G Model

PEH-83; No. of Pages 6 ARTICLE IN PRESS

Performance Enhancement & Health xxx (2015) xxx–xxx

Contents lists available at ScienceDirect

Performance Enhancement & Health

journal homepage: www.elsevier.com/locate/peh

Psychological recovery: Progressive muscle relaxation (PMR), anxiety,

and sleep in dancers
Lana J. McCloughan a,∗ , Stephanie J. Hanrahan a , Ruth Anderson b , Shona R. Halson c
a
The University of Queensland, Schools of Human Movement Studies and Psychology, St Lucia, Australia
b
MiND HQ, United Kingdom
c
The Australian Institute of Sport, Belconnen, Australia

a r t i c l e i n f o a b s t r a c t

Article history: The current study was designed to test the efficacy of progressive muscle relaxation (PMR) in improving
Received 25 May 2015 the sleep onset latency (SOL) of full time dancers. A pre and post intervention study design examined sleep
Received in revised form duration and efficiency, and change in SOL as a function of trait anxiety using PMR for the intervention.
11 November 2015
Twelve female dancers aged 18–23 years were recruited from the Queensland University of Technology
Accepted 14 November 2015
Available online xxx
dance programme. Trait anxiety was differentiated into social evaluation, physical danger, and ambiguous
dimensions using the Endler Multidimensional Anxiety Scale-Trait (EMAS-T) scales. Sleep parameters
were monitored using wristwatch actigraphy over a 14 day period with a PMR intervention in Week 2.
Keywords:
Psychology Sleep duration and efficiency were compared to published data, and improvements in SOL were examined
Dance for those with poorer baseline SOL and higher trait anxiety. Sleep duration and efficiency in this sample did
Sport not significantly differ to that of previously published data from athlete and dance samples. Participants
Psychological stress with high trait social evaluation anxiety showed a statistically significant decrease in SOL from Week
Homeostasis 1 to Week 2 (Z = −2.02, p = .04), with a large effect size (r = .90) following PMR training. Sleep needs of
Actigraphy full time dancers differ to those of the general population. PMR is indicated as an effective strategy
for improving SOL in higher trait social evaluation anxiety elite performers. Replication with a large
randomised controlled trial and an athlete sample is needed.
© 2015 Elsevier Ltd. All rights reserved.

1. Introduction Recovery is defined as the re-establishment of psychologi-

This study was conceptualised in response to the assistance
given to athletes by the sports science and psychology staff at the
Australian Olympic team’s recovery centre during the London 2012
Olympic Games. Sleep was viewed as vital for athletes’ recovery at
the games, and progressive muscle relaxation (PMR) was employed
as a relaxation strategy to offset the psychological (cognitive) and
physical (somatic) stressors experienced. There is evidence for the
use of PMR in the general population as an effective treatment for
sleep issues, but little evidence exists to support the use of PMR for
performers. For the purpose of this study, “elite” refers to highly
skilled, and “performers” refers to those who perform or execute
a physical skill. The present study was a preliminary pilot evalua-
tion of PMR in full time dancers with the view to replication with
an athlete sample and a larger randomised controlled trial in the
future.
∗ Corresponding author.
E-mail address: lana.mccloughan@swimming.org.au (L.J. McCloughan).
cal and physiological resources to allow for future use (Kellman
& Kallus, 1999). Different performance contexts involve differ-
ent physical and mental stressors in training and performance,
and individuals differ in their abilities to cope with stressors.
Responsible for the secretion of the stress hormone cortisol, the
hypothalamic–pituitary–adrenal (HPA) axis is primarily activated
when the body responds to stress (Miller & O’Callaghan, 2002).
Socio-evaluative threat (the threat of negative evaluation from oth-
ers) during training and performance can activate the HPA axis
(Suay et al., 1999). During stress, elite performers experience a
deviation from the homeostasis state, requiring restoration during
recovery for training and performance standards to be maintained
(Beckmann & Kellmann, 2004).
Athletes, coaches, and trainers identify sleep as an important
aspect of the recovery process and crucial for optimal perfor-
mance (Postolache et al., 2005; Samuels, 2008). Physically, sleep
is critical for protein synthesis, growth hormone release, and for
the facilitation of glucose metabolism (Davenne, 2009; Spiegel,
Tasali, Leproult, & Van Cauter, 2009). Sleep also has been iden-
tified as the most important factor in performance on cognitive

http://dx.doi.org/10.1016/j.peh.2015.11.002
2211-2669/© 2015 Elsevier Ltd. All rights reserved.

Please cite this article in press as: McCloughan, L. J., et al. Psychological recovery: Progressive muscle relaxation (PMR), anxiety, and
sleep in dancers. Performance Enhancement & Health (2015), http://dx.doi.org/10.1016/j.peh.2015.11.002
G Model
PEH-83; No. of Pages 6 ARTICLE IN PRESS
2 L.J. McCloughan et al. / Performance Enhancement & Health xxx (2015) xxx–xxx
tasks (Pilcher & Huffcutt, 1996; Rosekind, 2005). Research on the
effects of sleep loss on athletic performance has found that mood,
psychomotor, and cognitive function decline more rapidly than
physical capabilities (Davenne, 2009; Mougin et al., 1991; Souissi,
Sesboüé, Gauthier, Larue, & Davenne, 2003). The benefits of sleep
extension have demonstrated measurably improved athletic per-
formance (Mah, Mah, Kezirian, & Dement, 2011). Therefore, sleep
appears to have a vital role in recovery, and the sleep needs of elite
performers may differ from other populations (Davenne, 2009).
Theorists have suggested that sleep quality and patterns dif-
fer for athletes compared to nonathletic populations (Davenne,
2009; Leger, Metlaine, & Choudat, 2005; Savis, 1994). Wristwatch
actigraphy has been used to measure the sleep of elite athletes
(Leeder, Glaister, Pizzoferro, Dawson, & Pedlar, 2012). Actigraphy
is an objective measure of sleep involving a device worn on the
wrist of the user to record the number and amplitude of move-
ments. Used in conjunction with a sleep diary, actigraphy provides
a validated alternative to laboratory-based polysomnography (PSG)
recording of some sleep parameters (Kushida et al., 2001; Vallieres
& Morin, 2003). Significant differences have been reported between
athletes and age- and sex-matched controls across time in bed,
sleep onset latency (SOL), time awake, sleep efficiency, actual sleep,
moving minutes, and moving time (Leeder et al., 2012). Greater
individual variance was found within each variable for the athletes,
suggested to be due to differential physiological and psychological
stress (Leeder et al., 2012). A study of elite dancers recorded simi-
lar baseline data to athletes during a normal training phase (Fietze
et al., 2009; Leeder et al., 2012).
Psychological factors such as trait anxiety have been found to
affect sleep quantity and quality (Du et al., 2009; Kajimura et al.,
1998; Savis, 1994). In several studies of both clinical and general
populations, individuals with high trait anxiety have demon-
strated chronically poor SOL and a higher number of awakenings
during the night (Du et al., 2009; Kajimura et al., 1998; Viens,
De Koninck, Mercier, St-Onge, & Lorrain, 2003). Pre-performance
sleep problems are widely reported by elite athletes and in elite
dance populations (Erlacher, Schredl, & Lakus, 2009; Fietze et al.,
2009). Recent research demonstrated a strong negative association
between pre-sleep state anxiety and self-reported sleep quality of
athletes (Romyn, Robey, Dimmock, Halson, & Peeling, 2015). In a
review of sleep and sport, it was concluded that more sophisti-
cated research was required because current interventions have
been based largely on clinical experience and evidence derived
from fields not relevant to athletes (Postolache et al., 2005). Sleep
medication is not ideal for athletes due to possible effects on phys-
ical and cognitive performance during subsequent training and
performance (Leger et al., 2005). For the management of insomnia
and sleep disruption in athletes, relaxation may greatly help dur-
ing regular training periods and before competitions (Leger et al.,
2005).
PMR has been one of the most widely investigated of all relax-
ation strategies and is recognised by the American Psychological
Association as an empirically supported treatment for insomnia
(de Niet, Tiemens, Kloos, & Hutschemaekers, 2009; McCallie, Blum,
& Hood, 2006; Morin et al., 1999). The mechanisms of its efficacy
are suggested to be based upon the known connection between
stress and sleep issues (Van Reeth et al., 2000). The conscious
directed initiation of the homeostasis-restoring parasympathetic
nervous system (PNS) branch of the autonomic nervous system
down-regulates the over-active HPA axis, supported by evidence
of a post PMR reduction in salivary cortisol and increased heart
rate variability (Dolbier & Rush, 2012).
PMR is the use of scripts (in-person, audio, or video) involving
tensing (4–7 s) and then relaxing (20–45 s) different muscle groups
throughout the body (McCallie et al., 2006; Mezo, Hall, Duggan, &
Noël, 2011; Taylor & Roane, 2010). PMR is undertaken seated on a
Please cite this article in press as: McCloughan, L. J., et al. Psychological recovery: Progressive muscle relaxation (PMR), anxiety, and
sleep in dancers. Performance Enhancement & Health (2015), http://dx.doi.org/10.1016/j.peh.2015.11.002
chair with the feet on the floor next to each other, knees in a 90◦
angle, arms resting on upper legs; or, laying down with arms next to
body and support under knees or knees bent; takes between 8 and
30 minutes; and may or may not involve daytime practice as well
as use before bedtime (Taylor & Roane, 2010). The feelings of relax-
ation and the contrast between feelings of tension and relaxation
raise individuals’ awareness and recognition of tension, allowing
conscious relaxation.
In summary, evidence has indicated that elite performers have
different sleep requirements than the general population. Sleep
is an important recovery strategy after physical and psychologi-
cal stress for elite performers to return to homeostasis (Halson,
2008). Trait anxiety has been found to influence poor sleep qual-
ity, in particular SOL, in general and clinical populations with sleep
issues. The efficacy of PMR in enhancing the sleep of elite perform-
ers has not been established. The current study was designed to
test the efficacy of PMR in improving the SOL of full time dancers. It
was hypothesised that full time dancers would record shorter sleep
durations with less efficient sleep than general populations in line
with published data; and that a PMR intervention would improve
the SOL of full time dancers with poor SOL and high trait anxiety.
2. Method
Participants were recruited from the Queensland University of
Technology (QUT) Dance programme (n = 12; mean age 20.09 years,
SD = 1.45; 84% identifying as Caucasian, 8% South African, and 8%
Asian). Participation was voluntary. Inclusion criteria for the study
comprised age of at least 18 years of age, female gender, and full-
time participation at an elite performance level. All participants
were in a stable training phase (daily average = 3 h 39 m, SD = 33 m)
during the study. A single gender sample was used to account for
known gender differences in sleep and the presentation of anxi-
ety (Endler, Parker, Bagby, & Cox, 1991; Leeder et al., 2012). Given
the physiological nature of sleep monitoring, exclusion criteria
included recent long haul travel, altitude exposure, concussion, and
the use of pharmacologic or natural sleep aides (Leeder, Gardner,
Foley, van Someren, & Pedlar, 2009; Pedlar et al., 2005).
After consent was obtained, participants completed a demo-
graphics questionnaire and the Endler Multidimensional Anxiety
Scale-Trait (EMAS-T), a 60-item self-report measure of four situa-
tional dimensions of trait anxiety including social evaluation (SE),
physical danger (PD), ambiguous (AM), and daily routines (DR;
Endler, Edwards, Vitelli, & Parker, 1991). Each item is rated on a
scale from 1 = not at all to 5 = very much, with a possible range of
15–75 for each subscale. Seven items are worded positively and
the response scale reversed to avoid response set bias. The reported
coefficient alphas range from r = .87 to r = .96, indicating high inter-
nal consistency (Endler, Edwards, et al., 1991; Endler, Parker, et al.,
1991). In the current study high internal consistency was reported
for the EMAS-T subscales SE (˛ = .73), PD (˛ = .76), and AM (˛ = .73).
The EMAS-T DR scale failed to demonstrate acceptable reliabil-
ity (˛ = .27), and was excluded from the final analyses. Moderate
to high test-retest reliabilities of the EMAS-T subscales have been
reported over different time intervals and in diverse groups, ran-
ging from r = .50 to .79 (Endler, Edwards, Vitelli, & Parker, 1989).
Mean scores for American undergraduate females for the EMAS-T
SE, PD, and AM subscales are 49, 66, and 43, respectively (Endler,
Edwards, et al., 1991; Endler, Parker, et al., 1991).
Over the duration of the study participants completed daily
sleep diaries morning and night, noting bed time, get-up time,
nap times, caffeine consumption and time, screen use time (televi-
sion, phone, computer, tablet) before sleep, and self-reported sleep
quality. At the start of Week 2, an 8.5 min PMR audio was sup-
plied to the participants (either on CD, USB, or MP3 device) with
G Model
PEH-83; No. of Pages 6 ARTICLE IN PRESS
L.J. McCloughan et al. / Performance Enhancement & Health xxx (2015) xxx–xxx
Table 1
Participant means and standard deviations for all study variables in Weeks 1 and 2.
Variable Week 1
M SD
Bedtime (hh:mm) 23:03
Get-up time (hh:mm) 06:55
Time in bed (h:m) 7:52
Sleep onset latency (m:s) 5:37
Sleep duration (h:m) 6:56
Sleep efficiency (%) 88.06
Time awake/light sleep (h:m) 0:45
Self-reported sleep quality 3.55
Average screen time (h:m) 1:08
Average caffeine serves per day .95
Average last caffeine serve time (h:m) 6:14pm
instructions to do PMR at least once daily after the completion of
training but prior to bed. Choice of PMR location, position (seated
or laying down), gender of voice on PMR audio recording (male or
female), and time of day (hh:mm) were recorded in a PMR diary.
The activity monitors are wristwatch-like devices that contin-
uously record body movement (stored in 1-min epochs for the
current study; Phillips Respironics, Bend, Oregon). The monitors
were worn by participants on the same, non-dominant wrist for
the duration of the study, with the exception of when swimming
or showering. Time was scored as awake unless two of the following
conditions were met simultaneously: (a) the sleep diary indicated
that the participant was lying down attempting to sleep; (b) the
activity counts from the monitor were sufficiently low to indicate
that the participant was immobile; or (c) the participant recorded
that they were either sleeping or waking by pressing the button
on the actigraphy monitor, marking the data. The scoring process
was conducted using the Phillips Respironics’ Actiwatch Algorithm
with sensitivity set at medium (Kushida et al., 2001). The following
dependent variables were derived from the sleep diary and activ-
ity monitor data: bedtime (hh:mm), get-up time (hh:mm), time in
bed (h:m), sleep onset latency (m:s), sleep duration (h:m), sleep
efficiency (%; sleep duration as a percentage of time in bed), and
time awake/light sleep (h:m; the amount of time spent awake or
sleeping lightly after sleep onset).
After the completion of the study participants were offered feed-
back regarding their individual sleep data. Upon commencement
of data collection, a unique code was generated for each partici-
pant, and all data were de-identified. All monitoring was conducted
between June and September, 2013. All materials and procedures
were approved by The University of Queensland School of Psychol-
ogy ethics committee (approval #13-PSYCH-MAP-36-AH).
Initial data analyses were performed using the Statistical Pro-
gram for the Social Sciences (SPSS; Version 20). All data were
screened to assess for patterns in missing values, and assump-
tions of normality in variable distribution were tested. Means and
standard deviations were obtained for all variables for Week 1 and
Week 2. Intercorrelations between variables were undertaken, and
T-tests were used to compare sleep duration and efficiency with
previously published athlete and dance samples. Wilcoxon signed-
rank tests were performed to assess differences in Week 1 and
Week 2 mean SOL and self-reported sleep quality.
3. Results
There were no missing data and all data were inspected to
ensure that scores were within scale response limits. Normality
was evaluated by examining skewness and kurtosis values and data
were screened for potential outliers. All variables met the assump-
tions of normality except sleep onset was positively skewed.
An inverse transformation to normalise the distribution was
Please cite this article in press as: McCloughan, L. J., et al. Psychological recovery: Progressive muscle relaxation (PMR), anxiety, and
sleep in dancers. Performance Enhancement & Health (2015), http://dx.doi.org/10.1016/j.peh.2015.11.002
3
Week 2
M SD
1:33 22.57 1:27
1:10 06:47 1:04
0:44 7:50 0:42
4:39 5:15 4:58
0:39 6:53 0:37
5.45 87.83 4.00
0:22 0:46 0:19
.50 3.68 .40
0:43 0:55 0:38
.44 .79 .44
3:36 6:43pm 4:22
performed (Tabachnick & Fidell, 2007). The transformation failed
to improve the skewness therefore analyses of the un-transformed
data are presented. Positive skew of data had no implication for the
Wilcoxon signed-rank tests (as a repeated measures analysis). No
multivariate or univariate outliers were found.
The group’s means for the EMAS-T were: social evaluation
M = 44.50, SD = 6.42, physical danger M = 39.25, SD = 4.41, and
ambiguous M = 38.67, SD = 5.50. A summary of the means and
standard deviations for all variables are presented in Table 1. PMR
was used 90% of the prescribed times, with eight sessions missed
out of a possible 84 (mostly when bedtime was late at night).
The majority of PMR sessions were completed at home (96%) and
lying down (87%). Use of male or female voices in the guided PMR
recordings was evenly distributed (46% male voice and 54% female
voice); with only two of the 12 participants consistently using the
same gender audio over the seven day PMR period. Weeks 1 and 2
correlations are reported in Tables 2 and 3, respectively. In Week
1, time of last caffeine serve significantly positively correlated with
average screen time (later caffeine serves related to longer screen
time duration), and SOL significantly negatively correlated with
sleep efficiency (longer SOL related to poorer efficiency).
T-tests were conducted comparing the current sample’s sleep
data to that of previously published athlete and dance samples
(Fietze et al., 2009; Leeder et al., 2012). The baseline recordings
of sleep duration (M = 6 h 56 m, SD = 39 m) and efficiency (88%,
SD = 5%) reported no significant difference with published actig-
raphy recordings of an athlete sample (duration M = 6 h 55 m,
SD = 43 m; efficiency M = 81%, SD = 6%), and a dance sample (dura-
tion M = 6 h 58 m, SD = 43 m; efficiency M = 81%, SD = 4%; Fietze et al.,
2009; Leeder et al., 2012). Further analyses focused on changes in
the participants’ sleep onset time because prior research has identi-
fied it as the sleep variable most likely to be affected by using PMR
before bed (de Niet et al., 2009). To explore the effectiveness of
PMR in reducing sleep onset times in high trait anxiety individuals,
three Wilcoxon Signed Rank Tests were conducted. To evaluate the
change in sleep onset times pre and post intervention, individuals
were selected for inclusion in each analysis if their SOL at base-
line was above the Week 1 sample mean (M = 5 m 37 s, SD = 4 m
39 s), and their trait anxiety scores were above the sample mean
on the trait anxiety of interest (social evaluation, physical danger,
ambiguous).
Selecting those with poorer Week 1 SOL (below the 50th per-
centile) and higher trait anxiety scores (above the 50th percentile)
produced different group sizes for each type of trait anxiety. Those
with poor SOL and high trait social evaluation anxiety (n = 5)
showed a statistically significant decrease in SOL from Week 1
(M = 8 m 00 s, SD = 4 m 00 s) to Week 2 (M = 4 m 18 s, SD = 3 m 36 s;
Z = -2.02, p = .04), with a large effect size (r = .90), and a statisti-
cally significant increase in self-reported sleep quality from Week 1
(M = 3.51, SD = .45) to Week 2 (M = 3.74, SD = .47; Z = −2.06, p = .04),
G Model
PEH-83; No. of Pages 6 ARTICLE IN PRESS
4 L.J. McCloughan et al. / Performance Enhancement & Health xxx (2015) xxx–xxx

Table 2
Week 1 intercorrelations of the variables of interest.

Measure 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

1. EMAS-T social evaluation –

2. EMAS-T physical danger .53 –
3. EMAS-T ambiguous .47 .19 –
4. Average self-reported sleep quality during study .45 .22 −.05 –
5. Average sleep duration .18 −.13 .30 .51 –
6. Average sleep onset latency −.07 .18 .13 .27 .23 –
7. Average sleep efficiency .06 −.34 -.09 .02 .36 −.59* -
8. Average screen time duration .12 .14 -.15 .25 .14 .49 -.27 -
9. Average caffeine serves per day .42 .28 .70* −.10 −.03 −.11 .06 −.40 -
10. Average last caffeine serve time .21 .36 −.06 .30 .06 .22 −.02 .69* −.38 –

Note. With the exception of the variables measured prior to the commencement of the study (EMAS-T social evaluation, EMAS-T physical danger, EMAS-T ambiguous, the
data presented represent means across 7 days (i.e., Week 1).
*
p < .05.

Table 3
Week 2 intercorrelations of the variables of interest.

Measure 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

1. EMAS-T social evaluation –

2. EMAS-T physical danger .53 –
3. EMAS-T ambiguous .47 .19 –
4. Average self-reported sleep quality .22 .05 −.12 –
5. Average sleep duration .08 −.39 .25 .53 –
6. Average sleep onset latency .04 .06 −.21 .53 .11 –
7. Average sleep efficiency .11 −.27 .06 .05 .19 −.40 –
8. Average screen time duration .22 .31 −.27 .31 −.01 .50 .20 –
9. Average caffeine serves per day .40 .02 .25 −.29 −.19 −.45 .21 −.30 –
10. Average last caffeine serve time −.16 −.03 −.36 .04 −.01 .38 −.05 .45 −.47 –

Note. With the exception of the variables measured prior to the commencement of the study (EMAS-T social evaluation, EMAS-T physical danger, EMAS-T ambiguous), the
data presented represents means across 7 days (i.e., Week 2).
*p < .05

with a large effect size (r = .65). For those with poor SOL and high
physical danger anxiety (n = 3) there was no significant change in
SOL from Week 1 (M = 9 m 40 s, SD = 4 m 38 s) to Week 2 (M = 4 m
17 s, SD = 4 m 57 s; Z = −1.60, p = .11), and no significant change in
self-reported sleep quality from Week 1 (M = 2.20, SD = .54) to Week
2 (M = 2.31, SD = .62; Z = −1.63, p = .10). For those with poor SOL and
high ambiguous anxiety (n = 4) there was no significant change in
SOL from Week 1 (M = 6 m 25 s, SD = 2 m 13 s) to Week 2 (M = 2 m
52 s, SD = 1 m 58 s; Z = −1.83, p = .07), and no significant change in
self-reported sleep quality from Week 1 (M = 2.66, SD = .14) to Week
2 (M = 2.83, SD = .07; Z = −1.89, p = .06).
4. Discussion
The aim of the current study was to test the efficacy of PMR
as a natural sleep aide and recovery strategy for full time dancers
to assist applied performance psychologists in preparing perform-
ers mentally with empirically sound techniques to ensure quality
recovery and performance/s. PMR is widely used by athletes,
although the efficacy of its application in this context has not been
evaluated.
Hypothesis 1, that elite performers would record shorter sleep
durations with less efficient sleep than general populations in
line with published data, was supported. A substantial body of
research has documented sleep differences between elite perform-
ers and general populations (Davenne, 2009; Fietze et al., 2009;
Forndran, Lastella, Roach, Halson, & Sargent, 2012; Leeder et al.,
2012). Scheduling of training has previously been identified as a
factor in restricted sleep duration in elite performers and the mean
bed time (11.00 pm) and wake up time (6.51 am) of the dancers in
the current study may have contributed to the short duration and
high efficiency of their sleep (Forndran et al., 2012).
Hypothesis 2, that a PMR intervention would improve the SOL of
elite performers with poor SOL and high trait anxiety, was partially
supported. Post intervention reduction of SOL of elite performers
was reported for those who recorded above the 50th percentile
on social evaluation anxiety and below the 50th percentile sleep
onset times in Week 1. Although an alternative trait anxiety mea-
sure may be considered instead of the EMAS-T to provide one global
trait anxiety score, differentiating the dimensions of trait anxiety
was beneficial in the current study because it provided a nuanced
viewpoint that would not have emerged had a global trait anxiety
measure been used.
An expanding body of literature has documented the rela-
tionship between trait anxiety and sleep issues (Du et al., 2009;
Kajimura et al., 1998; Viens et al., 2003). Dance involves significant
aesthetic and high social identity components that may explain
why the sample in the current study recorded higher trait social
evaluation anxiety than physical danger or ambiguous anxiety.
Socio-evaluative threat has been identified in previous research
into the stress responses of athletes in competitive contexts, sug-
gesting that athletes with high trait social evaluation anxiety may
benefit from PMR recovery interventions (Suay et al., 1999). The
theorised activation of the HPA axis in response to physical and
mental stress is consistent with the proposed mechanisms of PMR
in activating the PNS to down-regulate the stress response, as
evidenced by reduced cortisol and heart rate variability (Dolbier
& Rush, 2012; Miller & O’Callaghan, 2002). On a broader scale,
down-regulating the stress response is complimentary to optimis-
ing recovery to the homeostasis state in elite performers (Kellman
& Kallus, 1999).
General findings indicate the self-report sleep quality and actig-
raphy data did not correlate in the study, supporting previous
research indicating perception of sleep is often distorted (Dickinson
& Hanrahan, 2009). However, the high trait anxious, poor SOL group
that experienced an improvement in SOL with PMR also recorded a
significant improvement in self-reported sleep quality from Week
1 to Week 2. The findings need to be explored further for possible

Please cite this article in press as: McCloughan, L. J., et al. Psychological recovery: Progressive muscle relaxation (PMR), anxiety, and
sleep in dancers. Performance Enhancement & Health (2015), http://dx.doi.org/10.1016/j.peh.2015.11.002
G Model
PEH-83; No. of Pages 6 ARTICLE IN PRESS
L.J. McCloughan et al. / Performance Enhancement & Health xxx (2015) xxx–xxx
placebo or expectation effects, and research into the relationship
between self-reported sleep and performance is indicated.
Caffeine and screen time were included in the current study as
potential confounds of the effects of PMR in reducing SOL. In Week
1, time of last caffeine serve correlated with the average screen
time, but the overall lack of significant correlations between screen
time, caffeine serves, or time of last caffeine serve and any of the
sleep variables suggests there were no relationships that would
affect the interpretation of the PMR and sleep data.
Caution must be used in interpreting the results due to the small
sample size. Based on a recommended power analysis a sample size
of approximately 30 participants was required for the analysis used
in the current study (Cohen, 1992). However, for within-subject
exploratory applied performance research with a physiological out-
come variable a sample of 12 is adequate (Atkinson & Nevill, 2001).
Nevertheless, the limited sample size prevented the allocation of a
control group.
5. Conclusion
General findings of physical, cognitive, and mood effects due to
sleep loss are widely reported in clinical, general, and performance
samples (Fietze et al., 2009; Postolache et al., 2005; Savis, 1994).
Despite indicators of quality sleep, athletes may require more sleep
than they achieve on average (Davenne, 2009; Mah et al., 2011).
Sub-optimal sleep duration can be further exacerbated for indi-
viduals with sleep problems, affecting recovery from training and
performance stressors. The use of PMR delivered by audio in the
home environment appears to enhance recovery and sleep in full
time dancers with high trait social evaluation anxiety and poor SOL.
In applied settings the relevance for physical performance of poor
SOL may be less important than the individual’s perception of poor
sleep quality. It would appear research is supporting the hypothe-
sis that interventions that reduce state anxiety (and subsequently
improve SOL, even if by only minutes that are insignificant in the
overall objective measurement of the quality of sleep) improve the
self-report of sleep quality.
It is recommended that training of applied psychologists work-
ing with elite performers needs to include empirically supported
treatments such as PMR, with accurate recommendations for its use
as outlined in the current pilot study. In addition, in consideration
of the importance of the role of sleep in recovery, recommen-
ding fundamental sleep hygiene strategies to clients is required in
practice with elite performers. Furthermore, in view of the detri-
mental effects prescription sleep medication may have on physical
and cognitive performance identified by Leger et al. (2005), repli-
cation of this study with an athlete sample and a large randomised
controlled trial evaluating the effect of PMR on the sleep and recov-
ery of elite performers with social evaluation anxiety-related sleep
onset problems is strongly suggested.
Acknowledgements
The Australian Institute of Sport supplied the actigraphy devices
and the computers and software for data processing and analy-
sis. Acknowledgement to Laura Juliff (Australian Institute of Sport)
and Assoc Prof Gene Moyle (Queensland University of Technology,
Dance). There has been no financial assistance with this project.
References
Atkinson, G., & Nevill, A. M. (2001). Selected issues in the design and analysis of
sport performance research. Journal of Sports Sciences, 19, 811–827. http://dx.
doi.org/10.1080/026404101317015447
Beckmann, J., & Kellmann, M. (2004). Self-regulation and recovery: Approaching an
understanding of the process of recovery from stress. Psychological Reports,
95(3,Pt2), 1135–1153. http://dx.doi.org/10.2466/PR0.95.7.1135-1153
Please cite this article in press as: McCloughan, L. J., et al. Psychological recovery: Progressive muscle relaxation (PMR), anxiety, and
sleep in dancers. Performance Enhancement & Health (2015), http://dx.doi.org/10.1016/j.peh.2015.11.002
5
Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155.
Davenne, D. (2009). Sleep of athletes: Problems and possible solutions. Biological
Rhythm Research, 40(1), 45–52. http://dx.doi.org/10.1080/09291010802067023
de Niet, G. J., Tiemens, B. G., Kloos, M. W., & Hutschemaekers, G. J. M. (2009). Review
of systematic reviews about the efficacy of non-pharmacological interventions
to improve sleep quality in insomnia. International Journal of Evidence-Based
Healthcare, 7, 233–242. http://dx.doi.org/10.1111/j.1744-1609.2009.00142.x
Dickinson, R. K., & Hanrahan, S. J. (2009). An investigation of subjective sleep and
fatigue measures for use with elite athletes. Journal of Clinical Sport Psychology,
3, 244–266.
Dolbier, C. L., & Rush, T. E. (2012). Efficacy of abbreviated progressive muscle
relaxation in a high-stress college sample. International Journal of Stress
Management, 19, 48–68. http://dx.doi.org/10.1037/a0027326
Du, H.-R., Zhao, H.-Z., Yan, H.-L., Tang, Y.-F., Cui, E.-L., & Li, C. (2009). Correlation
between state-trait anxiety and sleep structure in patients with insomnia.
Chinese Mental Health Journal, 23, 868–871.
Endler, N. S., Edwards, J. M., Vitelli, R., & Parker, J. D. (1989). Assessment of state
and trait anxiety: Endler multidimensional anxiety scales. Anxiety Research, 2,
1–14. http://dx.doi.org/10.1080/08917778908249322
Endler, N. S., Edwards, J. M., Vitelli, R., & Parker, J. D. A. (1991). Endler
multidimensional anxiety scales: Manual. Los Angeles, CA: Western
Psychological Services.
Endler, N. S., Parker, J. D., Bagby, R. M., & Cox, B. J. (1991). Multidimensionality of
state and trait anxiety: Factor structure of the endler multidimensional anxiety
scales. Journal of Personality and Social Psychology, 60, 919–926. http://dx.doi.
org/10.1037/0022-3514.60.6.919
Erlacher, D., Schredl, M., & Lakus, G. (2009). Subjective sleep quality prior to home
and away games for female volleyball players. International Journal of Dream
Research, 2, 70–72.
Fietze, I., Strauch, J., Holzhausen, M., Glos, M., Theobald, C., Lehnkering, H., et al.
(2009). Sleep quality in professional ballet dancers. Chronobiology
International, 26, 1249–1262. http://dx.doi.org/10.1080/07420520903221319
Forndran, A., Lastella, M., Roach, G. D., Halson, S. L., & Sargent, C. (2012). Training
schedules in elite swimmers: No time to rest? In X. Zhou, & C. Sargent (Eds.),
Sleep of different populations (pp. 6–10). Adelaide, Australia: Australasian
Chronobiology Society.
Halson, S. L. (2008). Nutrition, sleep and recovery. European Journal of Sport Science,
8, 119–126. http://dx.doi.org/10.1080/17461390801954794
Kajimura, N., Kato, M., Sekimoto, M., Watanabe, T., Takahashi, K., Okuma, T., et al.
(1998). A polysomnographic study of sleep patterns in normal humans with
low- or high-anxiety personality traits. Psychiatry and Clinical Neurosciences,
52(3), 317–320. http://dx.doi.org/10.1046/j.1440-1819.1998.00401.x
Kellman, M., & Kallus, K. W. (1999). Mood, recovery-stress state, and regeneration.
In M. Lehmann, C. Foster, H. Gastmann, H. Keizer, & J. M. Steinacker (Eds.),
Overload, fatigue, performance incompetence, and regeneration in sport (pp.
101–117). New York: Plenum.
Kushida, C. A., Chang, A., Gadkary, C., Guilleminault, C., Carrillo, O., & Dement, W. C.
(2001). Comparison of actigraphic, polysomnographic, and subjective
assessment of sleep parameters in sleep-disordered patients. Sleep Medicine, 2,
389–396. http://dx.doi.org/10.1016/S1389-9457(00)00098-8
Leeder, J., Glaister, M., Pizzoferro, K., Dawson, J., & Pedlar, C. (2012). Sleep duration
and quality in elite athletes measured using wristwatch actigraphy. Journal of
Sports Sciences, 30, 541–545. http://dx.doi.org/10.1080/02640414.2012.660188
Leeder, J. D. C., Gardner, A. S., Foley, S., van Someren, K., & Pedlar, C. R. (2009). The
effect of jet lag on parameters of sleep in elite divers quantified by actigraphy.
Medicine & Science in Sports & Exercise, 41(5), 57–58. http://dx.doi.org/10.1249/
01.MSS.0000354738.28757.87
Leger, D., Metlaine, A., & Choudat, D. (2005). Insomnia and sleep disruption:
Relevance for athletic performance. Clinics in Sports Medicine, 24, 269–285.
http://dx.doi.org/10.1016/j.csm.2004.12.011, viii
Mah, C. D., Mah, K. E., Kezirian, E. J., & Dement, W. C. (2011). The effects of sleep
extension on the athletic performance of collegiate basketball players. Sleep:
Journal of Sleep and Sleep Disorders Research, 34, 943–950. http://dx.doi.org/10.
5665/sleep.1132
McCallie, M. S., Blum, C. M., & Hood, C. J. (2006). Progressive muscle relaxation.
Journal of Human Behavior in the Social Environment, 13(3), 51–66. http://dx.doi.
org/10.1300/J137v13n03 04
Mezo, P. G., Hall, J., Duggan, C. M., & Noël, V. A. (2011). An initial comparison of live
instruction and immersive video modes of progressive muscle relaxation.
Journal of Technology in Human Services, 29, 212–223. http://dx.doi.org/10.
1080/15228835.2011.616470
Miller, D. B., & O’Callaghan, J. P. (2002). Neuroendocrine aspects of the response to
stress. Metabolism: Clinical and Experimental, 51(6), 5–10. http://dx.doi.org/10.
1053/meta.2002.33184
Morin, C. M., Hauri, P. J., Espie, C. A., Spielman, A. J., Buysse, D. J., & Bootzin, R. R.
(1999). Nonpharmacologic treatment of chronic insomnia. An American
Academy of Sleep Medicine review. Sleep, 22, 1134–1156.
Mougin, F., Simon-Rigaud, M., Davenne, D., Renaud, A., Garnier, A., Kantelip, J., et al.
(1991). Effects of sleep disturbances on subsequent physical performance.
European Journal of Applied Physiology and Occupational Physiology, 63, 77–82.
http://dx.doi.org/10.1007/BF00235173
Pedlar, C., Whyte, G., Emegbo, S., Stanley, N., Hindmarch, I., & Godfrey, R. (2005).
Acute sleep responses in a normobaric hypoxic tent. Medicine and Science in
Sports and Exercise, 37, 1075–1079.
Pilcher, J., & Huffcutt, A. (1996). Effects of sleep deprivation on performance: A
meta-analysis. Sleep, 19, 318–326.
G Model
PEH-83; No. of Pages 6 ARTICLE IN PRESS
6 L.J. McCloughan et al. / Performance Enhancement & Health xxx (2015) xxx–xxx

Postolache, T. T., Hung, T.-M., Rosenthal, R. N., Soriano, J. J., Montes, F., & Stiller, J.
W. (2005). Sports chronobiology consultation: from the lab to the arena. Clinics
in Sports Medicine, 24, 415–456. http://dx.doi.org/10.1016/j.csm.2005.01.001
Romyn, G., Robey, E., Dimmock, J. A., Halson, S. L., & Peeling, P. (2015). Sleep,
anxiety and electronic device use by athletes in the training and competition
environments. European Journal of Sport Science, 20, 1–8. http://dx.doi.org/10.
1080/17461391.2015.1023221
Rosekind, M. R. (2005). Underestimating the societal costs of impaired alertness:
Safety, health and productivity risks. Sleep Medicine, 6, S21–S25. http://dx.doi.
org/10.1016/S1389-9457(05)80005-X
Samuels, C. (2008). Sleep, recovery, and performance: The new frontier in
high-performance athletics. Neurologic Clinics, 26, 169–180. http://dx.doi.org/
10.1016/j.ncl.2007.11.012
Savis, J. C. (1994). Sleep and athletic performance: Overview and implications for
sport psychology. The Sport Psychologist, 8, 111–125.
Souissi, N., Sesboüé, B., Gauthier, A., Larue, J., & Davenne, D. (2003). Effects of one
night’s sleep deprivation on anaerobic performance the following day.
European Journal of Applied Physiology, 89, 359–366. http://dx.doi.org/10.1007/
s00421-003-0793-7
Spiegel, K., Tasali, E., Leproult, R., & Van Cauter, E. (2009). Effects of poor and short
sleep on glucose metabolism and obesity risk. Nature Reviews Endocrinology, 5,
253–261. http://dx.doi.org/10.1038/nrendo.2009.23
Suay, F., Salvador, A., González-Bono, E., Sanchıı́s, C., Martıı́nez, M.,
Martıı́nez-Sanchis, S., et al. (1999). Effects of competition and its outcome on
serum testosterone, cortisol and prolactin. Psychoneuroendocrinology, 24,
551–566. http://dx.doi.org/10.1016/S0306-4530(99)00011-6
Tabachnick, B., & Fidell, L. (2007). Using multivariate statistics (5th ed). Boston:
Pearson Education.
Taylor, D. J., & Roane, B. M. (2010). Treatment of insomnia in adults and children: A
practice-friendly review of research. Journal of Clinical Psychology, 66,
1137–1147. http://dx.doi.org/10.1002/jclp.20733
Vallieres, A., & Morin, C. M. (2003). Actigraphy in the assessment of insomnia.
Sleep, 26, 902–906.
Van Reeth, O., Weibel, L., Spiegel, K., Leproult, R., Dugovic, C., & Maccari, S. (2000).
Interactions between stress and sleep: From basic research to clinical
situations. Sleep Medicine Reviews, 4, 201–219. http://dx.doi.org/10.1053/smrv.
1999.0097
Viens, M., De Koninck, J., Mercier, P., St-Onge, M., & Lorrain, D. (2003). Trait anxiety
and sleep-onset insomnia: Evaluation of treatment using anxiety management
training. Journal of Psychosomatic Research, 54(1), 31–37. http://dx.doi.org/10.
1016/S0022-3999(02)00568-8

Please cite this article in press as: McCloughan, L. J., et al. Psychological recovery: Progressive muscle relaxation (PMR), anxiety, and
sleep in dancers. Performance Enhancement & Health (2015), http://dx.doi.org/10.1016/j.peh.2015.11.002