Assessment of hydration Status and sleep in athletes during Ramadan month

Ramadan fasting (RF) can induce hypohydration in athletes due to the abstention from water during daylight hours, as well as sleep disturbances related to modified training schedules and increased nighttime social activities. These changes may negatively affect athletic performance, making regular assessment of hydration and sleep essential.

This review is based on data from systematic reviews, meta-analyses, umbrella reviews, narrative reviews, and expert consensus to provide practical recommendations tailored to the context of Ramadan.

Body mass alone is not a reliable indicator for daily monitoring of hydration status due to changes in body composition during RF. Monitoring the specific gravity and color of the first morning urine sample is a simple, quick, and effective method. Pre- and post-exercise body mass measurement remains the most accurate approach for estimating acute fluid loss. For sleep monitoring, smartwatches and actigraphy are recommended. In the absence of these tools, sleep diaries may be used with caution. Standardized sleep questionnaires are not well-suited to the specific characteristics of Ramadan and should be avoided. Moreover, a state of hyperhydration may disrupt nighttime sleep by increasing nocturnal urination, highlighting the importance of simultaneously monitoring hydration status and sleep.

Hydration status and sleep must be rigorously monitored throughout Ramadan to preserve overall health, reduce physiological strain, and optimize athletic performance.