05 November 2014

Sleep deprivation in long mountain ultra trail running

Strangely, one thing I already now know that I will miss if I am only running shorter skyrunning and mountain trail ultramarathons next year is the absolute fatigue towards the end of the race due to not only the physical exhaustion, but also the sleep deprivation. I both dread and long for this feeling of having given everything and being on the limits for what both my body and mind tolerate. As I discussed in one of my recent posts the struggle to be in control in this stressful situation is something which clearly motivates me to race and it is something which has been found to motivate also mountaineers in long and strenuous alpine climbs. It is also fascinating how quickly at least I tend to forget how difficult and dangerous some situations are and it is almost surrealistic to see how I and my teammate Otto looked before we started Petite Trotte à Léon (PTL), half way in Morgex after approximately 100 miles and 15000 D+ meters, and immediately after the race. It is clear that the deterioration was rather severe towards the end of the race, we look surprisingly fresh in Morgex, and that is largely due to the sleep deprivation I think.
Pictures by Carole Pipolo before, during and after PTL 2014 of Otto and myself in the Swedish team "Living the Dream".
The sleep deprivation I felt towards the end of both Tor des Géants (TDG) in 2013 and Petite Trotte à Léon (PTL) in 2014 really forced me to struggle to be in control of my body and my faculties. In TDG I got strong déjà vu experiences the last two days of the race, I had a very strong almost psychotic paranoid experience during the last night of the race when I firmly believed that I would be forced to abandon the race if I was overtaken by runner’s behind me lower in the valley, and the last morning of the race just hours before finishing I literally struggled to not fall asleep during each step on the single-track between the Bonatti and Bertone refugios (mountain huts) and fall to my death down in the beautiful Val Ferret. Nevertheless, thinking back I did not completely lose control, which I clearly did the last night of PTL. Despite caffeine tablets, load music and interesting conversation with my teammate Otto I was more sleeping than awake when ascending Col Tricot, the last major climb of the race, and I was lucky that the climb was traversing a valley on a large fire-road giving me space to stumble as I was losing my balance. I woke up at the top of the climb, only to find myself in a real nightmare on the very last descent from Bellevue to Les Houches through the dark forest of Arandellys. I still do not know how I survived this descent without falling on the wet slippery roots in the dark. I also had quite strong visual hallucinations with rocks and trees turning into various faces this last night, something I did not experience at all during TDG. In contrast, I had just one déjà vu experience during PTL and that came one of the first nights of the race and it is strange that I reacted that differently in both races. Reading race reports from TDG, PTL and other long mountain ultramarathons and discussing with other runners it is clear that one person can react quite differently on sleep deprivation at different races. That different persons react differently is perhaps not so strange and one of my favorite YouTube films is Nickademus Hollon’s compilation of “Tor des Geants 2014 Hallucination Stories”, which clearly illustrates how different the reactions can be. My favorite story is the one 8 minute into the film where one runner describes how he during the race actually thought he was Barack Obama.
As clearly sleep deprivation is a major factor in longer mountain ultramarathons it is with great interest I read a new article by Hurdiel and colleagues about lack of sleep during the 100 mile (168 km) Ultra Trail du Mont Blanc in 2013 (Hurdiel et al “Combined effects of sleep deprivation and strenuous exercise on cognitive performances during The North Face® Ultra Trail du Mont Blanc® (UTMB®)” J Sport Sci 2014; Epub ahead of print). In the study, 17 finishers (16 males and 1 woman with a mean age of 43.4 ± 6.4 years and finish time of 36 h 02 min ± 7 h 18 min) and mean duration of sleep deprivation (between wake-up time on race day and finish time) of 46 h 38 min ± 5 h 20 min were tested with a wrist-worn triaxial actigraph to record sleep time and cognitive objective psychomotor vigilance performance was evaluated before and immediately after the race with simple 10-minutes serial response time tests. The actigraph data indicated 12 ± 17 min of rest during the race, comprising of 1.2 ± 1.4 naps. Naps lasted 9 ± 5 min (range of 4 to 22 min) and nine runners did not sleep at all. Analysis of sleep data revealed that rest as a function of time in the race fit a (second order) quadratic regression model, with longer time in the race not surprisingly correlating with longer sleep duration in the race. Eight of the runners (47%) experienced clinical symptoms of sleep deprivation including four runners (24%) with visual hallucinations, five runners (29%) with difficulties keeping their eyes open while running and three runners (18%) with loss of balance during the race. The cognitive objective psychomotor vigilance performance was impaired after the race with a mean response time of 86% of that before the race and the number of errors of commission was statistically significant greater after the race, although there was a very large inter-individual variation. Most interestingly, there was no correlation between cognitive performance and either amount of rest obtained or time into the race. It was therefore not possible to predict just by analyzing the duration of the sleep deprivation who will develop cognitive impairments, suggesting that there are personal factors that affect individual performance in the absence of sleep, and the authors conclude that these factors will require further research.
I think it would be very interesting to study sleep deprivation in the even longer continuous mountain ultramarathons like TDG, PTL or the new US races Tahoe 200 and Bigfoot 200 and how this could be affected by other factors like caffeine intake and race strategy. In retrospect it is absolutely clear that I probably would have gained by changing the race strategy and slept for one hour the last night of both TDG and PTL before the sleep deprivation became too severe, but on the other hand then I would not have tested my limits to the same extent.

03 November 2014

Review of the film MUT Runner by Sage Canaday

I have received some questions over the weekend on my last blog post about what motivates mountain ultra trail runners and apparently I am not the only one thinking about these questions. The elite MUT runner Sage Canaday, together with Vo2max Productions, just released a film simply called “MUT Runner” focused on this question and I just had to buy it and watch it over lunch today. It is available for download at Vimeo for $11.95.

The film starts with the quote ”All men should strive to learn before they die, what they are running from, and to, and why” by James Thurber and a main focus in the film is the recent development of mountain ultra trail (MUT) running. The film is based on interviews with a number of elite runners, like Anna Frost, Cameron Clayton, Cassie Scallon, Dakota Jones, Michele Yates, Max King, Rickey Gates, Rob Krar, Stephanie Howe and Timothy Olson but also key opinion leaders like Bryon Powell, Nancy Hobbs, and Buzz Burrell. There is much discussion about price money and sponsorship and how this is changing the sport. The runners interviewed fear that the motivations to run mountain ultra trail races have changed from love of the mountains to win/loose race goals with the increase in price money, competition and growth during recent years. However, all runners interviewed personally subscribe to the notion that money is just secondary and that the important thing for them still is personal achievements and being in the mountains. The film ends with the statement by Sage Canaday that “The longevity of the sport ultimately rides on the passion of individuals who collectively share a common bond. It is our love for the mountains and trails as well as our joy in finding peace and camaraderie during feats of endurance that will keep the core principles of the sport alive and well. This is what I believe.”  This is very much in line with the findings of mountain ultramarathon runners in general in personality surveys as I discussed in my last blog post.

Although the discussion about money and competition in mountain ultra trail running in the US is interesting, it is not particularly relevant for an amateur European runner like me and it is not what makes this film worth buying. What makes it a great film, actually one of the best mountain trail running films I have seen, is that Sage really succeeds in conveying his absolute love for the sport of running in the mountains through the great camerawork and ambience in the film. There are a lot of inspiring running scenes in beautiful landscapes, up over talus fields and along narrow ridges, in snow-clad mountains and over flowery pastures, accompanied by great music by Matt Flaherty and Take to The Oars. The film is quite short, just over 30 minutes, but sufficiently long to make an impression and definitively worth buying in my opinion. It is certainly on par with other mountain running films, like In the High Country or Dragon’s Back Race.  

31 October 2014

Personality profiles of mountain ultramarathon runners

The past few weeks have been quite stressful and the thing down-prioritized this time has been the blog. In contrast, despite another upper respiratory infection last week, I have upheld my basic training quite well the past weeks and, although I am now almost solely focusing on long slow distance training runs, been encouraged to find that I have regained some speed as I completed a 10k test run on an at least not completely flat trail course in under 40 minutes. The basis of my training is still my commuting runs to and from work and after an unusually warm fall it is now frost nights and cold clear days more resembling a mild February than end of October.

Morning and evening commuting runs in the flat landscapes around Uppsala
Although the mountain ultramarathon trail running season here in Europe barely is over, it is high time to think about the race schedule for next year. It will largely be luck deciding my own schedule – I have entered some lotteries and will form my plan depending on the outcome of those. I have two main alternatives with continuing with one or two longer multi-day races over 100 miles or focus more on several shorter more technical skyrunning ultramarathons. The very different nature of these races in terms of physical and psychological efforts made me think about what motivates me to be interested in both types of races. It is a subject I discussed with my teammate Otto Elmgart when running Petite Trotte à Léon (PTL) earlier this year and which has been in my mind since then. For me personally, it is mainly the possibility to experience the challenge of the mountain environment that is the common motivating factor for both types of races. It also made me think about what the personality profile is of mountain ultramarathon runners in general and I decided to look what can be found in the scientific literature. I also decided to see if there were any differences with other endurance and/or mountain sports. Mountain ultramarathon running is really special in that it requires the ability to cope and persevere with pain/suffering for long durations over several hours/days, but also the adrenaline rush and fear caused by being in dangerous high-risk exposed mountain environment. I often get the question if I am really running in terrains in the Alps like the one in Kilian’s movies and although I wish I did I have neither the skill nor is it in my personal risk comfort zone, although I become really inspired by for instance his latest movie of his Tour du Tour when he tests Salomon’s new X Alp collection. I get an adrenaline rush just by watching the film and mountain running like this is really a high-risk activity.

There has not been anything written about mountain ultramarathon running as a high-risk activity. In contrast, the literature about mountaineering as a high-risk adventure extreme sport and the motivation factors and personalities of mountaineers and alpinists is well studied with plenty of scientific articles. However, traditionally, mountaineers have since the 1980s been classified as only “sensation-seekers” driven by the adrenaline rush (see for instance Zuckerman’s books about subject in 1979 and 1994). Hence, when looking more carefully there exist not many good studies of the underlying motives for high-risk, long-duration, low-sensation activities such as mountaineering. Nevertheless, I found a really interesting recent study by Barlow and colleagues comparing mountaineers with skydivers that clearly showed that there are different motives behind these activities (Barlow et al “Great expectations: Different high-risk activities satisfy different motives” J Pers Soc Psychol 2013; 105: 458-475). In this study, the motive for mountaineering was not associated with sensation-seeking, as skydiving was, but rather so called “emotion regulation and agency”.  This means that the mountaineers sought their high-risk activity in order to exercise control, so called "agency", over their emotions and feelings during dangerous situations affecting their life to a greater extent than those activities found nornally in their everyday life. Interestingly, the study also implicate that the mountaineers might be able to take their coping mechanisms in the high-stress mountain environment and transfer these coping skills to everyday life. It would be interesting to see whether the same findings could be applied also to mountain ultramarathon runners where the risk level, unless you run in environments like Kilian in the film above, is lower. Personally I actually think it quite likely that it would and that the same motivations at least partly could be found. Interestingly, when discussing my motivation for running PTL with Otto in an almost dream-like disoriented state the very last night of that race I came to the conclusion that this factor of experimenting with being on the border of not having control really was a major motivating factor for me personally and that some races have enabled me to experience this.

That it is not the adrenaline sensation seeking of being in a dangerous situation, but rather the opposite risk control and aversion, that motivates many mountaineers and perhaps also other participants of long-duration high-risk sports is further supported by recent phenomenological research through interviews performed by Bymer and colleagues (Bymer “Risk taking in extreme sports: A phenomenological perspective” Ann Leisure Res 2010; 13: 218-239 and Brymer & Schweitzer “Extreme sports are good for your health: a phenomenological understanding of fear and anxiety in extreme sports” J Health Psychol 2013; 18: 477-487). It is very interesting to read how participants of high-risk sports of long duration have to cope with fear by embracing it, much like ultramarathon runners often cope with pain by embracing it. I have previously written about my experiences of fear of heights and experiences of pain during ultramarathons and can now see a similarity in at least my personal coping mechanisms.  Also other recent studies come to the same conclusions as Barlow and Brymer that many high-risk sport participants are not simply seeking sensation but that there might be other motives (see for instance Castanier et al “Beyond sensation seeking: affect regulation as a framework for predicting risk-taking behaviors in high-risk sport” J of Sport Exer Psychol, 2010; 32: 731-738; Kerr & Mackenzie “Multiple motives for participating in adventure sports” Psychol Sport Exercise 2012; 13: 649-657).

I have not found any article specifically discussing the risk taking aspects of mountain ultramarathon running. However, as mentioned, I have previously looked at articles regarding pain coping mechanisms and also the seeking of Runner’s High among ultramarathoners. There exist also plenty of articles about the personality profiles of ultramarathon runners (see list below). The problem with these studies is that all are rather small, poorly controlled, and almost all use different types of personality tests and questionnaires. The only common conclusion I could see was that many ultramarathon runners were more motivated by personal achievement and task/process goal oriented rather than interested in winning or losing a race compared to other runners or athletes.  That the studies come to so divergent conclusions rather emphasize my belief that we all have different motivations to running and the important is to find your own. In mountain ultramarathon running I think it also important to know you own subjective risk-level as some courses are more strenuous and exposed than others.

Studies of personality profiles of ultramarathon runners

(% male)
Not access to article or abstract, only second-hand information in other articles
Higher scores in the confidence-in-finishing scale in finishers of an ultramarathon compared to non-finishers
At least one 50K race
No personality differences between ultramarathon runners and other runners or healthy controls.
MMM 50 (80)
Not access to article or abstract, only second-hand information in other articles
MMM 50 (80);
Old Dom ER 100 (161)
Ultramarathon runners feel higher depression, fatigue and confusion, and less tension and vigor immediately post race compared to pre.race
Acevedo 1992
WSER (161);
Leadville (161)
Competitive and task/process goal oriented, but not win/lose oriented. No differences between finishers/non-finishers and males/females
Iditasport (161)
Extrovert and open. Low disinhibition. No differences between different sports, or males/females. No particular sensation-seeking
Marathon des Sables (230 over 6 days)
Personal goal achievement most motivating factor. Compared to marathoners, MdS participants seek life meaning and nature, while being not competitive
At least one 24-h or 100 km race
In Japanese ultramarathoners, the personality types introversion/judging and sensing/feeling (ISFJ) and intuition/feeling (INFJ) were common
Puffer UM (73)
There was confusion pre-race and post-race increases in total mood disturbance (TMD) with decreased vigor, increased confusion and increased fatigue
At least one 50K race
Interviews of 8 elite female runners showed normative body disentangled from ideal running body. Pain nuanced and negotiated
At least one 50K race
General health orientation and personal achievement/psychological coping were strongest motivations. High task/process goal orientation.
Marathon of Britain (282 over 6 days)
There were changes in emotions during multi-day UM. Trait emotional intelligence correlates with pleasant emotions
24-hour race (average 158 km)
After a 24-hour flat ultramarathon, stress decrease and recovery increase and return to baseline not until 2 weeks after the race.
Umstedt 100 mile (161) + UM in general
Both cognitive and affective factors important for motivation to run UM. UMs are different than other athletes and play harder and may think more
TransEurope FootRace 2009
TEFR09 participants appeared less cooperative and reward dependent, but more spiritually transcendent, than controls
At least one 50M race
Phenomenological interviews identify 5 themes of the UM. Among them were the UM community, discovery & personal achievement most important.
SMI = Self-motivation Inventory (SMI) (Dishman & Ickes 1981)
PHN = Philosophies of Human Nature Scale (Wrightsman 1964)
POMS = Profile Of Mood States (McNair,Lorr & Droppleman 1971; Pollock 1979)
SOQ = Sport Orientation Questionnaire (Gill & Deeter 1988)
TSCI = Trait Sport-Confidence Inventory (Vealy 1986)
CR = Commitment to Running Scale (Carmack & Martens 1979)
NEO-FFI(S) = NEO-Five Factor Inventory Short Form (Costa & McCrae 1992)
SSS-V = Zuckerman’s Sensation Seeking Scale (SSS-V) (Zuckerman 1994)
MOMS = Motivation of Marathoners Scales (Masters 1993)
MBTI = Myers-Briggs Type Indicator Form G (Briggs-Myers & Briggs 1985)
PSQ = Perception of Success Questionnaire (Roberts 1998)
BRUMS = Brunel Mood Scale (Terry 1999)
EIS = Trait Emotional Intelligence Questionnaire (Petrides 2000)
RESTQ-S = Recovery-Stress Questionnaire for Athletes (Kellmann & Kallus 2001)
PII = Personal Involvement Inventory (Zaichkowksi 1994)
CIP = Customer Involvement Profile (Laurent & Kapferer 1977)
TCI = Temperament and Character Inventory Test (Cloninger 1994)
GSE = General Self-Efficacy Test (Jerusalem & Schwarzer 1992)

Folkins and Wieselberg-Bell not surprisingly found significantly higher scores in the confidence-in-finishing scale in finishers of an ultramarathon compared to non-finishers (Folkins & Wieselberg-Bell “Personality profile of ultramarathon runners: a little deviance may go a long way” J Sport Behavior 1981; 4: 119-127).

McCutcheon and Yoakum surprisingly found no personality and motivational differences between ultramarathon runners and other runners and age-matched non-runners (McCutcheon & Yoakum “Personality attributes of ultramarathoners” J Personal Assess 1983; 47: 178-180).

Tharion and colleagues looked at stress indicators after a 50 or 100 mile mountain ultramarathon already in 1988 (Tharion et al “Profile and changes in moods of ultra-marathoners” J Sport Exerc Psychol 1988; 10: 229-235). They found that immediately post-race the runners felt more depression, fatique and confusion, but less tension and vigor compared to before the race.

Acevedo and colleagues, in a study of 47 runners in the 161 km (100 miles) Western States Endurance Run (WSER) and 65 runners in the 161 km (100 miles) Leadville Trail 100, found that mountain ultramarathon runners were more confident, more committed to running, higher in competitiveness, lower on win orientation and higher on goal orientation compared to other athletes (Acevedo et al  “Cognitive orientations of ultramarathoners” Sport Psychol 1992; 6: 242-252). There were no difference in responses between males or females, finishers and non-finishers, and participants in WSER versus those running Leadville. There was an unexpected relationship between importance of place goal and finishing time with those runners focusing on place goals finishing slower. The authors speculate that this might be due to either that focusing on others  might lead to a poor race strategy with regards to for instance hydration and nutrition, or, alternatively, that the runners focusing less on place are more experienced and familiar with the competitions. In summary, however, ultramarathon runners in Acevedo’s study tended in general to focus on achievement on personal goals.

Stuempfle and colleagues found in a study of 66 participants (among them 35 runners) in the Iditasport 161 km (100 mile) winter race in Alaska  that endurance athletes were extrovert and open with low disinhibition (Stuempfle et al “Personality profiles of Iditasport ultramarathon participants” J Appl Sport Physiol 2003; 15: 258-263). There were no differences between cyclists, runners, skiers and individuals on snowshoes. In contrast to the findings in the Acevedo study the athletes were not particularly goal oriented, however, the contradiction might be an artifact of the work-related emphasis of the questionnaire used in the study.

Doppelmayer and Mokenthin in a study of 54 runners of Marathon des Sables (MdS), a 6-day stage race of 230 kilometers, found the runners to be driven by personal goal achievement and, compared to marathoners, being more oriented to seek life meaning and being close to nature (Doppelmayr & Mokenthin “Motivation of participants in adventure ultramarathons compared to other foot races” Biol Sport 2004; 21: 319-323). They study confirm that ultramarathon runners are not particularly competitive.

Hashimoto and colleagues in a study of 52 Japanese runners having completed at least one ultramarathon found the personality types introversion/judging and sensing/feeling (ISFJ) and intuition/feeling (INFJ) more common than in the general population (Hashimoto et al “Motivation and psychological characteristics of Japanese ultra-marathon runners using Myers-Brigg type indicatior” Jpn J Hlth Hum Ecol 2006; 72: 15-24).

Micklewright and colleagues analyzed the mood changes in association with a 72 km mountain ultramarathon in South Africa in 8 runners and found confusion pre-race and post-race increases in total mood disturbance (TMD) with decreased vigor and increased confusion and fatigue (Micklewright et al “Perceived exertion influences pacing among ultramarathon runners but post-race mood change is associated with performance expectancy” SAJSM 2009; 21: 167-172).

Hanold interviewed 8 female elite ultramarathoners about their body perceptions and found the normative body disentangled from the ideal running body. Pain perception was nuanced and negotiated (Hanold “Beyond the marathon: (De)construction of female ultrarunning bodies” Soc Sport J 27: 160–177, 2010).

Krouse and colleagues got responses on a web-based survey from 344 female ultramarathon runners and found that a wish for general health improvement and internal personal achievement/ psychological coping were the strongest motivations (Krouse et al “Motivation, goal orientation, coaching, and training habits of women ultrarunners” J Strength Cond Res. 2011; 25: 2835-42). High task/ process goal orientation was found similarly to other studies.

Lane and Wilson in a study of 34 runners of the Marathon of Britain, a 6-day stage race over 282 kilometers, observed large changes in emotions during multi-day UM (Lane & Wilson “Emotions and trait emotional intelligence among ultra-endurance runners” J Sci Med Sport 2011; 14: 358-362). Trait emotional intelligence, measured with the EIS questionnaire, correlated well with pleasant emotions throughout the race.

Mueller analyzed over 400 runners of the Umstedt 100 mile (161 kilometers) race and found that both cognitive and affective factors are important for motivation to run an UM (Müeller “Involvement of ultramarathon runners: Understanding intention, behavior, and perceived skill of the “Absolute Unitary Being” J Research 2012; 7: 17-22).  Compared to other athletes, ultramarathon runners are different than other athletes and in short “play harder and may think more”.

Freund and colleagues showed that 11 participants in the 4487 multi-day TransEurope FootRace (TEFR09) were less cooperative, but more spiritually accepting and self-transcendent, as well as less harm avoidant and reward dependent but more explorative than controls (Freund et al “Ultra-marathon runners are different: Investigations into pain tolerance and personality traits of participants of the TransEurope FootRace 2009” Pain Practice 2013; 13: 524-532).

Simpson and colleagues performed qualitative phenomenological interviews with 26 runners having completed at least one 50M (80 km) race in the past (Simpson et al “”It’s not about taking the easy road”: the experiences of ultramarathon runners” Sport Psychologists 2014; 28: 176-185). In the interviews, five major motivational themes were identified: community, preparation & strategy, management, discovery, and personal achievement. In particular, the runners stressed the importance of the ultramarathon running community and the possibilities to achieve personal goals as motivating factors. The interviews confirm the findings by Acevedo that ultramarathon runners really are focused not on outcome goals (i.e. time/winning), but rather process/task goals.