Monitoring athletes’ hydration status and sleep patterns during Ramadan observance: methodological and practical considerations

During Ramadan, dehydration and disturbed sleep patterns are common, so accurate reliable methods for the assessment of hydration and sleep of athletes are necessary to maintain performance. The purpose of this review is: (1) to identify appropriate tools/methods for monitoring hydration status and sleep in sports people; (2) to discuss which of these tools/methods can be confidently used by sport scientists and trainers during Ramadan; and (3) to discuss the possible link that may exist between sleep and hydration status. Several markers of hydration status are currently used and include body mass, plasma/serum osmolality, dilution techniques, and neutron activation analysis. Used in an appropriate context, all can be indicative of the hydration status in the laboratory. In the field, monitoring hydration status in physically active individuals and athletes may be performed using a combination of body mass with some measure of urine concentration (e.g. urine osmolality, urine-specific gravity, urine color) and sensation of thirst. During Ramadan, appropriate timing of sample collection and the use of reference methods in future studies are warranted. In the field, careful use of body mass in conjunction with urine indices may be used to monitor the hydration status of subjects practicing physical activity during Ramadan. There is a need for the use of polysomnography or actigraphy for sleep assessment during Ramadan in future laboratory-based studies of athletes. However, in the field, monitoring sleep–wake patterns may be performed using actigraphy and/or the PSQI questionnaire.