Background: Sleep is a key determinant of recovery and performance in elite athletes, yet its optimization extends beyond sleep duration alone and encompasses multiple subjective and physiological dimensions. Environmental factors, including the sleep surface, represent modifiable components of sleep that may influence perceived sleep quality. This study aimed to examine whether an individually adjustable modular sleep system improves subjective sleep quality in elite athletes and whether alterations in objective sleep metrics, circadian timing, or nocturnal autonomic physiology accompany such changes. Methods: Forty-three elite athletes participated in this pre–post-intervention study (without a control group). Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while objective sleep and physiological parameters were recorded using a wearable device (Oura Ring, 3rd generation). Outcomes were averaged across three consecutive nights at baseline (T0) and post-intervention (T1). Baseline values were derived from the final three nights of a standardized pre-intervention monitoring period (minimum 7 nights), and post-intervention values from the final three nights following a standardized intervention exposure period (minimum 14 nights). Statistical analyses included paired frequentist tests and complementary Bayesian paired-sample analyses. Results: Subjective sleep quality improved significantly following the intervention, with a mean reduction in PSQI score of 0.67 points (p < 0.001). In contrast, no meaningful changes were observed in total sleep time (p = 0.28), REM duration (p = 0.26), circadian timing (p = 0.47), or nocturnal minimum heart rate (p = 0.42), as supported by the absence of physiological changes in these parameters. Conclusions: It seems that an individually adjustable sleep system can be able to improve perceived sleep quality in elite athletes without disrupting sleep architecture, circadian regulation, or nocturnal autonomic function. In athletes whose sleep duration and physiological sleep metrics are already near optimal, such micro-environmental interventions may offer a feasible, low-risk means of enhancing recovery by targeting subjective sleep quality. This dimension dissociates from objective sleep measures. Optimizing the sleep surface may therefore represent a practical adjunct to existing recovery strategies in high-performance sport.
Marshall et al. (Fri,) studied this question.