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A Thirty-Five-Minute Nap Improves Performance and Attention in the 5-M Shuttle Run Test During and Outside Ramadan Observance

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A Thirty-Five-Minute Nap Improves Performance and Attention in the 5-M Shuttle Run Test During and Outside Ramadan Observance sports Article A Thirty-Five-Minute Nap Improves Performance and Attention in the 5-m Shuttle Run Test during and outside Ramadan Observance Hsen Hsouna 1,2, Omar Boukhris 1,2 , Khaled Trabelsi 2,3 , Raouf Abdessalem 1,2, Achraf Ammar 4 , Jordan M. Glenn 5,6 , Nick Bott 6,7, Nizar Souissi 1,2, Paola Lanteri 8 , 9 9,10,11, , 1,2, Sergio Garbarino , Nicola Luigi Bragazzi * y and Hamdi Chtourou y 1 “Physical Activity, Sport and Health” Research Unit, UR18JS01, National Sport Observatory, Tunis 1003, Tunisia; [email protected] (H.H.); [email protected] (O.B.); [email protected] (R.A.); [email protected] (N.S.); [email protected] (H.C.) 2 High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; [email protected] 3 Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia 4 Institute of Sport Science, Otto-von-Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany; [email protected] 5 Department of Health, Exercise Science Research Center Human Performance and Recreation, University of Arkansas, Fayetteville, AR 72701, USA; [email protected] 6 Neurotrack Technologies, 399 Bradford St. Redwood City, CA 94063, USA; [email protected] 7 Department of Medicine, Clinical Excellence Research Center, Stanford University School of Medicine, Stanford, CA 94305, USA 8 Neurophysiopathology Unit, Foundation IRCCS Carlo Besta Neurological Institute, 20133 Milan, Italy; [email protected] 9 Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy; [email protected] 10 Department of Health Sciences (DISSAL), Postgraduate School of Public Health, University of Genoa, 16132 Genoa, Italy 11 Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, ON M3J 1P3, Canada * Correspondence: [email protected] These authors contributed equally. y Received: 27 May 2020; Accepted: 6 July 2020; Published: 11 July 2020 Abstract: Ramadan observance is characterized by several changes in behaviors, such as food and sleep, which could affect physical and cognitive performance. The aim of the present study was to investigate the effects of a 35-min nap (N35) opportunity on physical performance during the 5-m shuttle run test (5mSRT); attention; feelings; mood states; and perceptual measures of stress, fatigue, and muscle soreness during Ramadan observance. Fourteen physically active men (22 3 years, ± 177 4 cm, 76 5 kg) were tested after a no-nap condition (N0), N35 15 days before Ramadan ± ± (BR), the last 10 days of Ramadan (DR), and 20 days after Ramadan (AR). Measures included the digit cancellation test (attention estimation), the profile of mood state (POMS), and the Hooper questionnaires. After a 5-min standard warm-up, participants performed the 5mSRT (6 30 s with × 35 s in between; best distance (BD), total distance (TD), and fatigue index (FI) were recorded), along with the rating of perceived exertion (RPE) after each test repetition. After the 5mSRT test, participants responded to the feeling scale (FS). The results showed that TD and FI during the 5mSRT were not affected by Ramadan observance. However, BD was significantly lower than DR compared to AR after N0 (D = 4.3 1.3%; p < 0.01) and N35 (D = 2.6 1.0%; p < 0.05). After N0, attention decreased − ± − ± significantly at DR in comparison with BR (p < 0.05) and AR (p < 0.001). BD and TD improved after N35 compared to N0 at BR (D = +4.4 2.1%, p < 0.05 for BD and D = +4.8 1.6%, p < 0.01 for TD), ± ± Sports 2020, 8, 98; doi:10.3390/sports8070098 www.mdpi.com/journal/sports Sports 2020, 8, 98 2 of 13 DR (D = +7.1 2.2%, p < 0.05 for BD and D = +5.1 1.6%, p < 0.01 for TD), and AR (D = +5.5 1.5%, ± ± ± p < 0.01 for BD and D = +5.2 1.2%, p < 0.001 for TD). A significant increase in attention was observed ± after N35 in comparison with N0 at DR (p < 0.01) and AR (p < 0.01). However, no changes were found for the perception of mood states, stress, sleep, muscle soreness, and the FI during the 5mSRT. Also, N35 was better than N0 for RPE at DR (p < 0.05), feelings at AR (p < 0.05), and fatigue estimation at AR (p < 0.01). A 35-min nap opportunity may have beneficial effects on physical and cognitive performances before, during, and after Ramadan. Keywords: performance; exercise; fasting; psychological; siesta 1. Introduction Intermittent fasting is an obligation for healthy pubescent Muslims during the month of Ramadan (observance lasting between 29 and 30 days) [1]. During this month, it is prohibited for Muslims to eat, drink, smoke, or have sexual intercourse from dawn to sunset (fasting period) [2]. As a result, these obligations reduce diurnal and increase nocturnal social activities in mainly Muslims countries [3]. Changes in eating schedules as well as other activities (i.e., late prayer (Taraweeh)) have considerable effects on sleep [4–7] and food/fluid intakes [8,9]. Other changes may also be observed during this month [10,11]. For example, Chtourou et al. [3] reported changes in mood states and participant chronotype during the month of Ramadan. With these changes, there is the possibility of negative effects on physical [12–15] and cognitive [11] performances during this month. Boukhris et al. [11] reported a significant decrease in sleep efficiency and duration during and after Ramadan compared to before the fasting month. Similarly, perception of sleep quality was reported to be lower during compared to before Ramadan [16]. In this context, it has been reported that light-sleep stage duration increases significantly during Ramadan. This may be attributed to an increase in the number of awakenings, reflecting increased nighttime metabolism due to the late Souhour meal (last meal before starting the day fast) [17]; it may also be attributed to increased food-seeking behaviors. Additionally, Zerguini et al. [18] suggested that poor sleep quality during Ramadan could be explained by the accommodation of late evening food intake. This reduction in sleep duration may impede physical performance as studies report that sleep reduction has negative impacts on cognitive [19,20] and physical [21,22] performance. As adequate sleep (quantity and quality) is important for maximizing cognitive and physical performance as well as physical recovery [23], recent studies suggest that the inclusion of a short nap during the daytime (i.e., between 13 h and 15 h) may help overcome these detrimental effects in performance. Previously, beneficial effects of a 30-min nap on 20-m sprint times have been reported [24]. When repeated sprint exercise was completed after a bout of sleep deprivation, Hammouda et al. [25] reported positive effects from 20-min and 90-min nap opportunities. The nap-related beneficial effects also exist after a night of normal sleep (25-min nap [26,27] and 45-min nap [28]). For example, during the 5-m shuttle run test (5mSRT), Boukhris et al. [26] and Abdessalem et al. [27] reported that a 25-min nap enhanced physical performance. In this way, Hammouda et al. [25] suggested that a nap opportunity could represent a full sleep cycle, which contains slow wave sleep (SWS) and rapid eye movement (REM) sleep stages. SWS is a known recovery period for daily metabolism. Thus, Boukhris et al. [26] reported that the beneficial effect of nap on physical performance could be explained by an improvement of alertness and reduction of sleepiness and fatigue. As the effects of Ramadan on sleep may represent a series of sleep abnormalities, the inclusion of a nap after sleep during this period may be beneficial for physical and cognitive performance. Therefore, the aim of the present study was to investigate the effects of a 35-min nap before, during, and after Ramadan on physical and cognitive performance in physically active men. In a recent study, Hsouna et al. [29] showed that 25-min of nap opportunity had no significant effect on Sports 2020, 8, 98 3 of 13 the 5mSRT performance and attention before and during Ramadan; a significant positive effect was reported only after Ramadan. The authors suggested that longer nap duration is required to elicit a significant effect on performance during Ramadan. Previous studies evaluating the effects of different nap durations (i.e., 25 min, 35 min, and 45 min) on physical and cognitive performance showed a more beneficial effect of nap of 35 min and 45 min durations compared to 25 min [26,28]. Therefore, we hypothesized that 35-min of nap opportunity before and during Ramadan would improve performance in both categories. We also collected mood states, subjective perception of stress, muscle soreness, fatigue, and sleep quality. We hypothesized that the 35-min nap opportunity would overcome the previously reported negative impacts of Ramadan on mood states [3] and sleep quality [16]. Finally, as Boukhris et al. [11] reported that the reductions in sleep duration during Ramadan were still present after the fasting month, we hypothesized that a 35-min nap would also be beneficial after Ramadan. 2. Materials and Methods 2.1. Participants A minimum of eleven participants was required for inclusion in the present study. This sample size was calculated using the software G*power (version 3.1.9.2; Kiel University, Kiel, Germany, α = 0.05 and power = 0.95) and based on the effect size (= 0.46) shown by Herrera et al. [30]. Due to potential dropout, twenty participants were recruited. Five participants were excluded from the data analysis as they did not complete all required sessions (n = 3) or failed to initiate sleep (n = 2).
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