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Abstract
Sleep is a crucial aspect of recovery and overall well-being, yet many adolescent female athletes
experience disruptions influenced by hormonal changes throughout the menstrual cycle. While
research on elite adult athletes has explored sleep disturbances related to training and competition,
there is limited understanding of how menstrual cycle fluctuations impact sleep in younger athletes.
Variations in estrogen and progesterone levels across the follicular and luteal phases are known to
affect sleep patterns, including sleep quality, duration and onset latency. Increased progesterone in the
luteal phase, for example, has been linked to poorer sleep efficiency and greater difficulty falling
asleep. Additionally, menstrual-related symptoms such as cramps, fatigue, and mood changes may
further interfere with rest and recovery. Given the importance of sleep for athletic performance and
well-being, the first chapter of this thesis seeks to examine the current knowledge on how different
phases of the menstrual cycle influence sleep in adolescent female athletes.
The second chapter of this thesis presents an original study that examined how different phases of the
menstrual cycle affect sleep in adolescent female athletes. Over the course of three menstrual cycles,
ten participants (14.5 ± 1.9) who were in their early-to-mid and mid-to-late pubertal stages, tracked
their sleep using both subjective and objective methods. They recorded sleep duration and perceived
sleep quality in a sleep diary. Simultaneously, wrist-worn actigraphy devices (Fitbit) measured
objective sleep metrics, including sleep duration, sleep quality, sleep onset latency, wake episodes,
and wake time. The reliability of both subjective and objective sleep measures in adolescent female
athletes during the follicular phase (FP) and luteal phases (LP) of the menstrual cycle was examined.
Subjective measures demonstrated poor reliability in the luteal phase (sleep duration: ICC = -0.22;
sleep quality: ICC = -0.49) but fair to good reliability during the follicular phase for sleep duration
(ICC= 0.69; CV = 4.9%) and sleep quality (ICC = 0.57; CV = 8.9%). Objective measures showed
poor reliability during the luteal phase for sleep duration (ICC = -0.17; CV 11%) and sleep quality
(ICC= 0.00; CV = 9.2%) but fair reliability during the follicular phase for sleep duration (ICC = 0.38;
CV = 7.2%) and sleep quality (ICC = 0.51; CV = 5.8%).
When comparing objective data to subjective data, participants overestimated subjective sleep
duration compared to the objective sleep duration data with the average difference being (1.38 h; p =
3.00 x 10-47; effect size = 1.20). When comparing the two menstrual phases, sleep onset latency was
non-significantly worse during the luteal phase compared to the follicular phase (LP = 20.8 mins; FP
= 16.0 mins; p= 0.68; effect size = -1.54). Objective sleep quality was non-significantly worse in the
luteal phase in comparison to the follicular phase (LP = 75.4; FP = 77.1%; p = 0.34; effect size = 1.56)
and sleep duration was non-significantly shorter in the luteal phase compared to the follicular phase
(LP = 9.04 hrs; FP = 9.09 hrs; p = 0.72; effect size = 0.24). Lastly, the mid-late pubertal group had
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significantly longer sleep duration during the follicular phase compared to the early-mid pubertal
group (7.98 vs 7.44 h; p =0.03; effect size = -4.36 ± 0.12).
The final chapter discusses the study’s findings, indicating that although both subjective and objective
measures have their advantages, the subjective measures tended to be more reliable during specific
menstrual cycle phases. The participants underestimated their sleep duration, reinforcing the
importance of combining objective and subjective measures to get more accurate assessments of sleep
duration. The adolescent female athlete’s sleep quality and sleep onset latency can slightly be
impacted by the menstrual cycle phases and sleep patterns were subtly worse during the luteal phase
in comparison to the follicular phase; however, there were no statistically significant differences
observed in the sleep measures studied. Sleep patterns do seem to improve in the mid-late pubertal
maturation stage when compared to the early-mid pubertal stage. The data show that it is important to
understand and take into consideration the menstrual cycle phases and the maturation stages of our
athletes when creating training and recovery plans for these adolescent female athletes; however,
more investigation is required to understand the potential effects of the menstrual cycle on sleep
disturbances and its effect on female participation and performance in sport.
Type
Thesis
Type of thesis
Series
Citation
Date
2025-09-12
Publisher
The University of Waikato
Supervisors
Rights
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