ORIGINAL RESEARCH article
Front. Psychol.
Sec. Sport Psychology
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1619220
This article is part of the Research TopicMental Health in Recreational and Elite SportsView all 12 articles
Identifying anxiety and sleep problems, associated factors and sex differences in endurance and ultra-endurance runners
Provisionally accepted
- 1Ultra Sports Science Foundation, 69130 Pierre-Bénite, France, Pierre-Bénite, France
- 2Vinalopó University Hospital, Elche, Spain
- 3Institute of Primary Care, University of Zurich, Zurich, Switzerland, Zurich, Switzerland
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Background: Anxiety and sleep problems may negatively impact health and athletic performance.Methods: We conducted a cross-sectional survey study in endurance (21.1km to 42.2km) and ultra-endurance runners (42.2km), screening for anxiety and sleep problems, assessing potential associated factors and sex differences. Statistical methods included descriptive statistics, testing of group differences with the Kruskal-Wallis H-test, and Dunn´s post-hoc tests, allowing for Bonferroni correction for multiple comparisons, predictive techniques, and regression analysis.Results: A total of 601 runners participated (female n=222; male n=379; their mean age was (42.8±10.1 years). Overall, 13.5% screened positive for anxiety (female 16.2% compared to men 11.9%; n.s.) and 28.8% for sleep problems (female 32.9% compared to men 26.4%; n.s.). Anxiety and sleep problems were observed significantly more often in half marathon runners (25.2%; (p<0.001) and 38.3%, (p=0.02), respectively) compared to marathon (9.8% and 28.4%) and ultramarathon distance runners (11.1% and 28.2%). No statistical differences were found between sexes and performance levels (elite versus non-elite). Associated factors for anxiety included sleep problems (p<0.001), younger age (<29 years; p<0.001), years practicing the sport (>10 years; p=0.006), and distance category (p=0.03). Associated factors for sleep disturbances problems included anxiety (p<0.001), competition frequency (>4 per year; p=0.006), and injury-related absences (p=0.001).Mental health issues, such as anxiety and sleep problems are common in endurance and ultra-endurance runners and positive screening for anxiety co-existed and was associated with positive screening for sleep problems. This study demonstrates that identifying and screening for anxiety and sleep problems is important, as well as the need for creating awareness, education, preventative strategies, and support services.
Keywords: endurance sports, Marathon, Mental Health, performance, Ultramarathon
Received: 27 Apr 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Scheer, Valero, Valero, Weiss, Rosemann and Knechtle. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Beat Knechtle, Institute of Primary Care, University of Zurich, Zurich, Switzerland, Zurich, Switzerland
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