The Two Overlooked Factors That Can Throw Off Athletes When It Matters Most
You can do everything "right" before a big race and still wake up feeling like something is off. Maybe you spent the night staring at the ceiling, replaying race-day logistics in your head.
Or you arrive at a high-altitude training camp feeling strong, only to find that the thinner air leaves you more tired than expected. These situations can happen even to elite athletes.
Two scientific reviews looked at what happens when sleep gets disrupted or the body has to adjust to altitude, highlighting challenges that can affect performance before an athlete even reaches the starting line.
About the reviews
One systematic review of sleep in elite athletes pulled together 37 studies on sleep quality and disturbances among elite athletes.
The researchers looked at when sleep problems tend to appear, including during intense training, travel, and the lead-up to competition.
The second review on altitude sickness examined what happens when athletes train or compete at higher elevations, where less oxygen is available in the air. It also looked at strategies athletes and coaches can use to help the body adjust and monitor its response.
The pre-race sleep problem is more common than you might think
Across the research, reported sleep disturbance ranged from 13% to 70% among elite athletes. Before competitions specifically, two studies found that 64% to 66% of athletes experienced sleep disturbances. Separate research on female athletes' sleep points to cycle-related differences worth factoring in as well.
Physical fatigue wasn't always the reason. For some athletes, their bodies were tired but their minds were still going. Thoughts about the competition and nervousness can make it harder to fall asleep or stay asleep.
The review identified this mental "switched on" feeling, called cognitive arousal, along with restricted sleep, as key contributors to sleep problems.
Altitude creates a different challenge. Acute mountain sickness affects roughly 25% to 43% of people who ascend to elevations between 2,500 and 4,300 meters. Above 6,000 meters, the rate can climb above 60%. Headache, nausea, fatigue, and dizziness are common symptoms.
Strong cardiovascular fitness doesn't eliminate that risk. At higher elevations, there is less oxygen available, so the body needs time to adjust to the change.
How to prepare when conditions change
The takeaway from both reviews isn't to completely transform an athlete's entire routine. It's to account for demands that fitness alone can't solve.
- Before a big competition: Give yourself 30 to 60 minutes to wind down before bed. Dim the lights, put away stimulating screens, and stick with familiar bedtime cues instead of going straight from race planning to sleep.
- After long-distance travel: Give your sleep routine, and the rest of your post-exercise recovery, some extra attention. Travel was one of the situations the sleep review linked with greater disruption, so don't assume you'll immediately settle back into your normal sleep pattern.
- When heading to altitude: Build in time for your body to adjust before pushing hard. The altitude review recommends roughly one to two days of adaptation for every 600 meters gained above 2,500 meters.
- While training at altitude: A pulse oximeter can help track blood oxygen saturation and give athletes and coaches another piece of information about how the body is responding. It shouldn't replace paying attention to symptoms, but it can add useful context.
The takeaway
Training builds fitness, but it doesn't fully prepare the body for disrupted sleep or a sudden change in altitude.
Planning for those challenges can help athletes protect recovery and perform more consistently when it matters most.