{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:24:50Z","timestamp":1791822290505,"version":"4.3.4"},"reference-count":37,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>This study aimed to compare 4 weeks of cranial electrotherapy stimulation (CES) versus cognitive behavioral therapy for insomnia (CBT-I) in athletes with poor sleep quality pre-competition as measured by changes in daily mood state and physiologic parameters of sleep. Athletes with poor sleep quality in their pre-competition phase were recruited. Four weeks of CES and CBT-I were used to compare the effects on daily mood state and physiologic parameters of sleep. The participants were divided into a CES and a CBT-I group. The Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Profile of Mood States (POMS), nighttime heart rate variability (HRV), and sleep architecture of cardiopulmonary coupling (CPC) analyses were assessed before and after the interventions. Twenty-four participants (time to competition = 46.71 \u00b1 11.21 days) completed the study. Decreases in PSQI and ESS scores were observed in both groups. A decrease in confusion and tension scores and improvement of sleep efficiency were noted after CBT-I (p &lt; 0.05). Changes in light sleep (stages S1 and S2) and deep sleep (stages S3 and S4) were observed (p &lt; 0.05), accompanied by alterations in HRV (p &lt; 0.05). Both interventions for athletes experiencing poor sleep quality before competition had efficacy in improving sleep quality and reducing daytime sleepiness. CES could cause alterations in sleep architecture and autonomic nervous regulation, and CBT-I contributed to a reduction in negative mood states. This study is tiny and limited by the absence of a control group, which may introduce psychological bias, and future research should include control conditions and extended follow-up assessments to validate these findings.<\/jats:p>","DOI":"10.3390\/life15060905","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T10:10:16Z","timestamp":1749031816000},"page":"905","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparing the Effects of Cranial Electrotherapy Stimulation and Cognitive Behavioral Therapy for Insomnia on Daily Mood and Physiological Sleep Parameters in Athletes with Poor Pre-Competition Sleep Quality"],"prefix":"10.3390","volume":"15","author":[{"given":"Yung-An","family":"Tsou","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 40447, Taiwan"},{"name":"Department of Audiology and Speech-Language Pathology, Asia University, Taichung 41354, Taiwan"},{"name":"School of Medicine, China Medical University, Taichung 404328, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2721-0687","authenticated-orcid":false,"given":"Bao-Lien","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, China Medical University, Taichung 406040, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5546-5874","authenticated-orcid":false,"given":"Wen-Dien","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Sport Performance, National Taiwan University of Sport, Taichung 404401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1123\/ijspp.2014-0565","article-title":"Sleep and recovery in team sport: Current sleep-related issues facing professional team-sport athletes","volume":"10","author":"Fullagar","year":"2015","journal-title":"Int. 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