Sleep and Mental Health Screening in Canadian Student-Athletes: Prevalence and Implications for Care

Background: Holistic student-athlete care, including sleep and mental health assessments, is recommended but sometimes overlooked due to time, resource constraints, and liability concerns. Sleep is important for health, yet student-athletes balancing athletic and academic demands can experience compromised sleep. Poor sleep and insufficient sleep can cause fatigue, worsen mental health, and increase injury risk. Cumulative sport-related stressors may heighten the risk of mental health issues like anxiety and depression(1,2). Understanding how many student-athletes screen positive for sleep and mental health issues can inform program and resource needs, especially in Canada where varsity sport funding is limited and screening is not standard. This study assessed the baseline prevalence of sleep difficulties, fatigue, clinical insomnia, anxiety, and depression in student-athletes at a mid-sized Canadian university. Hypothesis: N/A. Methods: Student-athletes from 11 teams (cheerleading, basketball, hockey, rugby, volleyball, wrestling) completed validated questionnaires electronically during baseline evaluation (August to October 2024). Instruments included the Athlete Sleep Screening Questionnaire (ASSQ), Fatigue Severity Scale (FSS), Insomnia Severity Index (ISI), Generalized Anxiety Disorder Questionnaire (GAD-7), and Patient Health Questionnaire (PHQ-9). Prevalence and 95% confidence intervals (CI) were estimated for moderate to severe sleep difficulty (ASSQ≥8), fatigue (FSS≥36), insomnia (ISI≥15), anxiety (GAD-7≥10), and depression (PHQ-9≥10), and explored by sport and gender. Results: Of 218 student-athletes (128 female, 90 male), 26.3% (95% CI: 20.8–32.6) reported moderate to severe sleep difficulty. The highest prevalence was observed in women’s wrestling (41.2%, 95% CI: 20.9–64.9) and cheerleading (36.4%, 95% CI: 19.3–57.8). Fatigue was reported by 14.8% (95% CI: 10.6–20.2), with higher rates among females (19.1%, 95% CI: 13.1–26.9) than males (8.9%, 95%. Conclusion: Approximately one in four student-athletes reported sleep difficulty and one in seven reported fatigue, indicating a need for follow-up and potential referral to a sleep specialist. Nearly one in five screened positive for anxiety and one in six for depression, with higher prevalence among females. These findings support implementing screening protocols and allocating resources to better manage sleep and mental health in student-athletes.