***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We describe the development of a cognitive therapy intervention for  chronic insomnia .  The therapy is based on a cognitive model which suggests that the processes that maintain insomnia include : ( 1 ) worry and rumination , ( 2 ) attentional bias and monitoring for sleep-related threat , ( 3 ) unhelpful beliefs about sleep , ( 4 ) misperception of sleep and daytime deficits and ( 5 ) the use of safety behaviors that maintain unhelpful beliefs . The aim of cognitive therapy for insomnia is to reverse all five maintaining processes during both the night and the day . In an open trial 19 patients meeting diagnostic criteria for primary insomnia were treated with cognitive therapy for insomnia . Assessment s were completed pretreatment , posttreatment and at 3- , 6- and 12-month followup . The significant improvement in both nighttime and daytime impairment evident at the posttreatment assessment was retained up to the 12 month followup The aim of this study was to identify indicators of non-functional overreaching ( NFOR ) in team sport athletes undertaking intensive training loads . Eighteen semi-professional rugby league players were r and omly assigned into two pair matched groups . One group completed 6 weeks of normal training ( NT ) whilst the other group was deliberately overreached through intensified training ( IT ) . Both groups then completed the same 7-day stepwise training load reduction taper . Multistage fitness test ( MSFT ) performance , $ $ \ifmmode\exp and after\dot\else\exp and after\.\fi{V}{\text{O}}_{{2\max } } $ $ , peak aerobic running velocity ( Vmax ) , maximal heart rate , vertical jump , 10-s cycle sprint performance and body mass were measured pre- and post-training period and following the taper . Hormonal , haematological and immunological parameters were also measured pre-training and following weeks 2 , 4 and 6 of training and post-taper . MANOVA for repeated measures with contrast analysis indicated that MSFT performance and $ $ \ifmmode\exp and after\dot\else\exp and after\.\fi{V}{\text{O}}_{{2\max } } $ $ were significantly reduced in the IT group over time and condition , indicating that a state of overreaching was attained . However , the only biochemical measure that was significantly different between the IT and NT group was the glutamine to glutamate ( Gln/Glu ) ratio even though testosterone , testosterone to cortisol ( T/C ) ratio , plasma glutamate , and CK activity were significantly changed after training in both groups . Positive endurance and power performance changes were observed post-taper in the IT group confirming NFOR . These changes were associated with increases in the T/C ratio and the Gln/Glu ratio and decreases in plasma glutamate and CK activity . These results indicate that although there was no single reliable biochemical marker of NFOR in these athletes , the Gln/Glu ratio and MSFT test may be useful measures for monitoring responses to IT in team sport athletes BACKGROUND Chronic insomnia is a common health problem with substantial consequences in older adults .  Cognitive behavioral treatments are efficacious but not widely available . The aim of this study was to test the efficacy of brief behavioral treatment for insomnia ( BBTI ) vs an information control ( IC ) condition . METHODS A total of 79 older adults ( mean age , 71.7 years ; 54 women [ 70 % ] ) with chronic insomnia and common comorbidities were recruited from the community and 1 primary care clinic . Participants were r and omly assigned to either BBTI , consisting of individualized behavioral instructions delivered in 2 intervention sessions and 2 telephone calls , or IC , consisting of printed educational material . Both interventions were delivered by a nurse clinician . The primary outcome was categorically defined treatment response at 4 weeks , based on sleep question naires and diaries . Secondary outcomes included self-report symptom and health measures , sleep diaries , actigraphy , and polysomnography . RESULTS Categorically defined response ( 67 % [ n = 26 ] vs 25 % [ n = 10 ] ; χ(2 ) = 13.8 ) ( P < .001 ) and the proportion of participants without insomnia ( 55 % [ n = 21 ] vs 13 % [ n = 5 ] ; χ(2 ) = 15.5 ) ( P < .001 ) were significantly higher for BBTI than for IC . The number needed to treat was 2.4 for each outcome . No differential effects were found for subgroups according to hypnotic or antidepressant use , sleep apnea , or recruitment source . The BBTI produced significantly better outcomes in self-reported sleep and health ( group × time interaction , F(5,73 ) = 5.99 , P < .001 ) , sleep diary ( F(8,70 ) = 4.32 , P < .001 ) , and actigraphy ( F(4,74 ) = 17.72 , P < .001 ) , but not polysomnography . Improvements were maintained at 6 months . CONCLUSION We found that BBTI is a simple , efficacious , and durable intervention for chronic insomnia in older adults that has potential for dissemination across medical setting s. TRIAL REGISTRATION clinical trials.gov Identifier : NCT00177203 We determined the effect of coingestion of caffeine ( Caff ) with carbohydrate ( CHO ) on rates of muscle glycogen re synthesis during recovery from exhaustive exercise in seven trained subjects who completed two experimental trials in a r and omized , double-blind crossover design . The evening before an experiment subjects performed intermittent exhaustive cycling and then consumed a low-CHO meal . The next morning subjects rode until volitional fatigue . On completion of this ride subjects consumed either CHO [ 4 g/kg body mass ( BM ) ] or the same amount of CHO + Caff ( 8 mg/kg BM ) during 4 h of passive recovery . Muscle biopsies and blood sample s were taken at regular intervals throughout recovery . Muscle glycogen levels were similar at exhaustion [ approximately 75 mmol/kg dry wt ( dw ) ] and increased by a similar amount ( approximately 80 % ) after 1 h of recovery ( 133 + /- 37.8 vs. 149 + /- 48 mmol/kg dw for CHO and Caff , respectively ) . After 4 h of recovery Caff result ed in higher glycogen accumulation ( 313 + /- 69 vs. 234 + /- 50 mmol/kg dw , P < 0.001 ) . Accordingly , the overall rate of re synthesis for the 4-h recovery period was 66 % higher in Caff compared with CHO ( 57.7 + /- 18.5 vs. 38.0 + /- 7.7 mmol x kg dw(-1 ) x h(-1 ) , P < 0.05 ) . After 1 h of recovery plasma Caff levels had increased to 31 + /- 11 microM ( P < 0.001 ) and at the end of the recovery reached 77 + /- 11 microM ( P < 0.001 ) with Caff .  Phosphorylation of CaMK(Thr286 ) was similar after exercise and after 1 h of recovery , but after 4 h CaMK(Thr286 ) phosphorylation was higher in Caff than CHO ( P < 0.05 ) . Phosphorylation of AMP-activated protein kinase (AMPK)(Thr172 ) and Akt(Ser473 ) was similar for both treatments at all time points . We provide the first evidence that in trained subjects coingestion of large amounts of Caff ( 8 mg/kg BM ) with CHO has an additive effect on rates of postexercise muscle glycogen accumulation compared with consumption of CHO alone INTRODUCTION Elite athletes frequently undergo periods of intensified training ( IT ) within their normal training program . These periods can lead athletes into functional overreaching , characterized by high perceived fatigue , impaired sleep , and performance . Because whole-body cryostimulation ( WBC ) has been proven to be an effective recovery method in the short term ( < 76 h ) , we investigated whether daily WBC sessions during IT could prevent exercise and sleep-related signs of overreaching . METHODS After a normal training week ( BASE ) , 10 elite synchronized swimmers performed two 2-wk IT periods in a r and omized crossover fashion using WBC daily ( ITWBC ) or not ( ITCON ) , separated by 9 d of light training . Swim time trials ( 400 m ) were performed at BASE and after each IT to quantify blood lactate ( [La]B ) , HR ( HR400 ) , salivary alpha amylase ( [α-amylase]s400 ) , and cortisol ( [cortisol]s400 ) responses . Swimmers wore a wrist actigraph nightly to monitor sleep patterns . RESULTS Swim speed ( 400 m ) , [La]B400 , and [α-amylase]s400 decreased from BASE to ITCON , although no significant changes were found after ITWBC . Decreased swim speed was correlated to decreased HR400 and [cortisol]s400 . During ITCON , significant decreases in actual sleep duration ( -21 ± 7 min ) and sleep efficiency ( -1.9 % ± 0.8 % ) were observed , with increased sleep latency ( + 11 ± 5 min ) and fatigue compared with BASE , although these variables did not change during ITWBC . Using a qualitative statistical analysis , we observed that daily WBC use result ed in a 98 % , 59 % , 66 % , and 78 % chance of preserving these respective variables compared with ITCON . CONCLUSION WBC use during IT helped mitigate the signs of functional overreaching observed during ITCON , such as reduced sleep quantity , increased fatigue , and impaired exercise capacity . These results support the daily use of WBC by athletes seeking to avoid functional overreaching during key periods of competition preparation Abstract Objectives : To improve well-being and performance indicators in a group of Australian Football League ( AFL ) players via a six-week sleep optimisation programme . Design : Prospect i ve intervention study following observations suggestive of reduced sleep and excessive daytime sleepiness in an AFL group . Methods : Athletes from the Adelaide Football Club were invited to participate if they had played AFL senior-level football for 1–5 years , or if they had excessive daytime sleepiness ( Epworth Sleepiness Scale [ ESS ] > 10 ) , measured via ESS . An initial education session explained normal sleep needs , and how to achieve increased sleep duration and quality . Participants ( n = 25 ) received ongoing feedback on their sleep , and a mid-programme education and feedback session .  Sleep duration , quality and related outcomes were measured during week one and at the conclusion of the six-week intervention period using sleep diaries , actigraphy , ESS , Pittsburgh Sleep Quality Index , Profile of Mood States , Training Distress Scale , Perceived Stress Scale and the Psychomotor Vigilance Task . Results : Sleep diaries demonstrated an increase in total sleep time of approximately 20 min ( 498.8 ± 53.8 to 518.7 ± 34.3 ; p < .05 ) and a 2 % increase in sleep efficiency ( p < 0.05 ) . There was a corresponding increase in vigour ( p < 0.001 ) and decrease in fatigue ( p < 0.05 ) . Conclusions : Improvements in measures of sleep efficiency , fatigue and vigour indicate that a sleep optimisation programme may improve athletes ’ well-being . More research is required into the effects of sleep optimisation on athletic performance ABSTRACT The concept of recovery strategies includes various ways to achieve a state of well-being , prevent underrecovery syndromes from occurring and re-establish pre-performance states . A systematic application of individualised relaxation techniques is one of those . Following a counterbalanced cross-over design , 27 sport science students ( age 25.22 ± 1.08 years ; sports participation 8.08 ± 3.92 h/week ) were r and omly assigned to series of progressive muscle relaxation , systematic breathing , power nap , yoga , and a control condition . Once a week , over the course of five weeks , their repeated sprint ability was tested . Tests ( 6 sprints of 4 s each with 20 s breaks between them ) were executed on a non-motorised treadmill twice during that day intermitted by 25 min breaks . RM-ANOVA revealed significant interaction effects between the relaxation conditions and the two sprint sessions with regard to average maximum speed over all six sprints , F(4,96 ) = 4.06 , P = 0.004 , = 0.15 . Post-hoc tests indicated that after systematic breathing interventions , F(1,24 ) = 5.02 , P = 0.033 , = 0.18 , participants performed significantly better compared to control sessions . As the focus of this study lied on basic mechanisms of relaxation techniques in sports , this r and omised controlled trial provides us with distinct knowledge on their effects , i.e. , systematic breathing led to better performances , and therefore , seems to be a suited relaxation method during high-intensity training ABSTRACT Elite soccer players are at risk of reduced recovery following periods of sleep disruption , particularly following late-night matches . It remains unknown whether improving sleep quality or quantity in such scenarios can improve post-match recovery . Therefore , the aim of this study was to investigate the effect of an acute sleep hygiene strategy ( SHS ) on physical and perceptual recovery of players following a late-night soccer match . In a r and omised cross-over design , two highly-trained amateur teams ( 20 players ) played two late-night ( 20:45 ) friendly matches against each other seven days apart . Players completed an SHS after the match or proceeded with their normal post-game routine ( NSHS ) . Over the ensuing 
    Output:
    
Evidence suggests that  sleep extension  had the most beneficial effects on subsequent performance .
Consistent with previous research , these results suggest that sleep plays an important role in some , but not all , aspects of athletes ’ performance and recovery .