitive; 33% of physical, readiness, and availability; and 50% of mood and subjective wellbeing studies) in female athletes. Only 2 studies were of high-quality according to a modified version of the Newcastle-Ottawa Scale, indicating a lack of high-quality evidence in the reviewed literature. Lack of control for sleep, athletic population, and menstrual characteristics were particularly apparent. This review highlights lower sleep duration and/or quality being detrimental to sport-specific performance; cognitive performance; physical performance, readiness, and availability; and mood and subjective wellbeing of female athletes. However, more high-quality research is needed to describe sufficiently the relationship between sleep and performance in female athletes.