European Journal of Sport Science

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3-min whole body cryotherapy/cryostimulation

after training in the evening improves sleep
quality in physically active men

Wafa Douzi, Olivier Dupuy, Maxence Tanneau, Geoffroy Boucard, Romain

Bouzigon & Benoit Dugué

To cite this article: Wafa Douzi, Olivier Dupuy, Maxence Tanneau, Geoffroy Boucard, Romain
Bouzigon & Benoit Dugué (2018): 3-min whole body cryotherapy/cryostimulation after training in the
evening improves sleep quality in physically active men, European Journal of Sport Science, DOI:
10.1080/17461391.2018.1551937

To link to this article: https://doi.org/10.1080/17461391.2018.1551937

Published online: 14 Dec 2018.

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European Journal of Sport Science, 2018
https://doi.org/10.1080/17461391.2018.1551937

ORIGINAL ARTICLE

3-min whole body cryotherapy/cryostimulation after training in the

evening improves sleep quality in physically active men

WAFA DOUZI1, OLIVIER DUPUY1, MAXENCE TANNEAU1, GEOFFROY BOUCARD2,

ROMAIN BOUZIGON3, & BENOIT DUGUÉ 1
1
Laboratoire Mobilité Vieillissement Exercice (MOVE)-EA6314, Faculty of Sport Sciences, University of Poitiers, Poitiers,
France; 2Centre de Recherches sur la Cognition et l’Apprentissage (UMR7295), Université de Poitiers and Université François-
Rabelais de Tours, Poitiers, France & 3Laboratoire C3S (EA 4660), Unité de Promotion, de Formation et de Recherche
(UPFR) des Sports, Université de Franche Comté, Besançon, France

Abstract
Exercise training during evening may disturb sleep patterns and hinder recovery process. The present study aimed to examine
the effect of whole body cryotherapy (WBC) exposure after training in the evening on sleep quality and night heart rate
variability (HRV). A total of 22 physically active men were randomized to undergo either WBC (3-min at −40°C, wind
speed of 2.3 m s−1) or passive recovery (control) following an evening training consisting of 25 min of continuous running
at 65% of the maximal aerobic speed (MAS) followed by intermittent running at 85% of the MAS. Each night following
the training, the number of movements and HRV during sleeping time were recorded. The next morning, subjective sleep
quality and perceived pain were assessed using Spiegel questionnaire and a visual analogue scale, respectively. The
number of movements during the night following WBC was significantly reduced (p < 0.05) compared with the control
condition. Subjective sleep quality following WBC was significantly better than the control group (p < 0.05). During the
estimated slow-wave sleep (SWS), the high frequency power (HF) was higher in the WBC group than the control group
(p < 0.05), and the low frequency power (LF) and the LF/HF ratio were lower than the control group (p < 0.05). Pain was
significantly reduced following WBC compared to the control (p < 0.01). In conclusion, the use of 3-min WBC after
training in the evening improves subjective and objective sleep quality in physically active subjects, which may be due to
greater pain relief and improved parasympathetic nervous activity during the SWS period.

Keywords: Cryotherapy, cold exposure, sleep, heart rate variability, parasympathetic system, pain

Highlights
. The use of 3-min whole-body cryotherapy/cryostimulation after evening training improves the subjective sleep qualityand
the morning form state.
. The use of 3-min whole-body cryotherapy/cryostimulation after evening training improves the objective sleep quality by
reducing the number of movements during sleep.
. The use of 3-min whole-body cryotherapy/cryostimulation after evening training enhances the pain relief and
improvesparasympathetic nervous activity during the deep sleep (slow wave sleep).

Introduction
2015). However, high-level athletes often travel or
Adequate sleep is essential for maintaining high levels train in the evening and at night due to busy sche-
of mental and physical performance in professional dules, which can easily disrupt normal sleep-wake
athletes (Chennaoui, Arnal, Sauvet, & Léger, cycles and may even cause poor sleep quality. It is
2015). Sleep is considered as an important recovery assumed that performing physical exercise less than
process due to its physiological restorative effects 4 h before bedtime induces sleep disturbances
for reinstating molecular homeostasis, synaptic plas- (Chennaoui et al., 2015). In professional soccer
ticity and cellular maintenance (Fullagar et al., players, late-night exercise induces a greater

Correspondence: Benoit Dugué, Faculté des Sciences du Sport et Laboratoire “Mobilité, Vieillissement, Exercice”, Université de Poitiers, 8
allée Jean Monnet, Poitiers 86000, France. E-mail: [email protected]

© 2018 European College of Sport Science

2 W. Douzi et al.

number of sleep disturbances compared to daylight latency, as well as a decrease in skin temperature
exercise (Meyer, Wegmann, Poppendieck, & Fulla- may have an analgesic effect and lower delayed
gar, 2014). Similarly, 53% of elite Australian athletes onset of muscle soreness facilitating therefore a
(n = 283) reported increased sleep disturbances after better quality of sleep. Cryo stimulus/stimuli may
a night match or training (Juliff, Halson, & Peiffer, also have the power to readjust hormonal circadian
2015). Furthermore, high intensity exercise con- rhythm and biological clock after a disturbance
ducted in the evening for judo competitors results induced by high-intensity exercise close to bedtime.
in an increased number of awakenings and delayed Nevertheless, the effect of cold exposure in the
sleep onset, and a recent review/ meta-analysis evening and quite near bedtime on sleep quality has
expressed that intense exercise very close to not been investigated.
bedtime might impaired sleep-onset latency, total Therefore, it is unclear whether whole body
sleep time and sleep efficiency (Stutz, Eiholzer, & cryotherapy can mitigate sleep disturbances resulting
Spengler, 2018). Disturbed sleep following late- from evening exercise. Also, autonomic nervous
night exercise is explained either by increased activity has not been investigated during sleep follow-
arousal and prolonged wakefulness induced by phys- ing evening cryotherapy exposure. Nevertheless,
ical exercise (Meyer et al., 2014) or an increase in there are several investigations reporting an increase
perceived pain induced by the physical exercise (Full- of parasympathetic activity from 5 to 20 min follow-
agar et al., 2015). Inadequate sleep quality and quan- ing cold exposure (Hausswirth et al., 2013; Schaal
tity likely hinders psychological and physical recovery et al., 2013). Heart rate changes during sleep are
and limits training adaptations by impeding muscle related to sleep stage, awakenings, and body move-
protein accumulation (Fullagar et al., 2015). From ments (Johns, Thornton, & Doré, 1976). Also, it
a psychological point of view, sleep loss disrupts was recognized that parasympathetic function, quan-
mood, confidence and perceptual awareness. In tified by heart rate variability indices, is strongly cor-
addition, athletes with sleep loss are more likely to related with sleep quality (Schaal et al., 2013). As
suffer from exercise-related injuries (Chennaoui shown in a previous study, poor sleep quality was
et al., 2015). A decrease in proprioception, postural associated with a disturbance in heart rate variability
control (Dattilo et al., 2011; Gosselin et al., 2009) (HRV) (Schaal et al., 2013). Sleep is characterized by
and reaction time (Martin, 1981) could explain large variations in HRV signals that decrease in non-
such feature. Indeed, maintaining good sleep REM (Rapid Eye Movement) sleep and increase in
quality to facilitate the recovery process has been a REM sleep (Stein & Pu, 2012). Previous studies
concern for athletes over the last decade. In this (Brandenberger, Buchheit, Ehrhart, Simon, &
context, several studies have been conducted to Piquard, 2005; Buchheit, Simon, Piquard, Ehrhart,
evaluate the effect of slightly decreasing the body & Brandenberger, 2004) used HRV analyses, particu-
temperature on sleep quality (Bouzigon, Ravier, larly in slow wave sleep episodes (SWS) in which
Dugue, & Grappe, 2014; Haddad, Parouty, & Buch- there are fewer body movements, decreased arousal
heit, 2012; Schaal et al., 2015). It has been reported and a more regular respiratory pattern (Brandenber-
that cold water immersion improves sleep quality fol- ger et al., 2005). We assumed that a single exposure
lowing daily training (Haddad et al., 2012) and daily to whole body cryotherapy improves sleep quality
training in the heat (Skein, Wingfield, Gale, after evening training and stimulates the reactivation
Washington, & Minett, 2018). It was recently of parasympathetic nervous activity. To verify this
shown that cryotherapy exposure, which consists of hypothesis, we examined the impact of 3-min whole
short exposure to very cold air (from −110°C to body cryotherapy exposure on subjective and objec-
−195°C) in special rooms (cryo chambers or cryo tive sleep quality and night HRV analysis following
cabins) after exercise promotes good sleep quality a standardized training session in physically active
both in elite synchronized female swimmers (during men.
a period of intense training associated with symptoms
of overtraining; the swimmers experienced 3-min
exposure at −110°C, daily for 14 days) and in pro- Methods
fessional basketball players (the players experienced
Subjects
a single 3-min exposure at −130°C) (Bouzigon
et al., 2014; Schaal et al., 2015). Twenty-two physically active, regularly training (at
Cryotherapy/cryostimulation is commonly used for least 3 sessions per week, with sessions lasting at
analgesic and anti-inflammatory purposes (Dupuy, least for 1 h) and healthy men (age: 28.5 ± 7.3
Douzi, Theurot, Bosquet, & Dugué, 2018). The years; weight: 71.7 ± 12.4 kg; height: 176.1 ±
effects of cryostimulation in the decrease in body 6.1 cm; maximal aerobic speed (MAS): 17.2 ±
temperature could have an impact on sleep onset 1.3 km/h) participated in the study. The participants
 Cryostimulation improves sleep quality 3

were free of injury and illnesses, including sleep- cryotherapy session in a whole-body cryotherapy
related issues. They provided their written informed chamber with technology based on forced convec-
consent, which conformed to the code of ethics of tion. This cryotherapy chamber was recently vali-
the Declaration of Helsinki. The study was accepted dated (Bouzigon et al., 2017), and it was shown
by the local ethics committee. Participants refrained that a 3-minute exposure induced the same skin
from heavy exercise for one day before the experiment, temperature decreases as a 3-minute exposure
and coffee and alcohol were forbidden 24 h before and between −60°C and −160°C in previous technologies
after the experiment. They were instructed not to (whole body or partial body cryotherapy chambers).
perform any recovery procedure, such as massage or Before exposure to cryotherapy, the blood pressure
the use of compression garments, other than cryother- of each participant was measured at the left brachial
apy. As this investigation was a free-living investi- artery using a sphygmomanometer (Omron Hem-
gation, the volunteers were instructed to keep their 7120, Omron Healthcare, Kyoto, Japan), and
regular sleeping habits and to behave as similarly as further assessments were performed to determine
possible on both conditions (sleeping habits, number whether the subject had any contraindications to
of hours spent in bed, the level of light). cryotherapy. The cryotherapy chamber was housed
in a truck trailer and was composed of two chambers.
First, the subject spent 30 s at −25°C in the first
Experimental design
chamber and then 3 min in the main chamber at an
The experiment was held for two weeks. Each session exposure temperature of −40°C and with an
occurred once per week on the same weekday and at average wind speed of 2.3 m s−1. During the
the same time during the day (starting at 7 pm). Subjects exposure, the participant wore a surgical mask, a
undertook a standardized training session for 55 min. headband over his ears, underwear, socks, gloves
Then, each subject was assigned to a 3-min whole- and slippers.
body cryotherapy session using a recently described
chamber (AuroreConcept®, Noisels, France) (Bouzi-
gon et al., 2017) or 3-min passive recovery (participant Measurements
were seated) in a random order. The randomization
Skin temperatures. The main cryotherapy chamber
was performed using random permutation tables, gen-
was equipped with three thermal probes (CT LT,
erated by a computer algorithm. The night following
Optris, Berlin, Germany) to measure the skin temp-
the recovery (cryotherapy or passive), subjects wore
erature at the trunk, abdomen and upper thighs
accelerometers and heart rate monitors and recorded
every 30 s during the exposure time.
their bedtime and waking time in a logbook.

Ratings of perceived fatigue and pain. Perceived pain

Training session and fatigue were assessed before and immediately
In both trials, the 55 min standardized training after the exercise session, and the next morning (at
session was performed on a track at a temperature the time of wake-up) using a visual analogue scale
of 21–22°C. Each session consisted of a 5-min (VAS) ranging from 0 to 10 in which 0 corresponds
warm up, followed by a continuous exercise bout at to no pain or perceived fatigue and 10 represents
65% MAS for 25 min and an intermittent exercise pain or extreme fatigue (Costello, Algar, & Donnelly,
bout consisting of 3 sets of 7 min at 85% MAS separ- 2012; Delextrat, Calleja-González, Hippocrate, &
ated by 2 min of active recovery at 60% MAS. During Clarke, 2013).
the exercise bouts, all participants adjusted their
speed and pace using a heart rate monitor (Polar Heart rate variability assessment at night. Participants
V800 GPS, Finland) and were instructed to use the wore a heart rate monitor (Polar V800 GPS sport
same speed in both trials. A checking was performed watch, Kempele, Finland) each night after exposure
a posteriori. All of our subjects followed the instruc- to cryotherapy or control session. They were asked
tion seriously and no speed differences were observed to manually start recording the R-R intervals at
between the two sessions. There were no verbal bedtime and stop when they woke up. Data files
encouragements nor other environmental factors were transferred to the computer using the Polar
that could affect arousal or sleep. Flow application (Polar, Kempele, Finland) and
were analysed using Kubios HRV software (version
2.1, 2012, MATLAB, Kuopio, Finland). For each
Recovery
subject, the night HRV was assessed during the
Thirty minutes after the training session, subjects entire sleep night, the first 4 h of sleep and the first
underwent either passive recovery or a 3-min 10-min stationary segment in the first slow-wave
4 W. Douzi et al.

sleep (SWS) episode. As reported in previous study distribution was tested for each variable using the
(Dupuy, Bherer, Audiffren, & Bosquet, 2013), the Shapiro–Wilk test. Paired t-test or non-parametric
4-hour analysis started 30 min after the recorded Wilcoxon test were used to assess the significant differ-
bedtime. The SWS episode was determined accord- ence between the two conditions [cryotherapy (WBC)
ing to the method of Brandenberger et al. (2005). vs passive recovery (control)]. The results of the tests
This segment was characterized by a stable HRV were considered significant at p ≤ 0.05. The Hedges’
signal of 15 min with a round Poincaré plot and a g parameter (g) was used to assess the effect size of
low standard deviation of normal-to-normal intervals the changes and was then interpreted with the
(SDNN). The Kubios HRV software provided a Cohen’s criteria (Cohen, 1988) as a small (0.2 < g ≤
spectral analysis of low frequency (LF: 0.04– 0.5), moderate (0.5 < g ≤ 0.8), or large (g > 0.8)
0.15 Hz) and high frequency (HF: 0.15–0.40 Hz) effect. The required sample size was calculated from
bands. Other time and frequency domain measures our control data using G∗ Power version 3.1, according
were obtained, such as the mean heart rate to Beck (Beck, 2013). Using an a priori repeated-
(HRmean), R-R interval (RRI), square root of the measures design with a desired power (1-beta) set at
mean-squared differences of RRI (RMSSD), stan- 0.80, and an alpha risk of 0.05, twenty-one subjects
dard deviation (SD), total power (LF+ HF) and represent a sufficient number of subjects to detect a
LF/HF power ratio. significant difference. The results were expressed as
the means with the standard deviation (SD).
Sleep quality assessment. Concerning the sleep quality
assessment, each night after exposure to cryotherapy Results
or passive recovery, all participants wore a wrist acti-
graph (WGT3X-BT monitor, Pensacola, USA) to Sleep assessment using accelerometery
record movements during sleep. Volunteers were As shown in Figure 1, the number of movements
asked to start the recording at bedtime and stop it detected in the three spatial axes during sleep was sig-
when waking up the next morning. They were nificantly lower the night following WBC compared
instructed to note in a logbook, the hour at which to the control condition [X (p < 0.01), Y (p < 0.01);
they went to bed and woke up. This actigraph is Z (p < 0.01)]. The effects size of these changes in
equipped with a receiver that captures movements on the three spatial axes ranged from medium to large
the horizontal, vertical and perpendicular axes. Data effects (−0.6 < g < 0.8). Sleep efficiency after WBC
were sampled over a constant interval (epoch length exposure (88.8 ± 6.3) was significantly higher than
of 60 s) and were extracted as the sum of the vector the control (84.3 ± 6.5) (p < 0.05).
magnitude in counts/minute (calculated as the square
root of the sum of the square of acceleration for each
of the three axes) using actiLife software (version Subjective assessment of sleep
6.11.0, Fort Walton Beach, FL, USA). The total
The next morning after WBC exposure, Spiegel’s
sleep time was estimated from the provided bedtime
total questionnaire score was significantly higher
and wake up time, and the movements during sleep
than after passive recovery (WBC: 20.9 ± 3.5 vs
were calculated for each participant as follows: total
control: 23.1 ± 2.5, p < 0.05), which indicated
counts in each axis (x, y, and z)/total sleep time. For
improved subjective sleep quality. For the Spiegel
the sleep analysis, sleep efficiency [(actual sleep time/
questionnaire items, WBC induced a better
total sleep time)∗ 100] was recorded. Also, subjective
morning form state (p < 0.05) than the control con-
sleep quality was assessed using the Spiegel Sleep
dition. The number of hours spent in bed was
Quality Perception Questionnaire (Spiegel, 1984)
similar in both conditions (WBC: 414 min ± 43 min
completed in the morning following WBC exposure
vs control: 434 min ± 57 min).
or passive recovery. Subjects answered six items, with
scores that range from 0 to 5, for sleep time, quality
of sleep, nocturnal awakenings, dreams and morning Heart rate variability during sleep
form state. The total score of the Spiegel questionnaire
determined the subjective sleep quality. The time and frequency domain analyses of HRV
during sleep are presented in Table I. There were
no significant differences between the two conditions
for any parameter of heart rate variability recorded
Statistical analysis
during the entire night sleep and the first 4-hour
All data were stored in an electronic database and ana- period. In contrast, when HRV was assessed during
lysed using specialized statistical software (Statistica the first 10-min SWS episode, we found that HF in
7.0, StatSoft, Tulsa, OK, USA). The Gaussian the WBC condition was significantly higher than in
 Cryostimulation improves sleep quality 5

Figure 1. Counts per minute on the 3 movement axes (x: horizontal, y: vertical, and z: perpendicular) during sleep following whole body
cryotherapy (WBC) or passive recovery (control). ∗ Significant difference from the control at p < 0.01.

the control condition (p < 0.05), and the LF and LF/HF (WBC: 6.3 ± 0.8 vs control: 5.2 ± 2.0, p = 0.41 con-
were significantly lower than in the control condition. cerning perceived fatigue; and WBC: 4.5 ± 1.8 vs
We found no differences for other HRV analyses. control: 3.3 ± 2.0, p = 0.59 concerning pain/muscle
soreness). When calculating the changes ((morning
– evening score)/evening score) in the pain scores,
Skin temperature we observed a significant larger decrease in the
WBC (−58%) than in the control (−20%) condition
The skin temperature was assessed in the main
(p < 0.01).
cryotherapy chamber at the end of the exposure, the
skin temperature reached 15.0°C ± 1.7°C for the
chest, 14.1°C ± 2.1°C for the abdomen and 12.4°C
± 1.6°C for the upper thighs. Discussion
The aim of this study was to investigate the impact of
cold-exposure on sleep quality after an evening train-
Perceived fatigue and pain
ing. The main findings was that a single session of
After the exercise session, perceived fatigue and pain/ whole- body cryotherapy (3-min at −40°C; wind
muscle soreness were similar between the conditions speed at 2.3 m s−1) in the evening improves the

Table I. Averages of HRV analyses during the entire night sleep, the first four hours and the SWS episode after exposure to WBC or passive
recovery (control).

Whole Night 4 hours SWS

Control WBC Control WBC Control WBC

Mean RR (ms) 1152 ± 169 1103 ± 276 1126 ± 174 1059 ± 284 1112 ± 167 1137 ± 159
Mean HR (bpm) 53 ± 8 52 ± 8 54 ± 9 52 ± 12 55± 9 54 ± 8
SDNN (ms) 66 ± 17 72 ± 21 64 ± 27 66 ± 31 31 ± 10 39 ± 27
RMSSD (ms) 68 ± 28 75 ± 28 67 ± 40 67 ± 39 32 ± 16 44 ± 35
HF nu 38 ± 17 38 ± 12 42 ± 22 44 ± 21 34 ± 16 43 ± 17∗
LF nu 61 ± 17 61 ± 12 58 ± 22 56 ± 21 66 ± 16 57 ± 17∗
Total Power (ms2) 4317 ± 1984 5202 ± 2964 5298 ± 4850 5242 ± 4900 954 ± 569 1932 ± 3263
LF/HF 2 ± 2.5 2 ± 0.9 3±2 3±2 3±2 2 ± 2∗
SD1 (ms) 48 ± 20 53 ± 20 47 ± 28 47 ± 28 22 ± 11 32 ± 25
SD2 (ms) 79 ± 17 85 ± 22 77 ± 28 79 ± 34 38 ± 10 44 ± 29

∗
Significantly different from control. Abbreviations: RR, R-R interval; HR, Heart rate; SDNN, standard deviation of normal-to-normal
intervals; RMSSD, square root of the mean-squared difference of R-R interval; HF, high-frequency bands; LF, low frequency bands; Total
power, LFnu + HFnu; LF/HF, LF/HF power ratio; SD1, standard deviation 1 of Poincaré plot; SD2, standard deviation 2 of Poincaré plot.
6 W. Douzi et al.

subjective and objective sleep quality, enhances the during light sleep and decreased during deep sleep.
reactivation of parasympathetic activity and reduces Accordingly, the observed lower motor activity
the perceived pain 24 h after a standardized exercise levels following WBC exposure may be explained
regimen in physically active men. by deeper sleep and better sleep quality. Further-
Whole body cryotherapy exposure improved sub- more, sleep efficiency was improved following WBC
jective sleep quality and enhanced the morning exposure. This finding was consistent with a recent
form state. These results were consistent with pre- study (Schaal et al., 2015) conducted during an
vious studies investigating the effect of cooling inter- intense training period associated with a disruption
ventions (cold water immersion and cryotherapy) on in sleep quantity and quality. It was demonstrated
subjective sleep quality (Bouzigon et al., 2014; that the daily use of WBC for two weeks improved
Haddad et al., 2012). The beneficial effect of swimmers’ tolerance to training load by preserving
cryotherapy may be explained by a reduction of sleep quantity and promoting the onset of sleepiness,
muscle soreness and improvement of well-being particularly during periods of increased physical and
(Dupuy et al., 2018), which together lead to psychological stress. Interestingly, the reduced body
improved mood and subjective sleep quality. A pre- temperature may have potentially affected sleep by
vious study examined the relationship between sleep improving sleep propensity (O’Connor, Breus, &
disturbances and perceived pain and reported that Youngstedt, 1998).
an increase in pain levels disrupts sleep by increasing In addition, the perceived pain was reduced by
arousal and triggering other neurobiological sequelae 58% following cold exposure. This finding confirmed
of stress (Lautenbacher, Kundermann, & Krieg, the analgesic effect of cryotherapy reported in recent
2006). These authors suggested that greater pain studies (Dupuy et al., 2018; Lombardi, Ziemann, &
relief enhances sleep quality and prevents its disturb- Banfi, 2017). It is recognized that the exposure to
ance. Therefore, the observed pain reduction in the cold stimulates the production of beta-endorphin, a
present study, likely due to the analgesic effect of neurotransmitter exerting analgesic effects, respon-
cryotherapy, may promote better sleep quality and a sible for a sense of well-being (Leppäluoto et al.,
less disturbed sleep pattern. However, a recent 2008), which may explain the improved morning
study (Skein et al., 2018) examining the effect of form state and reduced muscle soreness. Also, nora-
cold-water immersion on subjective and objective drenalin is produced and also has analgesic properties
sleep quality reported improved subjective sleep (Leppäluoto et al., 2008). Moreover, skin tempera-
quality without a change in the objective sleep charac- tures reached 12°C at the end of exposure in some
teristics, which may suggest a placebo effect for the body areas. It was shown that a reduction of skin
cooling intervention. temperature below 13.6°C stimulates the analgesic
The objective sleep quality was evaluated in the effect of cryotherapy by blunting nerve conduction
present study by assessing sleep efficiency and the and acetylcholine formation (Bugaj, 1975).
number of movements during sleep on the three The heart rate (HR) and heart rate variability
spatial axes. These variables were recorded with a (HRV) were considered physiological biomarkers
wrist actigraph validated against laboratory polysom- related to sleep stages (Lan, Tsuzuki, Liu, & Lian,
nography, and considered as an accurate tool for 2017). From a global view of the entire sleep night
measuring and quantifying sleep (American Sleep and the first 4-hour analysis, HRV was unaffected
Disorders Association, 1995). As shown in Figure by cold exposure. By contrast, HRV analysis during
1, WBC exposure in the evening induced lower the first detected SWS episode was dominated by
motor activity during sleep across the three spatial parasympathetic activity in the WBC group. This
axes (horizontal, vertical, and perpendicular) than finding was determined from a higher HF power
in the passive recovery. As reported in previous (variations at normal respiratory frequencies, 9–
studies, the decrease of motor activity levels is indica- 24 times/min, 0.15–0.4 Hz), which is modulated by
tive of deeper sleep (Middelkoop Huub, Hilten Bob, parasympathetic nervous systems inputs, and a
Kramer Cor, & Kamphuisen Hilbert, 1993; Miwa, decrease in the LF/HF ratio that indicates decreased
Sasahara, & Matsui, 2007). A previous study investi- sympathetic activity (Stein & Pu, 2012). In this sense,
gating the effect of training load on sleep quality our results showed greater parasympathetic and
showed that high levels of motor activity were associ- lower sympathetic activity during the SWS episode
ated with an increased number of awakenings during following cold exposure. It is known that cold
sleep, whereas low levels of motor activity indicated exposure prompted parasympathetic activity reactiva-
deeper sleep (Middelkoop Huub, et al., 1993). tion after physical exercise by increasing central
Based on the frequency of rotational motion (roll- blood volume and blood pressure (Mourot et al.,
overs) during sleep, Miwa et al. (Miwa et al., 2007) 2008), which stimulates arterial and cardiopulmon-
proposed that recorded movements increased ary baroreceptors (Zalewski et al., 2014) that reduce
 Cryostimulation improves sleep quality 7

sympathetic nerve activity and increase parasympa- Beck, T. W. (2013). The importance of a priori sample size esti-
thetic activity (Zalewski et al., 2014). These results mation in strength and conditioning research. Journal of
Strength and Conditioning Research, 27(8), 2323–2337.
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the effect of cold exposure on the autonomic Dugue, B. (2017). Validation of a new whole-body cryotherapy
nervous system (Haddad et al., 2012; Schaal et al., chamber based on forced convection. Journal of Thermal Biology,
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use of whole-body cryostimulation to improve the quality of
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Dupuy, O., Douzi, W., Theurot, D., Bosquet, L., & Dugué, B.
Romain Bouzigon, has been employed by Cryantal Development (2018). An evidence-based approach for choosing post-exercise
and is nowadays acting as a part-time consultant for Société recovery techniques to reduce markers of muscle damage, sore-
Aurore Concept, 77186 Noisiel, France. ness, fatigue, and inflammation: A systematic review With
meta-analysis. Frontiers in Physiology, 9, 403. doi:10.3389/
fphys.2018.00403
ORCID Fullagar, H. H., Duffield, R., Skorski, S., Coutts, A. J., Julian, R.,
& Meyer, T. (2015). Sleep and recovery in team sport: Current
BENOIT DUGUÉ http://orcid.org/0000-0003- sleep-related issues facing professional team-sport athletes.
2660-8244 International Journal of Sports Physiology and Performance, 10
(8), 950–957.
Gosselin, N., Lassonde, M., Petit, D., Leclerc, S., Mongrain, V.,
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