Changes in the objective measures of sleep in association with menses among female athletes with excessive daytime sleepiness.

Excessive daytime sleepiness (EDS) can impair athletic performance. In female athletes, sleep architecture changes in association with the menstrual cycle; however, studies examining the relationship between menstrual cycle and sleep, particularly EDS, remain limited. Therefore, we conducted subgroup analyses of our previous study, comparing changes in sleep measures associated with menses between athletes with and without EDS. Female collegiate athletes with regular menstrual cycles were recruited for this study. Participants underwent home electroencephalogram monitoring during the first and second nights after the onset of menses, and one night between the seventh and 10th nights after menses onset (mid-follicular phase). The Epworth Sleepiness Scale (ESS) was used to assess EDS. Interactions between the presence of EDS (i.e., ESS ≥ 11) and changes in objective measures of sleep in association with menses were analyzed. Data from 45 athletes, including 24 with EDS, revealed distinct changes in wake after sleep onset (WASO) among athletes with EDS compared with those without EDS (interaction p = 0.010). Specifically, athletes with EDS experienced increased WASO on the first night after the onset of menses compared with other nights (ANOVA p = 0.030). Pairwise comparisons showed significant differences between the first and second nights after menses onset (p = 0.035). Female collegiate athletes with regular menstrual cycles are more likely to experience EDS in association with increased WASO during the first night after the onset of menses.