Sleep Strategies and Performance Outcomes in Ultramarathon Runners: A Systematic Review
4 affiliations
- 1Physiotherapy Department, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
- 2Physiotherapy Department, Bond University, Gold Coast, Queensland, Australia
- 3Griffith University, School of Allied Health, Sport and Social Work, Parklands Drive, Southport Gold Coast Queensland, Australia
- 4Doctor of Physiotherapy Student, Bond University, Gold Coast, Queensland, Australia
Abstract
Context:: Ultramarathon events impose prolonged physiological and cognitive demands, often spanning 1 or more nights with limited sleep opportunity.
Objective:: To examine associations between pre-race and intra-race sleep strategies and physical and cognitive performance outcomes in ultramarathon runners.
Data Sources:: PubMed, EMBASE, PsycINFO, SPORTDiscus, and Web of Science were searched from inception to July 25, 2025.
Study Selection:: Primary observational or experimental studies published in English, or available in English translation were eligible when they involved ultramarathon runners (>42.2 km) and reported sleep as a variable of interest in relation to race performance or cognitive performance.
Study Design:: Systematic review.
Level of Evidence:: Level 3.
Data Extraction:: Two reviewers independently extracted study design, participant characteristics, race characteristics, sleep outcomes, performance outcomes, and cognitive outcomes. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal checklists.
Results:: Nine studies involving 2262 participants were included, with overall low risk of bias. Of the 4 studies examining pre-race sleep, 3 reported a significant association or group difference with a race-performance outcome. Reduced sleep was generally associated with poorer physical and cognitive performance. Greater intra-race sleep duration was consistently associated with longer finish times, reflecting additional nonmoving time and increased sleep need in longer events. Greater pre-race sleep duration, including sleep extension, was associated with faster finish times, and better pre-race sleep quality was linked to higher cognitive performance.
Conclusion:: Pre-race sleep extension was associated with faster finish times, although the observational evidence does not establish causality. Further research using objective sleep measures and controlled designs is required.
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BibTeX
@article{brown2026sleep,
title = {{Sleep Strategies and Performance Outcomes in Ultramarathon Runners: A Systematic Review}},
author = {Daniel A. Brown and Jason Parreira and Katie Spencer and Serena Skinner and Wataru Goto and Larissa Sattler},
journal = {Sports Health},
year = {2026},
month = oct,
doi = {10.1177/19417381261494498},
url = {https://doi.org/10.1177/19417381261494498},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Sleep Strategies and Performance Outcomes in Ultramarathon Runners: A Systematic Review
AU - Daniel A. Brown
AU - Jason Parreira
AU - Katie Spencer
AU - Serena Skinner
AU - Wataru Goto
AU - Larissa Sattler
PY - 2026
DA - 2026/10/28
JO - Sports Health
DO - 10.1177/19417381261494498
UR - https://doi.org/10.1177/19417381261494498
AB - Context:: Ultramarathon events impose prolonged physiological and cognitive demands, often spanning 1 or more nights with limited sleep opportunity. Objective:: To examine associations between pre-race and intra-race sleep strategies and physical and cognitive performance outcomes in ultramarathon runners. Data Sources:: PubMed, EMBASE, PsycINFO, SPORTDiscus, and Web of Science were searched from inception to July 25, 2025. Study Selection:: Primary observational or experimental studies published in English, or available in English translation were eligible when they involved ultramarathon runners (>42.2 km) and reported sleep as a variable of interest in relation to race performance or cognitive performance. Study Design:: Systematic review. Level of Evidence:: Level 3. Data Extraction:: Two reviewers independently extracted study design, participant characteristics, race characteristics, sleep outcomes, performance outcomes, and cognitive outcomes. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal checklists. Results:: Nine studies involving 2262 participants were included, with overall low risk of bias. Of the 4 studies examining pre-race sleep, 3 reported a significant association or group difference with a race-performance outcome. Reduced sleep was generally associated with poorer physical and cognitive performance. Greater intra-race sleep duration was consistently associated with longer finish times, reflecting additional nonmoving time and increased sleep need in longer events. Greater pre-race sleep duration, including sleep extension, was associated with faster finish times, and better pre-race sleep quality was linked to higher cognitive performance. Conclusion:: Pre-race sleep extension was associated with faster finish times, although the observational evidence does not establish causality. Further research using objective sleep measures and controlled designs is required.
SN - 1941-7381
SN - 1941-0921
ER -