The impact of COVID on sleep & mental health
Coping with COVID in the NBA
A significant consideration by the performance staff heading into the NBA Bubble was the potential accumulative increase in player stress and anxiety associated with adhering to the daily NBA Coronavirus disease (COVID-19) protocols,1 2 environmental transition into the Bubble (quarantine and isolation),3 coupled with training and competition demands. The impact of such cumulative stress and anxiety negatively affects players mental health,4 5 resulting in significant sleep-related issues6 with detrimental effects on player health, recovery and performance.7 The National Basketball Players Association (NBPA) highlighted that the uncertainty of the situation the impact of COVID-19 on the players and staff, likely to result in a range of emotions such as “anxiety, fear, uncertainty, confusion, hypervigilance, depression, an increased sense of vulnerability, boredom, and a heightened awareness of the needs for self-care”.8 In response, the NBA expanded their mental health guidelines by adopting new rules that required all teams to have at least one mental health professional on their full-time staff for 2019-2020 season.1
Sleep strategies used in the NBA bubble
A typical NBA season faces many unique sleep challenges,7 and the importance of sleep on mental health is unquestionable9 with clear association of many if not all mental health problems with sleep-related issues. Additionally, the importance of sleep in the context of the NBA is increasingly recognised by players as an essential element of their preparation.10 11 Thus utilizing sleep strategies in the Bubble would benefit both sleep and mental health as well as performance. The NBA Bubble was unique in eliminating travel entirely. Thus, the bubble served as a real-life experiment with many general managers commenting on how well rested their players appeared to be. To a certain extent, sleep inside the bubble was comparable to sleeping in the Olympic village which comes with its unique set of challenges.12 One main challenge was getting used to the change in pace from a normal travel-congested schedule to no travel, as well as other issues such as proximity to other teams’ members (competitors), loneliness, lack of companionship, feeling isolated and trapped, all of which would increase anxiety. Indeed, for any athlete, particularly NBA rookies, the similarities of such an experience to the first-time Olympian, living in the Olympic Village can be an intimidating prospect.12 Thus, a list of sleep strategies were formulated with the goal of promoting sleep and mental health. Once teams arrived at the bubble, they completed a 48 hours quarantine period and these initial hours served as a way for teams coming from other times zones to the east coast to assist with circadian adjustment. The sleep strategies advised during the NBA bubble are outlined in Table 1. Key to the successful implementation, sleep strategies were simple, easy to understand and not erroneous for player to adapt.
Authors and Affiliations:
Stephen P. Bird, Ph.D.
Associate Professor, Sport and Exercise, School of Health and Wellbeing, University of Southern Queensland, Ipswich QLD Australia
Athlete Health and Performance Lead, Basketball New Zealand, Wellington New Zealand
Meeta Singh, MD
Service Chief and Section Head Henry Ford Sleep Disorders Center Detroit, MI USA
Jonathan Charest, Ph.D.
Department of Psychology, University Laval, Québec City, Quebec, Canada
Centre for Sleep & Human Performance, Calgary, Alberta, Canada
Thomas Huyghe, Ph.D. (c)
Universidad Católica de Murcia, Murcia,Spain
Julio Calleja-Gonzalez, Ph.D.
Department of Physical Education and Sport, University of the Basque Country, Vitoria, Spain
Competing Interests: None for every author
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