Introduction: Sleep serves as an indicator of mental health [1], while physical activity is considered to be related to both sleep and mental health [2]. In the early stages of the COVID-19 pandemic, most countries implemented lockdown restrictions [3]. The reduction in physical activity and the secondary psychological issues that arose from the lockdown have significantly affected the sleep quality of elite athletes, ultimately resulting in an indirect impact on their athletic performance. Although a large number of studies have examined the impact of the COVID-19 pandemic on the sleep behavior of individuals at different levels of physical activity, a systematic and targeted evaluation of elite athletes is still lacking. Thus, this meta-analysis aims to assess the influence of the COVID-19 pandemic on the sleep behavior of elite athletes. Methods: This meta-analysis was performed by the PRISMA guidelines. A comprehensive search was conducted in online databases including PubMed, Web of Science, and CNKI to detect articles exploring the impact of the COVID-19 pandemic on the sleep behavior of elite athletes. Studies were included if they examined sleep duration among elite athletes without any pre-existing health conditions or no disease risks. In this study, the standardized mean difference (SMD) and the corresponding 95% confidence interval (95% CI) values were pooled using a random effects model. Additionally, a Leave-One-Out sensitivity analysis was performed to ensure the reliability of the results. Results: A total of nine studies met the criteria with n = 7379 included in this study. The pooled effect showed an increase in sleep duration in elite athletes under lockdown (SMD = -0.56; 95% CI = -0.66 ~ -0.47) and significantly affected by the COVID-19 pandemic (P < 0.01), with moderate heterogeneity between results (I² = 69%); a decrease in sleep quality (SMD = -0.62; 95%CI =-0.7 ~ -0.54) and significant (P < 0.01) with low heterogeneity (I² = 4%), and sleep latency was prolonged (SMD = 0.30; 95%CI = 0.13 ~ 0.46) and significant (P < 0.01) with moderate heterogeneity (I² = 71%). All the results were stable after sensitivity analyses. Conclusion: The COVID-19 pandemic has a significant negative impact on the sleep behavior of elite athletes, which is mainly manifested in the decrease of sleep quality, and an increase in sleep duration and sleep latency of elite athletes. More research on the sleep behavior of elite athletes is needed in the future, supporting decision-making in addressing the challenges posed to the mental health of elite athletes by the ongoing mutation of viruses in current contexts. [1] Reid et al., AM J
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