Extreme sports performance for more than a week with severely fractured sleep
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		    SLEEP BREATHING PHYSIOLOGY AND DISORDERS • SHORT COMMUNICATION
 
 Extreme sports performance for more than a week with severely fractured sleep Nikolaus C. Netzer 1,2,3,4 Stephan Pramsohler 1
 
 &
 
 Linda K. Rausch 2 & Hannes Gatterer 3 & Martin Burtscher 2 & Arn H. Eliasson 5 &
 
 Received: 11 May 2020 / Revised: 10 August 2020 / Accepted: 14 August 2020 # The Author(s) 2020
 
 Abstract Purpose Severely fractured sleep is mostly portrayed negatively, but investigations in extreme sports show that humans can maintain performance with a minimum of sleep. With two cases of long-lasting extreme sports performances, we demonstrate that severely fragmented sleep does not necessarily lead to a deterioration of physical and cognitive performance. Methods We performed continuous polysomnography on a 34 year-old skier for 11 days and nights during a world record attempt in long-term downhill skiing and monitored a 32 year-old cyclist during the Race Across America for 8.5 days via sleep and activity logs. Results The skier slept fractured fashion in 15–16 naps with a daily average of 6 h consisting of 77% in sleep stage 1 and 2, 11% in stage 3, and 13% in stage REM. The cyclist slept a total of 7 h and 52 min in 8.5 days, split up into 11 short naps and 6 sleep periods. The average duration of napping was 8.8 min and of sleep 64.2 min. Conclusions These two cases demonstrate that outstanding performances are possible with severely fractured sleep and/or sleep deprivation. In well-trained athletes, breaking new recordsis possible despite extreme sleep habits. Keywords Skiing . Bicycling . Extreme sleep fragmentation . Sleep diary . Polysomnography
 
 Introduction Under extreme conditions, humans are capable of performing on a high physical and mental level despite disrupted sleep or sleep deprivation, namely, in professional extreme sports events [1–5]. This observation has recently gained popular attention due to articles in the National Geographic
 
 * Nikolaus C. Netzer [email protected] 1
 
 Hermann Buhl Institute for Hypoxia and Sleep Medicine Research, University Innsbruck, Austria, Bad Aibling, Germany
 
 2
 
 The Institute of Sport Science, University Innsbruck, Innsbruck, Austria
 
 3
 
 Institute of Mountain Emergency Medicine, Eurac Research, Bozen, Italy
 
 4
 
 Department of Medicine, Division of Sport Medicine and Rehabilitation, University Hospitals, Ulm, Germany
 
 5
 
 Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
 
 Magazine [6]. However, it has been well established that continuous sleep fragmentation serves as a stressor for athletes in training [7, 8], and it can consequently lead to poor athletic performance as well as to mental health symptoms or disorders [9]. Although many elite athletes are frequently traveling through different time zones, a dysregulation of the circadian rhythm in the long-term is dangerous, because it can impair not only performance but also metabolism and psychological functions [9]. However, there is limited published information about the effect of disrupte		
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