Impact of competitive anxiety on mood, sleep, and physical activity levels in young Tunisian karate athletes: A multidimensional prospective observational study

This study examined the impact of competition-related anxiety on psychological and behavioral parameters of Tunisian karate athletes. A total of 176 young Tunisian karate athletes (aged 16-25 years) with at least 1 year of training and competitive experience voluntarily participated in this study. Validated instruments were administered 1 week before and on the day of the competition, including the State-Trait Anxiety Inventory, the Pittsburgh Sleep Quality Index, the Brunel Mood Scale, and the International Physical Activity Questionnaire. Paired Wilcoxon signed-rank tests were used to compare changes over time, and multiple linear regression models were used to identify predictors of state and trait anxiety. Anxiety, mood, sleep, and physical activity changed from 1 week before to competition day (all P < .001). One week before, state anxiety was higher with tension (β = 1.22, P < .001), fatigue (β = 1.49, P < .001), and confusion (β = 1.14, P < .001); trait anxiety was higher with anger (β = 1.15, P < .001), depression (β = 1.38, P < .001), and fatigue (β = 0.42, P = .004), and lower with confusion (β = -0.36, P = .009). State anxiety was positively associated with sleep disturbances (β = 5.94, P < .001); trait anxiety with poorer subjective sleep quality (β = 2.87, P < .001) and longer sleep latency (β = 0.26, P < .001). Vigorous MET-minutes predicted lower state anxiety (β = -0.009, P = .02) and walking predicted lower trait anxiety (β = -0.007, P = .007). State anxiety increased with confusion (β = 1.47, P < .001) and decreased with vigor (β = -0.94, P = .003); trait anxiety increased with depression (β = 1.53, P < .001) and fatigue (β = 1.34, P < .001). Daytime dysfunction predicted higher state anxiety (β = 8.91, P < .001) and sleep latency predicted higher trait anxiety (β = 0.10, P = .031). Moderate MET-minutes predicted higher state anxiety (β = 0.008, P = .02). Increases in state anxiety aligned with higher tension (β = 0.93, P < .001), fatigue (β = 0.61, P = .004), and confusion (β = 1.89, P < .001), and decreases with depression (β = -0.54, P = .02). Increases in trait anxiety were driven by depression (β = 1.67, P < .001) and fatigue (β = 1.06, P < .001). Greater daytime dysfunction predicted increases in state anxiety (β = 9.28, P < .001), whereas longer sleep latency (β = 0.19, P < .001) and shorter sleep duration (β = -3.18, P < .001) predicted increases in trait anxiety; activity changes were not significant. Competition anxiety in young karate athletes is chiefly associated with mood disturbances and sleep parameters; implementing mood-regulation and sleep-focused strategies may reduce anxiety in youth combat sports.