When it comes to optimal performance, football clubs analyse diet, physiology and a plethora of minute details to ensure players have the best chance of peaking at the right time. One area that may merit greater focus is sleep.
Insomnia and other sleep issues are prevalent across British society. It is estimated that 30% of the population do not enjoy good quality rest but in elite athletes that figure rises to more than 50%.
Sleep deprivation seeps into every part of the body and mind. In football, it makes a player more susceptible to injury and can hinder performance. Addictions to sleeping tablets and the tobacco product snus are becoming more common in the game, and even though there is well-tested treatment, many players avoid it because they do not want to be associated with an addiction or mental health issue.
“Because of the prevalence of sleeping problems in football, there’s a lot of unhealthy habits being developed,” says Dr Eidn Mahmoudzadeh, co-founder of the Sleep Project, which is working with clubs and players. “Many are dependent on sleeping tablets to get them off to sleep, particularly, but not exclusively, after night games. The issue with that is they are not good for you in the long term.”
Footballers face a number of issues that exacerbate the traditional reasons why people cannot sleep. They often work at night, fuelled by adrenaline, and because they get home late, 4am is considered reasonable for a player to get to sleep after an evening game. Some rewatch the match before bed, others find they have no choice but to rerun it in their mind, pondering every decision made. Maintaining a pattern is difficult when they regularly spend nights in hotels and, at elite level, travel to different time zones. Throw in being under the microscope of the general public and, in some cases, having a young family and it is easy to see how rapid eye movement is not what it should be.
Sleeping tablets are regarded as the answer by many players, and prescriptions can help to bring short-term rhythm to sleeping patterns, but they are a poor long‑term solution. Dele Alli has spoken of his addiction to these drugs and Como’s former Tottenham and Everton midfielder is not an isolated case.
Brentford’s Christian Nørgaard has credited the club’s sleep coach, Anna West, with preventing him from developing a sleeping pill addiction. I have spoken to players who have admitted to a sleeping pill addiction, in some cases having become reliant on the tablets when injured to help numb the pain. Medicinal assistance for sleep when injured can become a long‑term crutch.
“They’re addictive,” Mahmoudzadeh says. “They can lead to both physical dependence and psychological dependence. They don’t give you natural sleep and are a sedative, so they basically suppress all brain functions, which is why people lose memory. Their sedative effect helps you drift off, but that doesn’t end up producing natural sleep cycles, so when they wake up, sometimes they get a hangover from the drug itself but they also haven’t had good quality sleep and don’t get the benefits necessarily of the sleep.”
Another issue in football is snus, which provides energy but contains nicotine, which is addictive. Snus, popularised by Scandinavian players, comes in a pouch and is placed under the lip to be absorbed. It provides a stronger hit of nicotine than cigarettes but stays in the system for less time, meaning a user may need to use it with greater regularity. Its spike of nicotine can bring a desire for replenishment and may cause users to wake regularly in the night with withdrawal symptoms.
Although sleep specialists have been involved at certain clubs for years, interest in the area is growing. A report last year estimated that about 14 million people in the UK were living with undiagnosed sleep disorders that were costing the economy billions in lost productivity.
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Kobe Bryant said he worked on doubling the amount of time he slept and that it left him more energised, going from three to four hours a night up to seven or eight, and another leading basketball player, LeBron James, said sufficient sleep was the most important part of recovery from games – and he is still playing at 40.
A 2011 study of NBA players found that increasing sleep levels improved output. Stanford University researchers worked to extend the hours slept by basketball players and then tested their speed and shooting, finding they were faster and had an increase of 9.2% in three-point accuracy. The overall finding was “optimal sleep is likely beneficial in reaching peak athletic performance”.
Research has shown that 69% of people with sleep issues have not sought help, instead living with the problem for an average of six years. Left untreated, it can lead to other problems such as depression, and constant tiredness makes people more susceptible to infection. Cognitive behavioural therapy for insomnia is evidenced to be 70-80% effective but the stigma of such treatment leaves players wary.
“We are fighting against a mindset where people do not want to use psychological therapy, partly because they don’t want clubs to learn about their sleep problems or snus addiction because they don’t want to give their manager a reason to not pick them,” says Mahmoudzadeh, who says his company has been approached by a number of Premier League clubs and has worked extensively with a Women’s Super League team this season.
The game continues to evolve and needs to do more on sleep. Rest is mandatory for individuals to perform in any industry, and considering the physical and psychological demands of football, it should have greater focus. Tiredness infects every aspect of life, and surely that is worth solving.
