The Sleep-Wake Cycle Pattern of a Blind Trail Ultramarathon Runner and His Guide: The World's First Case

Trail running has seen a surge in participants, including individuals with disabilities, particularly in ultratrail running (UTRs). Sleep-wake patterns are crucial for optimal performances in UTRs, which present unique physiological and behavioral challenges. This case study evaluated the sleep-wake cycle of a blind trail ultramarathoner (BTR) and his guide (GTR) before, during, and after an 80 km UTR. Two male participants (BTR: 54 years, BMI: 26.1 kg/m²; GTR: 48 years, BMI: 24.2 kg/m²) were assessed using validated questionnaires (MEQ, ESS, ISI, and PSQI) and actigraphy over 35 days. The BTR exhibited a morning chronotype (MEQ = 63), mild insomnia (ISI = 11), poor sleep quality (PSQI = 5), and prolonged sleep latency (>60 min), while the GTR showed an indifferent chronotype (MEQ = 52), good sleep quality (PSQI = 3), and shorter latency (10 min). Post-competition, both athletes experienced an increased total sleep time (TST): the BTR by 17.8% (05:32:00 vs. 04:25:00) and the GTR by 5.5% (07:01:00 vs. 06:39:00). The BTR demonstrated a greater Wakefulness after sleep onset (WASO 01:00:00 vs. 00:49:00) and awakenings (15.4 vs. 6.1). A time series analysis revealed greater variability in the BTR's post-competition sleep efficiency and TST, while the GTR exhibited a greater stability of the circadian phase. These findings highlight the intricate sleep challenges faced by blind athletes, informing strategies to optimize recovery and performance.