Sleep Intervention Swiss Elite Athletes

• Background and Rationale Elite athletes often suffer from sleep disturbances due to high training loads, frequent travel, jet lag, pre-competition stress, and irregular routines. Poor sleep negatively affects cognitive function, immune response, recovery, and overall performance. It is also strongly associated with mental health challenges including anxiety, depression, and psychological distress.

Although interventions such as sleep hygiene education and sleep extension strategies show promise in improving subjective sleep quality, there is limited evidence on their long-term effectiveness or impact on mental health in elite athlete populations. Moreover, few studies examine what elements of sleep interventions athletes perceive as most helpful or what barriers they face.

This study seeks to close these gaps by evaluating the short- and long-term effects of a structured sleep intervention on sleep quality and mental health in elite Swiss athletes, with additional qualitative data on user experience.

• Study Objectives Primary Objective To determine whether a 4-week sleep intervention improves sleep quality and mental health (depression, anxiety, and well-being) in elite athletes.

Hypotheses

The intervention will reduce sleep disturbances and improve sleep quality.

The intervention will enhance mental health outcomes, including reduced symptoms of depression and anxiety and improved well-being.

Secondary Objectives To explore participant experiences, including perceived facilitators, barriers, and the most helpful components of the intervention.

• Study Design

This is a national, single-center, one-arm pre-post intervention study using a within-subjects design. It includes four measurement time points:

T0: Baseline

T1: Pre-intervention

T2: Post-intervention

T3: Two-month follow-up

• Participants Sample Size: 16 elite athletes from the recruit school (sport soldiers).

Inclusion criteria

Enrolled in the recruit school

Elite athlete status

Sufficient understanding of German

Exclusion criteria

Insufficient German to engage with the app

All participants are adults capable of providing informed consent.

• Intervention Component 1: Workshop A one-hour in-person workshop focused on the importance of sleep for physical and mental performance, sleep hygiene strategies, and goal setting. Participants identify personal motivations, which are later used to encourage adherence.

Component 2: App-Based Sleep Program ("7-Schläfer") Participants complete 7 modules (approx. 30 minutes each) over four weeks. Modules include guided audio exercises and psychoeducation about sleep. Participants can take private notes, which are not accessed by the research team. Weekly reminder emails with personalized motivational cues are sent to enhance engagement.

Participation in the intervention is free of charge. The app is provided at no cost and without data sharing.

• Outcomes and Measurements

Validated questionnaires will be used:

Sleep Quality: Visual analog scale (1 item)

Sleep Disturbance: Insomnia Severity Index (ISI, 7 items)

Well-Being: MHC-SF (14 items)

Depression: PHQ-9 (9 items)

Anxiety: GAD-7 (7 items)

Participants also report demographic data, sport type, training intensity, and adherence (module completion and perceived usefulness). Post-intervention, optional focus groups (2 groups of 6-9 athletes) explore facilitators, barriers, and perceived effectiveness.

• Data Collection and Management All data is collected through REDCap. Only three project staff members have access. Identifying data is stored separately and pseudonymized.
• Statistical Analysis Repeated measures ANOVA will assess within-subject changes across the four time points. Power analysis determined that 24 participants are needed for moderate effect detection. To account for attrition, 30 athletes will be recruited.

Qualitative data from focus groups will be analyzed using thematic analysis. Gender will be included as a control variable.

Missing data will be handled using multiple imputation. Participants must complete at least baseline and post-intervention assessments to be included in analysis.

• Ethics and Risk Assessment The study is categorized as minimal risk (ClinO, Art. 61, Cat. A). No vulnerable populations are included. Ethical risks are low and primarily involve potential distress when reflecting on sleep habits. Participants are provided with mental health resources and may contact the research team or sport psychology services at any time.
• Monitoring and Safety A trained monitor from the Swiss Federal Institute of Sport will conduct site visits at initiation, mid-study, and study close-out. Serious Adverse Events will be reported per ClinO requirements. No radiation, invasive procedures, or vulnerable groups are involved.
• Registration and Dissemination The study will be registered with SNCTP and ClinicalTrials.gov. Results will be published open access and anonymized data will be made publicly available after project completion.
• Funding Funded by the Swiss National Science Foundation (project number PT00P1_199093 / 1). There are no financial or personal conflicts of interest.

Inclusion criteria

elite athlete participating in the recruit school (sport soldiers), understanding German because the content of the App is only available in German

Exclusion criteria

not understanding German good enough to understand the content of the App