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This article, titled "EP07.70: Thickened nuchal translucency with a normal karyotype: management and prognosis," discusses the prognosis and management of fetuses with a thickened nuchal translucency but a normal karyotype. The study, conducted at the University Hospital Mongi Slim La Marsa in Tunis, examined fifteen cases of thickened nuchal translucency with confirmed normal karyotypes. The results showed that in some cases, the thickened nuchal translucency disappeared during gestation, while in others, chromosomal abnormalities were found. The article concludes that if the karyotype and ultrasound results are normal and there is no nuchal translucency on follow-up scans, the developmental outcomes of these children are expected to be similar to those of children in the general population. [Extracted from the article]

Rugby players must develop excellent levels of conditioning during adolescence. However, this pivotal period of life is also characterized by a surge in biological growth, which further increases the energy and nutritional requirements of this population. This study examined within-individual differences in energy intake (EI) and energy balance (EB) of 46 young rugby players during a pre-season micro-cycle. Two clusters were identified with significantly different characteristics and EB states, suggesting that young rugby players adjust their EI to match their body composition goals. The first cluster is characterized by players with a low body fat% (12.87 ± 2.53). They had a positive EB (330 ± 517 kcal), suggesting a goal of increasing muscle mass. Conversely, the second cluster is characterized by a higher body fat% (23.1 ± 1.6, p < 0.005) and reported a negative, lower EB (-683 ± 425 kcal, p < 0.005), suggesting a goal focused on reducing fat mass. Although our study provides more optimistic results than previous ones regarding the high risk of inadequate EI in young rugby players, we emphasize the importance of rigorous nutritional support, especially for players aiming to lose weight, to avoid severe caloric restriction, as well as the downstream effects of such practices on their nutritional status, given the higher risk of macro- (e.g., CHO < 6 g/kg/d) and micronutrient (e.g., iron < 11 mg/d, calcium < 1300 mg/d, vitamin D < 5 mg/d) deficiencies.

Background: Inconsistent sleep schedules, frequent awakening after sleep onset (WASO), and decreased sleep efficiency (SE) are common issues among adolescent team sports athletes. Moreover, research indicates that sleep problems are enhanced across schooldays. The aim of the present study was to assess sleep patterns of adolescent athletes and compare sleep parameters between schooldays and holidays. Methods: The chronotype and sleep quality of twelve adolescent basketball players (mean age: 15.58 ± 0.67 years) were assessed. Objective sleep parameters were then analyzed using actigraphy over a 12-day period, which included six days during the school period and six days during holidays. Results: Data showed that total sleep time (TST), SE, and WASO (382.48 min, 81.81%, and 66.70 min, respectively) did not meet international recommendations for sleep quantity and quality. During school weekdays, time in bed (TIB), TST, and SE significantly decreased compared to weekends ( p < 0.001, d = -1.49; p < 0.001, d = -1.64; and p = 0.01, d = -0.89, respectively). On weekdays, TIB, TST, and WASO were significantly lower on schooldays compared to holidays ( p < 0.001, d = -1.83; p < 0.01, d = -1.01; and p = 0.02, d = -0.77, respectively). While no significant difference was observed in social jetlag, the mid-point of sleep was significantly later on holiday weekdays compared to school weekdays ( p < 0.05, d = 0.65). Conclusions: Adolescent athletes experience insufficient sleep, especially on school weekdays, which is partially improved during weekends and holidays. Although sleep duration was longer during holidays, our results suggest that adolescent athletes' sleep was more fragmented. Consequently, it remains crucial to implement strategies to enhance their sleep health (e.g., napping).

Sleep and autonomic nervous system (ANS) influence each other in a bidirectional fashion. Importantly, it has been proposed that sleep has a beneficial regulatory influence over cardiovascular activity, which is mostly controlled by autonomic regulation through the activity of sympathetic and parasympathetic pathways of the ANS. A well-established method to non-invasively assess cardiac autonomic activity is heart rate variability (HRV) analysis. We aimed to investigate the effect of a 40-min nap opportunity on HRV. Twelve professional basketball players randomly accomplished two conditions: 40-min nap (NAP) and control (CON). Nocturnal sleep and naps were monitored by actigraphic recording and sleep diaries. Total sleep time (TST), time in bed (TIB), sleep efficiency (SE), sleep onset latency (SOL), and wake after sleep onset (WASO) were analyzed. HRV was analyzed in 5-min segments during quiet wake before and after each condition with controlled breathing. Were analysed high (HF) and low frequency (LF) bands, the standard deviation of NN interval (SDNN), HRV index and stress index (SI). Wellness Hooper index and Epworth Sleepiness Scale (ESS) were assessed before and after both conditions. There was no significant difference in TIB, TST, SE, WASO, and VAS between NAP and CON. A significant increase in SDNN, HRV index, and LF and a significant decrease in HF, SI, ESS, and Hooper's stress and fatigue scores were observed from pre- to post-nap. In conclusion, napping reduces sleepiness, stress and fatigue, and might provide an advantage by preparing the body for a much-required sympathetic comeback following peaceful rest., Competing Interests: The authors declare no conflict of interest., (Copyright © Institute of Sport – National Research Instutite.)

Low energy availability (LEA) has been associated with several physiological consequences, but its impact on sleep has not been sufficiently investigated, especially in the context of young athletes. This study examined the potential association between energy availability (EA) status and objective sleep quality in 42 male rugby players (mean age: 16.2 ± 0.8 years) during a 7-day follow-up with fixed sleep schedules in the midst of an intensive training phase. Participants' energy intake was weighed and recorded. Exercise expenditure was estimated using accelerometry. Portable polysomnography devices captured sleep on the last night of the follow-up. Mean EA was 29.3 ± 9.14 kcal·kg FFM -1 ·day -1 , with 47.6% of athletes presenting LEA, 35.7% Reduced Energy Availability (REA), and 16.7% Optimal Energy Availability (OEA). Lower sleep efficiency (SE) and N3 stage proportion, along with higher wake after sleep onset (WASO), were found in participants with LEA compared to those with OEA ( p = 0.04, p = 0.03 and p = 0.005, respectively, with large effect sizes). Segmented regression models of the EA-sleep outcomes (SE, sleep onset latency [SOL]), WASO and N3) relationships displayed two separate linear regions and produced a best fit with a breakpoint between 21-33 kcal·kg FFM -1 ·day -1 . Below these thresholds, sleep quality declines considerably. It is imperative for athletic administrators, nutritionists, and coaches to conscientiously consider the potential impact of LEA on young athletes' sleep, especially during periods of heavy training.

The effect of a 40-min nap opportunity on physiological responses and specific abilities was investigated. Twelve high-level professional basketball players (26.33±5.2 years; 193.17±7.1 m; 87.48±11.2 kg) undertook randomly 40-min nap opportunity (NAP) and control condition (CON). Wellness (Hooper Index) and Epworth Sleepiness Scale (ESS) were measured before and after both conditions. Defensive (DA) and offensive (OA) agility and upper body power (UBP) were assessed after both conditions. Shooting skill (SST) performance was evaluated prior and after a fatiguing task (FT). Heart rate (HR) and rating of perceived exertion (RPE) were recorded during SST-test, FT and SST-retest. ESS, Hooper's stress and fatigue score were significantly lower after nap compared to those before nap (0.009 ≤ p ≤ 0.03). Better performance was obtained in NAP compared to CON condition for DA, OA and UBP (0.0005 ≤ p ≤ 0.02). SST performance was significantly higher in NAP compared to CON in the retest session (p = 0.003, Δ = 20.2%).         The improved performance was associated with significant lower HR peak (p = 0.01, Δ = 5.25%) and RPE (p = 0.003, Δ = 15.12%). In conclusion, NAP reduced sleepiness and stress and fatigue and enhances physical outcomes of specific skills in elite basketball players.

The effect of 40-min nap (NAP) opportunity on psycho-physiological outcomes and technical performance during small-sided basketball game (SSG) was examined in ten professional basketball players. Nocturnal sleep and naps were monitored by actigraphic recording and sleep diaries. Nocturnal total sleep time (TST), time in bed (TIB), sleep efficiency (SE), sleep onset latency (SOL) and wake after sleep onset (WASO) were analyzed. Subjective sleep quality was assessed with visual analogue scale (VAS). Profile of mood state (POMS) and simple reaction time (SRT) were measured before and after Nap and no-nap (CON) conditions. During both test sessions, participants played 10-min SSG. Technical and tactical performances were assessed using Team Sport Assessment Procedure. Volume of play (VP), attack with ball (AB), efficiency index (EI) and performance score (PS) were determined. Heart rate (HR) was measured during SSG, and rating of perceive excretion (RPE) after. Lower HR (p ≤ 0.03, d ≥ 0.78) and RPE (p = 0.007, d = 1.11) were obtained in NAP compared to CON. There was no significant difference in TIB, TST, SE, WASO and VAS between CON and NAP conditions. AB, EI and PS were higher in NAP compared to CON (0.0002 ≤ p ≤ 0.001, 1.3 ≤ d ≤ 1.8). A significant reduction was observed in POMS' fatigue (p = 0.005, d = -1.16, Δ = -53.6%), anxiety (p = 0.02, d = -0.9, Δ = -32.1%), anger (p = 0.01, d = -0.94, Δ = -30.3%), and an improvement in vigor (p = 0.01, d = 0.99, Δ = + 23.8%); which may reflect better readiness after nap and more concentration to start a game-situation. In summary, NAP reduced fatigue, anger, anxiety and enhanced vigor, allowing better technical and tactical performances during basketball SSG., (Copyright © Biology of Sport 2023.)

A growing body of evidence indicates that napping is common among older adults. However, a systematic review on the effect of napping on the elderly is lacking. The aim of this systematic review was to (i) determine how studies evaluated napping behavior in older adults (frequency, duration and timing); (ii) explore how napping impacts perceptual measures, cognitive and psychomotor performance, night-time sleep and physiological parameters in the elderly (PROSPERO CRD42022299805). A total of 738 records were screened by two researchers using the PICOS criteria. Fifteen studies met our inclusion criteria with a mean age ranging from 60.8 to 78.3 years and a cumulative sample size of n = 326. Daytime napping had an overall positive impact on subjective measures (i.e., sleepiness and fatigue), psychomotor performances (i.e., speed and accuracy) and learning abilities (i.e., declarative and motor learning). Additionally, studies showed (i) consistency between nap and control conditions regarding sleep duration, efficiency and latency, and proportion of sleep stages, and (ii) increase of 24 h sleep duration with nap compared to control condition. Based on the findings of the present review, there is minimal evidence to indicate that napping is detrimental for older adults' nighttime sleep. Future studies should consider involving repeated naps during a micro-cycle in order to investigate the chronic effect of napping on older adults., Systematic Review Registration: identifier: CRD42022299805., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Souabni, Souabni, Hammouda, Romdhani, Trabelsi, Ammar and Driss.)

Objective: Disrupted sleep and training behaviors in athletes have been reported during the COVID-19 pandemic. We aimed at investigating the combined effects of Ramadan observance and COVID-19 related lockdown in Muslim athletes., Methods: From an international sample of athletes ( n = 3,911), 1,681 Muslim athletes (from 44 countries; 25.1 ± 8.7 years, 38% females, 41% elite, 51% team sport athletes) answered a retrospective, cross-sectional questionnaire relating to their behavioral habits pre- and during- COVID-19 lockdown, including: ( i ) Pittsburgh sleep quality index (PSQI); ( ii ) insomnia severity index (ISI); ( iii ) bespoke questions about training, napping, and eating behaviors, and ( iv ) questions related to training and sleep behaviors during-lockdown and Ramadan compared to lockdown outside of Ramadan. The survey was disseminated predominately through social media, opening 8 July and closing 30 September 2020., Results: The lockdown reduced sleep quality and increased insomnia severity (both p < 0.001). Compared to non-Muslim ( n = 2,230), Muslim athletes reported higher PSQI and ISI scores during-lockdown (both p < 0.001), but not pre-lockdown ( p > 0.05). Muslim athletes reported longer ( p < 0.001; d = 0.29) and later ( p < 0.001; d = 0.14) daytime naps, and an increase in late-night meals ( p < 0.001; d = 0.49) during- compared to pre-lockdown, associated with lower sleep quality (all p < 0.001). Both sleep quality (χ 2 = 222.6; p < 0.001) and training volume (χ 2 = 342.4; p < 0.001) were lower during-lockdown and Ramadan compared to lockdown outside of Ramadan in the Muslims athletes., Conclusion: Muslim athletes reported lower sleep quality and higher insomnia severity during- compared to pre-lockdown, and this was exacerbated by Ramadan observance. Therefore, further attention to Muslim athletes is warranted when a circadian disrupter (e.g., lockdown) occurs during Ramadan., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Romdhani, Ammar, Trabelsi, Chtourou, Vitale, Masmoudi, Nédélec, Rae, Al Horani, Ben Saad, Bragazzi, Dönmez, Dergaa, Driss, Farooq, Hammouda, Harroum, Hassanmirzaei, Khalladi, Khemila, Mataruna-Dos-Santos, Moussa-Chamari, Mujika, Muñoz Helú, Norouzi Fashkhami, Paineiras-Domingos, Khaneghah, Saita, Souabni, Souissi, Washif, Weber, Zmijewski, Taylor, Garbarino and Chamari.)

Background: Evidence suggests that athletes often experience chronic sleep disturbance. Napping is widely recommended as a safe and non-invasive intervention to counteract the negative effects of partial sleep deprivation. However, systematic reviews on the benefits of napping have yet to be undertaken., Objective: (i) To evaluate the effectiveness of diurnal napping opportunities on athletes' physical and cognitive performance and (ii) to outline how aspects of the study design (i.e., nap duration, exercise protocol, participants' fitness level and previous sleep quantity) can influence the potential effects of napping through a systematic appraisal of the literature., Methods: This systematic review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. PubMed, Web of Science and SCOPUS databases were searched up to June 2020 for relevant studies investigating the effect of napping on physical and cognitive performances in physically active participants. Fourteen strong-quality and four moderate-quality (mean QualSyst score = 75.75 ± 5.7%) studies met our inclusion criteria and were included in the final sample (total participants: 158 physically active and 168 athletes)., Results: Most studies (n = 15) confirmed the beneficial effects of napping and showed that diurnal napping improved short-term physical performance (n = 10), endurance performance (n = 3) and specific skills performance (n = 2). Two studies showed no significant napping effect and only one study showed reduced sprint performance following diurnal napping. Moreover, napping improved reaction time (n = 3), attention (n = 2) and short-term memory (n = 1) performances. Importantly, "replacement naps" improved both physical and cognitive performance regardless of the type of exercise. However, "prophylactic naps" improved only jump, strength, running repeated-sprint, attention and reaction time performances. In addition, this systematic review revealed that longer nap opportunities (i.e., 90 min) resulted in better improvement of physical and cognitive performance and lower induced fatigue., Conclusions: A diurnal nap seems to be an advantageous intervention to enhance recovery process and counteract the negative effect of partial sleep deprivation on physical and cognitive performance. Particularly, to optimize physical performances of athletes experiencing chronic lack of sleep, findings from the included individual studies suggest 90 min as the optimal nap duration. Diurnal napping may be beneficial for athletes but this benefit should be viewed with caution due to the quality of the evidence, risk of bias and the limited evidence about napping interventions., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)