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Over the last decade, Esports, defined as a form of organized video game competition, has emerged as a global phenomenon. The professional players who compete in Esports, namely, Eathletes, share many similarities with their traditional athlete counterparts. However, in sharp contrast to traditional athletes, there is a paucity of research investigating the factors that influence the performance of Eathletes. This gap in the literature is problematic because Eathletes are unable to make informed and empirically supported decisions about their performance management, unlike traditional athletes. Sleep is an important factor that influences athletic performance in traditional sports, particularly those that require a high level of cognitive demand. Research is yet to examine whether sleep also plays an important function in optimal performance and success of Eathletes in Esports. Accordingly, the aim of this opinion piece is to review the broader sleep and sports medicine literature and provide theoretically grounded suggestions as to how existing findings may apply to Eathletes competing professionally in Esports. Overall, it appears that Eathlete performance may be vulnerable to the deleterious effects of sleep restriction. Furthermore, Eathletes are likely at risk of sleep disturbances due to the unique situations and conditions that characterize Esports.
Sleep and performance in Eathletes: For the win!
 !""#$%&"
' ' 
!"() * +,
+%&"+- .
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' 0
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 "C &&<
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&B- &
"  BD""
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" -  C  
Sleep and performance in Eathletes: For the win!
 -  B-& "B 
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267<! &---"&"
B "' '67<
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 "  --"
&-" &67<,B&
 "&
 <) -
 -" - 
 <$ 
 &
& 
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67 "C && 
----6:7</"- 
"  
- &" 
 BD""
Sleep and Performance in Esports
-"&-6$ <297
B6<<  7657<*
B &--B&
- <
* "&&&
B& 
-"C "6<<7<
$D&&" 
 "B;6<<
">-7</""C &6B
 7"<
+& &  & 
 -C E;&&
&"&6<<"- 7<'
&  B&&
  <*B-
-C """
-&B B <)
-  6:?7
 617B& 687
& 627<) 
"FBBE &&
B"<&" B:2
 67C  D
<) & "&
<$  ;
 -&;  ;;
&6<<&7<$ 
" - 
<+C 
B" -
-;6<<*  -*EB7
 &687 
BB"657<) -
-B   "-"
* "&
 D & <D & 
---- &
 &D-"-;&;
67<)"&;-& 
C   "&- 
"<+& A
&"BD<  &
 6<<"7<!
B&& 
D & &"<';"
"&"D & 657<) 
 D
C "- "
Potential Risk Factors for Sleep Disturbances in Eathletes
C  -
B-- 67<
"D" 
"- C  A<*
BB  -;"-
Caffeine use<B;B6:7 -"
657<,  
 "DABA
 -C <'  " BBD
 "- / +"
&-B "6?;17<
) D  "-- 
& <
Air travel< -&  
- ;B &67<
*" -&&- 
68;27<# B
 "&-B B<' 
 C B""
AC -""67<
 A<
Pre-competition and competition nights. *;"
/-#67 &  
"<)B"- "
-  &"
"&"<*C &B-&;
  & -
; - D"<"-
 - D-";
  -<
Evening use of light emitting devices.& 
 & ;&B
C "&""67<*
"  
67<,B& BA
-& - B<
 -"
& &<
Sleep disorders.  
"C "C "67<)&
 "6<<'-B-"
&" -""-"
" " 
<) "-B
&6:7 - <
Performance enhancing substances. '-"*"
<)'/-  
"&"&- -"
<' *&
 "657<,D
& B&" -
<$& - "
   -6?7<
Conclusions and Future Research Directions
)C 
& B"- &
& <*&
B"   &
- <"
"D& - 
 C  A<$
 <
@  "-DB
- <, 
C & B"<
,B&B "DB
 "-"<#" 
&" &
 <'D   
 B7& 7
 -;7 
C &- 
<  B  B
 -B<
1. BA<21-<0>>BA<>>;
>-;;;;21;><! -21<'
2. )")G<Raising the stakes: E-sports and the professionalization of computer
3. #HHH,G<) 
&0" &B<Clin J Sport Med<
:< $ ,, /<0
D<Sports Med<293:96705I15<02<22?>:2?8;2:;
9< <&&
&"0"&B <
Sports Med<213:167051;?2<<>2<22?>:2?8;2?;21;D
5< GBH',!'<) &C 
0;"&B<Neurosci Biobehav Rev<2?3120915;52:<
<>2<25>< -&<2?<2?<22<
7. #<&<Prog Brain Res<
1< < -&-" <
Curr Neurol Neurosci Rep<2?3?67018<<>2<22?>82;2?;2?88;D<
8< +#G<G& ;&
- "<Curr Opin Behav Sci<293095;5<
10. '!!;!<&0&<
Neuropsychiatr Dis and Treat<22?069799;95?<0>>BBB<-<<<&
<  -+'+)<"  
253+'<0>> < -< <>B>>99:882>1??8<<
< $!+"'<%"&"D & 0& 
BB&  <Cortex<2?315015;2:<
13. /-JJ)J#J#J'<
0"&B;"<Br J Sports Med<
:< H)D)GA< 
B0"&B;"<JJ Int Soc Sports Nutr<
15. H+ KAJ+ KA;  J<!& 
 -<Appl Physiol Nutr Metab<2356:70999;95<J<>2<8>;
16.  J*J,JJHJ+HJ<J   -"
;<JEur J Sport Sci<J21316:709I9<
17. </ %E - 
G<<0>><>21>2>;- ;;
; ;; -;; ;;><! -21<
18. $'< G  +"<<
0>><>21>2> ;  ;;;"><
! -21<'-921<
8< # HB&'<*"L
M"0 "&<Br J Sports Med<
2< G/*<HBBB
;A<Chronobiol Int<22386:70?:I?5:<<>2<21>*;
21. ';N+,'<&D  
  -"
-<JChronobiol Int<2?3:6?70199;159<02<212>2?:291<2?
22. H+H!!B<J&& 0
D;""<JJ Sports Sci<
<  *#H,<!&
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:< +H<*;)<Chest<
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... They found that performance on rudimentary cognitive tasks (e.g., psychomotor vigilance task) was reliably impaired by sleep restriction, while more complex tasks (e.g., multitask tests) were also affected, but only if cognitive flexibility (i.e., adaptation to changing task requirements) was required. These findings are pertinent given that esports is often fast-paced and involves complex decision making within unpredictable match circumstances (Bonnar, Castine, et al., 2019). From a mental health perspective, sleep restriction is also known to contribute to disturbed mood states such as depression (Short et al., 2020), which is relevant given evidence of high depression scores in some esports athletes (Lee et al., 2020). ...
... Bonnar et al. (2022) also suggested that identifying and better understanding the risk factors associated with poor sleep in esports athletes will help improve the precision of sleep interventions, thereby making them more effective. In an early paper, a number of potential risk factors for suboptimal sleep in esports were initially proposed by Bonnar, Castine, et al. (2019), including caffeine use, air travel, elevated arousal on precompetition and competition nights, evening technology use combined with late training time, sleep disorders, and performance-enhancing substances. In a subsequent review, game genre and gaming culture were also proposed (Bonnar, Lee, et al., 2019). ...
... We found that night training schedules can delay esports athletes sleep patterns, resulting in reduced sleep duration if daytime commitments necessitate an earlier than desired wake-up time (Lee et al., 2021). In addition, it has previously been proposed that evening light exposure could impact the sleep of esports athletes (Bonnar, Castine, et al., 2019), which was based on concerns in the general sleep literature that late-night exposure to light emitted by screens can delay sleep onset via the suppression of melatonin (Wong & Bahmani, 2022). However, with many contrary findings reported over time, the current body of evidence is equivocal, and whether device use translates to disturbed sleep is contentious (Wong & Bahmani, 2022). ...
The present study investigated the influence and perspective of esports coaches and support staff on the sleep habits of esports athletes competing at professional and semiprofessional levels. Eighty-four esports coaches and support staff from 19 countries completed an online questionnaire. The first section obtained demographic information. The second section evaluated sleep hygiene knowledge using the Sleep Beliefs Scale. The third section assessed sleep monitoring and sleep hygiene practices used by coaches and support staff with esports athletes, barriers to the use of these practices, and conditions that impact the sleep of esports athletes. Overall, sleep hygiene knowledge was inadequate (<75%, based on the study of Miles et al.). Sleep monitoring frequency was low (48.8%), while sleep hygiene practices were implemented more often (66.7%). The most common barrier to sleep monitoring and sleep hygiene practices was players not liking it (50% and 46.3%, respectively). Night competitions (64.6%), congested competition times (51.2%), and night training schedules (47.6%) all rated highly as having an impact on esports athletes’ sleep. Sleep education and training for coaches and support staff in the optimal use of sleep monitoring and sleep hygiene practices may increase the frequency and quality of sleep health support provided to esports athletes.
... Increased oxidative stress can be an outcome of previous fatigue, sleep disruption, and autonomic system activation in Esports players [46]. The role of sleep deprivation in causing stress and ROS accumulation has been supported by several studies [48,49]. Air travel prior to competition, ingestion of caffeine and other stimulants, and stimulation by lights in the late evening hours or even overnight have been identified as the main factors for sleep disturbance, albeit no experimental data exist that link these factors to sleep disruption in Esports [48,50]. ...
... The role of sleep deprivation in causing stress and ROS accumulation has been supported by several studies [48,49]. Air travel prior to competition, ingestion of caffeine and other stimulants, and stimulation by lights in the late evening hours or even overnight have been identified as the main factors for sleep disturbance, albeit no experimental data exist that link these factors to sleep disruption in Esports [48,50]. We did not find any EEG sleep studies on the sleep quality of PEGs (e.g., investigating sleep phases). ...
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The aim of this review is to examine the links among the different factors that determine harmful or even deadly events in professional and semiprofessional intensive Esports players. Cases of serious injuries or even death in young (<35 years old) male professional Esports players are reported every year. Fatalities and injuries in professional Esports players (PEGS) have only affected male players, and these events have mostly been concentrated in Asia. Studies in the literature have reported several causes and mechanisms of injuries. Links between injuries and previous comorbidities have emerged from the extant literature; obesity and/or metabolic disorders, seizures (associated with overstimulation of the eyes), heart malfunctions, high basal and abrupt increases in systolic blood pressure (SBP), prolonged stress, and poor posture have been associated with injuries. Several clinical signs have been identified and the question emerges whether or not self-regulation by Esports associations or public health authorities is necessary.
... which can lead to impaired sports performance (Bonnar et al., 2019) such as slower reaction times, reduced endurance performance, and reduced motor performance (Lastella et al., 2014;Thun et al., 2015). ...
... Some of them will be mentioned in this paragraph. Firstly, adequate sleep may be an essential variable to ensure proper esports players' performance and health (Bonnar et al., 2019;Szot et al., 2022), and in traditional sports, insufficient sleep may lead to an increased injury risk (Charest & Grandner, 2020). So, an important goal may be to ensure enough sleep for e-athletes. ...
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In the last two decades, video games have gone from being pastimes to being a coveted profession with competitions broadcasted worldwide and high earnings for the winners. However, the esports environment is still little known, presenting a lack of knowledge on how to get physically ready to minimize the effect of prolonged sitting or avoid career-ending injuries. This article provides coaches and serious gamers with a program based on evidence and simple to implement. The main aims will be to prevent esports’ common injuries such as cervical and lumbar pain, wrist and shoulder overuse, and peripheral neuropathies. Our proposal contains protocols for warming-up, preventing injuries, and taking active breaks.
... In the last decade, esports competitive performance has gained special relevance, attracting the attention of numerous professionals who seek to improve performance in esports competitions to offer entertainment in the highest competitive level [49,55,57]. However, there is little scientific evidence regarding the factors that could most influence performance in esports [5,19], but the research by Nagorsky and Wiemeyer [35] stands out in particular, in which players from five different esports (Starcraft II, League of Legends, Rocket League, FIFA, and Counter Strike) were included and a model was established with six factors influencing performance (skills, condition, cognitive-tactical skills, psychic abilities, social abilities and personal factors), showing that in each of the esports these elements acquire a singular relevance. More specifically, research by Sharpe et al. [45] conducted in Counter Strike showed the influence of game score, reaction time, response time, keyboard proficiency, and mouse control on player performance, Therefore, each esports has its own demands and requirements and, among all the modalities, the multiplayer online battle arena (MOBA) genre perhaps being the most popular, and the one with the greatest expansion in recent years. ...
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The analysis of the most decisive factors in performance is fundamental in order to train on these aspects to maximize the chances of success in competition. However, in the field of esports, research that has analyzed performance is scarce and includes various modalities, making it difficult to draw conclusions for a specific esports. Due to the growing interest in League of Legends in recent years, this research focuses on this esports and has the following objectives: a) to analyze the differences in the variables of performance and heat rate (HR) as a function of winning or losing; b) to establish the differences in the HR of the players depending on the role of the player, the involvement of the player in the play, and the team that benefited from each action during the game; and c) to determine the physiological changes that players undergo depending on the type of action performed. Ninety games and 4638 plays of an elite League of Legends team composed of five male players were analyzed. The results showed that tower destruction and kills were the most decisive performance factors in the final result. Furthermore, although no differences in HR were found when comparing games won and lost, differences were observed depending on the player’s participation and the action performed, with actions that directly involved the player and favored the team showing the greatest differences in HR, more specifically the obtaining of neutral objectives (Baron Nashor and Elder Dragon), the destruction of structures closest to the nexus base and the team fights.
... As for other types of sports, we can find professional eSports players and amateur players. Professional players in eSports share many similarities with their traditional physical athlete counterparts: they train rigorously, compete in tournaments, and must abide by competition, association, and governing body rules [15]. They have the same mental and physical issues as physical athletes, sharing some concerns such as stress before competitions or short career life. ...
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Recently, electronic sports (eSports) became one of the growing forms of new media due to the wide diffusion of games and online technologies. Even if there is still a debate about the definition and characterization of eSports, eAthletes train heavily, compete in tournaments, must abide by competition, association, and governing body rules, just like all other athletes. Furthermore, as in any other competitive discipline, there can be injuries. Aberrant sitting posture, repetitive movements, screen vision, prolonged playing hours, and a sedentary lifestyle can lead to several medical hazards in musculoskeletal, ophthalmology, neurological, and metabolic systems. Moreover, several cardiovascular changes occur in eAthletes. This paper aims to explore the different injuries that can occur in a professional eAthlete, suggesting how every high-level gamer could benefit from a pre-participation evaluation and a correct injury prevention strategy.
... Very limited literature pertained to sleep in eSports professionals, even though this population of professional athletes may be uniquely vulnerable to poor sleep health due to factors including notable sleep-wake schedule irregularities, frequent and prolonged electronic screen exposure, and elevated caffeine consumption. If interested in sleep within this population of professional athletes, we recommend the work of Bonnar D and colleagues (2019) [17], Bonnar D and colleagues (2022) [18], and Lee S and colleagues (2021) [19]. ...
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Purpose of Review Sleep is an essential human behavior that plays a key role in proper biopsychosocial development as well as short- and long-term biological, physical, psychological, and cognitive health. Sleep plays a key role in athletic performance, influencing an athlete’s ability to train, recover, and perform, as well as their overall wellness. Over the recent decade, the awareness of sleep’s import has penetrated just about every professional sport domain. The purpose of the review was to identify and synthesize the literature published within the past 5 years (2018–2022) that relates to sleep and performance in professional athletes. Literature related to nonprofessional, high-level athletes (e.g., collegiate; Olympic) was omitted as well as those associated with non-traditional professional sports (e.g., eSports). Recent Findings Results from 38 articles were incorporated into this review, which covered (1) the sleep’s role in the training, physical injury prevention and recovery, competitive performance, and mental health of professional athletes, (2) common sleep problems and disorders in professional athletes, and (3) the impact of unique challenges from training, travel, competition, and other factors on sleep health. Additionally, we provide an orientation to utilized strategies and interventions to assist with sleep health in professional athletes, as well as conclude with a commentary on critical steps forward. Summary Sleep plays a critically important role in the training, recovery, performance, and overall wellness of professional athletes. Professional athletes are vulnerable to a variety of sleep-related problems and disorders, due to unique factors related to training, travel, and competition, among other factors. Improved, standardized research methodology and partnerships between professional athletes, coaches, teams, and organizations and researchers are necessary to advance the knowledge of sleep and performance in professional athletes, including identifying sport-specific differences and variation across individual characteristics, as well as developing individualizable, dynamic, and appropriate interventions for improving sleep health among professional athletes.
... Following the advancements in communication technologies throughout the 2000s and a consequent expansion of competitive gaming, by 2012 eSports started gaining scientific attention and research began to emerge in several fields. More specifically, the focus resided within the three core areas: (1) the definition of eSports and its classification in relation to traditional sports (Cunningham et al., 2018;Heere, 2018;Hallmann and Giel, 2018); (2) psychological and cognitive studies of professional players (Pluss et al., 2019;Matsui et al., 2019;Pedraza-Ramirez et al., 2020); (3) and social and psychological studies of eSports consumers (Bonnar et al., 2019;Rudolf et al., 2020;Huk, 2019). ...
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This study partially fills the gaps in the eSports marketing literature by analysing sponsorships and sponsorship related actors in the context of a specific eSports discipline. More specifically, the study adopts a qualitative approach and through an in-depth assessment of consumer perspective evaluates the extent to which sponsorship of a Counter Strike tournament can provide benefits to the brand of the sponsoring company. The sponsorships are examined in their ability to enhance brand recognition, brand attitude and purchase intentions. Additionally, the study investigates the factors constituting personal brands of professional eSports teams, players and tournament organisers, and examines the role of these actors within eSports sponsorships. The findings of the study reveal that the Counter Strike community represents a unique culture of passionate eSports fans with their own set of beliefs, values and traditions. Within that culture, sponsors are viewed as important figures that can either help to develop or destroy that culture. The study demonstrates that obtaining a deeper understanding of the discipline can provide companies with unique opportunities to form strong and meaningful connections with the eSports audience, which can lead to improvements in brand recognition, brand attitude and purchase intentions. The study also identifies potential benefits of team sponsorships yet shows that the perception of team sponsors is likely to depend on the personal brands of the sponsored teams and players. Elaborating on this, the study demonstrates the interrelated nature of team’s and players’ personal brands and provides insight on the factors that can be used in the evaluation of those brands. Finally, the study finds tournament organisers to also play a role in how consumers perceive sponsors at Counter Strike events and highlights the key attributes that make a high-quality tournament organiser.
The number of people participating in electronic gaming has increased exponentially in recent years. Gamers are susceptible to injuries. However, there are limited studies on gaming-related symptoms and musculoskeletal pain complaints amongst casual gamers. This study aimed to characterize gaming-related symptoms in adults participating in electronic gaming. An online survey assessing gaming characteristics, addictive qualities, and gaming-related symptoms was completed by 250 self-reported adult gamers (median age: 37.5 years; 56.0% female). Prevalence rates of gaming-related symptoms and musculoskeletal pain complaints were 61% (n = 153) and 34% (n = 86), respectively. Gaming session durations were significantly longer in participants reporting gaming-related symptoms or musculoskeletal pain complaints ( P < .001). Addictive qualities were independently associated with greater odds of having gaming-related symptoms (OR[95%-CI]: 3.69[1.84-7.39]; P < .001). Suboptimal screen height, concurrent mood disturbances, and concurrent sleep changes were independently associated with greater odds of having musculoskeletal pain complaints ( P < .05). Further analyses revealed significantly increased prevalence of mid-back, low-back, or mid + low-back pain in participants reporting poor ergonomics ( P < .05), compared to good ergonomics. Overall, increased time spent gaming, poor ergonomics, addictive qualities, and mood/sleep complaints were associated with gaming-related health conditions. As gaming continues to expand, recognition of gaming-related health conditions and their predisposing factors is critical.
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Introduction: Esports is a category of competitive video games that, in many aspects, may be similar to traditional sports; however, the gut microbiota composition of players has not been yet studied. Materials and methods: Here, we investigated the composition and function of the gut microbiota, as well as short chain fatty acids (SCFAs), and amino acids, in a group of 109 well-characterized Polish male esports players. The results were compared with two reference groups: 25 endurance athletes and 36 healthy students of physical education. DNA and metabolites isolated from fecal samples were analyzed using shotgun metagenomic sequencing and mass spectrometry, respectively. Physical activity and nutritional measures were evaluated by questionnaire. Results: Although anthropometric, physical activity and nutritional measures differentiated esports players from students, there were no differences in bacterial diversity, the Bacteroidetes/Firmicutes ratio, the composition of enterotype clusters, metagenome functional content, or SCFA concentrations. However, there were significant differences between esports players and students with respect to nine bacterial species and nine amino acids. By contrast, all of the above-mentioned measures differentiated professional athletes from esports players and students, with 45 bacteria differentiating professional athletes from the former and 31 from the latter. The only species differentiating all three experimental groups was Parabacteroides distasonis, showing the lowest and highest abundance in esports players and athletes, respectively. Conclusion: Our study confirms the marked impact of intense exercise training on gut microbial structure and function. Differences in lifestyle and dietary habits between esports players and physical education students appear to not have a major effect on the gut microbiota.
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Purpose of review: This article reviews the neurobehavioral deficits resulting from sleep loss in adults, various countermeasures to mitigate these effects, and biomarkers to identify individual differences in neurobehavioral responses. Recent findings: Total sleep deprivation and chronic sleep restriction increase the homeostatic sleep drive and diminish waking neurobehavioral functioning, producing deficits in attention, memory and cognitive speed, increases in sleepiness and fatigue, and unstable wakefulness. Recovery sleep, extension of sleep, and use of caffeine and/or naps are all effective countermeasures to mitigate these responses. Candidate gene and various "omics" approaches have identified biomarkers that may predict such responses. Sleep loss is increasingly prevalent and produces reliable, differential neurobehavioral deficits across individuals. Recent research has identified biomarkers to predict these responses, though future work is warranted, such that precise determination of who will develop neurobehavioral decrements from sleep loss will be possible.
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In healthy male top athletes several functions were measured after either a westbound flight over six time-zones (WEST: Frankfurt-Atlanta; n = 13) or an eastbound flight over eight time-zones (EAST: Munich-Osaka; n = 6). Under either condition the athletes performed two standardized exercise training units in the morning and in the afternoon within 24 h, investigations were done as controls in Germany and on day 1, 4, 6, and 11, after arrival. The primary aim of the study was to evaluate the effect of time-zone transitions on the 24h profiles of blood pressure (BP) and heart rate (HR) using an ambulatory BP device (SpaceLabs 90207), for up to 11 d after arrival at the destination. As additional parameters, we studied jet-lag symptoms, training performance, and training coordination by using visual analog scales. Finally, oral temperature and grip strength were measured, and saliva samples were analyzed for cortisol and melatonin. The study showed that all functions were disturbed on the first day after arrival at the destination, jet-lag symptoms remained until day 5-6 after WEST and day 7 after EAST, training performance was worst within the first 4 d after WEST. In accordance with earlier reports, cortisol, melatonin, body temperature, and grip strength were affected in their 24h profiles and additionally modified by the training units. Surprisingly, BP and HR were not only affected on the first day but also the time-zone transition led to an increase in BP after WEST and a decrease in BP after EAST. However, the training units seemed to influence the BP profile more than the time-zone transitions. HR rhythm was affected by both time-zone transitions and exercise. It is concluded that not only jet-lag symptoms but also alterations in physiological functions should be considered to occur in highly competitive athletes due to time-zone transition and, therefore, an appropriate time of reentrainment is recommended.