The effects of Ramadan intermittent fasting on sleep-wake behaviour and daytime sleepiness in team sport referees

Khaled Trabelsi, Liwa Masmoudi, Achraf Ammar, Omar Boukhris, Aïmen Khacharem, Mohamed Jemal, Sahar Zlitni, Nicola Luigi Bragazzi, Cain C T Clark, Michele Lastella, Hamdi Chtourou

    Research output: Contribution to journalArticlepeer-review

    1 Citation (Scopus)


    The aim of the present study was to evaluate the impact of Ramadan fasting on sleep quality and daytime sleepiness in team sport referees. Seventy-eight male amateur team sport referees (age: 31.1 ± 10.8 years) participated in this study. Participants responded to the Arabic version of the Pittsburgh Sleep Quality Index (PSQI) and the Epworth sleepiness scale (ESS) questionnaires before (10-days prior) and during (last 7-days) the month of Ramadan.PSQI and ESS scores increased significantly during Ramadan (both p < .001, ES = 0.56 and 0.54, respectively) with 83.3% of participants scoring ≥5 in the PSQI. The percentage of participants suffering from severe excessive daytime sleepiness (ESS score ≥ 16) was 3.8% before vs. 7.7% during Ramadan (p < 0.001). Sleep duration decreased by ~ 1 h during Ramadan (p < .001, ES = 0.61) and was associated with a delay in bedtime of ~ 2 h (p < 0.001, ES = 0.7) and of wake-up time of ~ 1 h (p < 0.001, ES = 0.5). The score for daytime dysfunction and subjective sleep perception, as components of the PSQI, increased (both p < 0.001; ES = 0.79, ES = 0.57, respectively), whereas the score for the use of sleep medication decreased during vs. before Ramadan (p = 0.041, ES = 0.47). Ramadan fasting impaired sleep quality and increased daytime sleepiness in team sport referees. Future studies, using objective assessment tools, are warranted.

    Original languageEnglish
    Pages (from-to)2411-2417
    Number of pages7
    JournalJournal of Sports Sciences
    Issue number21
    Early online date15 Jun 2021
    Publication statusPublished - 2 Nov 2021


    • Sleep habits
    • sleep quality
    • drowsiness
    • intermittent fasting
    • officials

    ASJC Scopus subject areas

    • Physical Therapy, Sports Therapy and Rehabilitation
    • Orthopedics and Sports Medicine


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