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Adequate sleep is crucial for elite athletes' recovery, performance readiness, and immune response. Establishing reference ranges for elite athletes enables appropriate contextualization for designing and targeting sleep interventions. Purpose: To establish sleep-quality reference ranges for Olympic and Paralympic cohorts using the Pittsburgh Sleep Quality Index (PSQI) and explore differences based on sex and sport types. Methods: Team USA athletes (men = 805, women = 798) completed the PSQI as part of a health-history questionnaire. Descriptive statistics were used to create reference ranges and linear models, and χ2 test of independence determined differences in PSQI global and component scores between sex, games, season, and participation. Results: Six hundred thirty-two (39.43%) athletes reported poor sleep (PSQIGlobal ≥ 5). Men displayed later bedtimes (P =.006), better global PSQI scores, shorter sleep latency, less sleep disturbance, and less use of sleep medication than women (all P <.001). Winter Games participants had later bedtime (P =.036) and sleep offset time (P =.028) compared with Summer Games athletes. Team-sport athletes woke earlier than individual-sport athletes (P <.001). Individual-sport athletes were more likely to have low (P =.005) and mild (P =.045) risk for reduced sleep duration than team-sport athletes. Conclusion: These data provide PSQI-specific reference ranges to identify groups at greatest risk for poor sleep, who may benefit most from targeted sleep interventions. [ABSTRACT FROM AUTHOR]

Background: The purpose of this report is to provide insight and details regarding the development and implementation of an injury and illness surveillance (IIS) system for the United States Olympic and Paralympic Committee (USOPC). Methods: The development and deployment of the IIS employed a multiphase approach. First, researchers determined variables to include in the IIS using the recommendations from the 2020 IOC consensus statement for reporting sport epidemiological data. Second, the hosting and deployment platforms were comprehensively evaluated for their suitability, ease of use, flexibility, and backend data structure (for both capture and aggregation). Third, focus groups consisting of the Sports Medicine department leadership and clinicians piloted the IIS system and revisions were made based on their feedback. Pilot testing of the IIS and follow-up focus groups were then conducted among all departmental clinicians to solicit additional feedback and drive further revisions. Finally, the IIS system was piloted among providers working during the 2023 Pan American and Parapan American Games to refine the system for future Games. After reviewing all potential software platform options (electronic medical record [EMR] system, athlete management systems, secure data collection platforms), Qualtrics (Qualtrics, Provo, UT, USA) was selected to host the IIS system. This choice was made due to the inability of the EMR and athlete-management systems to make frequent updates, modify existing questions, and provide the necessary form logic for the variety of scenarios in which the IIS system would be deployed. Feedback from the department's leadership and clinicians resulted in a number of changes, most notably being the ability to enter multiple diagnoses for a single injury event. Additionally, clinician feedback resulted in the creation of additional diagnostic codes not currently present in the OSIICS v14.0 diagnostic coding system, adding "non-sport" as an additional variable for injury setting, and developing a system for reporting return-to-sport date for time-loss injuries. Discussion: A multi-stage process of extensive planning, stakeholder feedback, and ongoing updates is required in order to successfully develop and implement an IIS system within a National Olympic and Paralynpic Committee. This process can be used to inform the development and implementation of IIS systems in other sporting organizations. [ABSTRACT FROM AUTHOR]

Context: Although fatigue has been implicated in anterior cruciate ligament (ACL) injury, few researchers have examined the timing of injury across a competitive sport season or within a competitive session to gain insight into the potential effects of fatigue on the incidence of ACL injury., Objective: To identify the time segments across a competitive season or within an individual competition associated with the greatest ACL injury incidence., Design: Descriptive epidemiology study., Methods: Data from the National Collegiate Athletic Association Injury Surveillance Program for 2004-2005 through 2015-2016 for basketball, lacrosse, and soccer were analyzed. Incidence rate ratios (IRRs) compared ACL injury rates by sport, sex, season segment, and competition period. Poisson regression was used to examine the associations between each of these categories and the incidence of ACL injury as well as interaction effects., Results: During the early regular season, the incidence rate was elevated relative to the preseason (IRR = 1.86; 95% confidence interval [CI] = 1.27, 2.74), middle regular season (IRR = 1.48; 95% CI = 1.01, 2.15), late regular season (IRR = 1.56; 95% CI = 1.08, 2.27), and postseason (IRR = 2.20; 95% CI = 1.06, 4.56). A sport-by-season interaction indicated this effect was largely attributable to a higher incidence in the early season among lacrosse athletes. An interaction between season segment and competition period ( P = .02) revealed a greater injury incidence before halftime in the early regular season (IRR = 0.38, 95% CI = 0.19, 0.76), but a greater incidence after halftime in the late regular season (IRR = 2.40, 95% CI = 1.15, 5.02). Fewer noncontact injuries occurred in soccer than in basketball or lacrosse., Conclusions: The ACL injury incidence was higher in the early part of the regular season, particularly among lacrosse athletes. Although the injury incidences before and after halftime were similar, further analyses of player time and time of injury within each half are necessary. Coaches and practitioners should be cognizant of the elevated injury incidence during the early season among lacrosse athletes. Future authors should consider more specific analyses to further elucidate the potential role of fatigue development in exacerbating the incidence of ACL injury in collegiate athletes both within games and across the season.