Abstract / Summary
Abstract Background Competitive esports involve prolonged sedentary behavior combined with high cognitive and emotional demands, potentially influencing acute physiological responses. However, evidence regarding acute cardiovascular, autonomic, and endocrine responses to competitive gaming remains inconsistent and methodologically heterogeneous. Methods In this randomized controlled crossover study, sixteen healthy male EA Sports FC players completed a one-hour competitive gaming session and a control condition (documentary viewing). Heart rate (HR), root mean square of successive differences (RMSSD) and standard deviation of NN-intervals (SDNN) for heart rate variability (HRV) were recorded continuously. Peripheral and central blood pressure, pulse wave velocity (PWV) and salivary cortisol were assessed at baseline, post-session, and after 15 min of rest. Linear mixed-effects models examined the effects of condition, time, and their interaction while accounting for period and sequence effects. Results RMSSD ( p = 0.005, ηₚ² = 0.13) and SDNN ( p = 0.040, ηₚ² = 0.08) showed a significant Condition x Time interaction, with an increase in the control condition, whereas no significant temporal changes were observed during gaming. No significant Condition x Time interactions were observed for HR, PWV, peripheral and central blood pressure. Salivary cortisol decreased over time in both conditions ( p < 0.001, ηₚ² = 0.33) without condition-specific effects ( p = 0.765). Conclusion In this laboratory setting, no significant condition specific temporal changes in acute hemodynamic or cortisol responses were detected during competitive gaming compared with passive documentary viewing. The observed differences in cardiac autonomic regulation were primarily driven by an increase in HRV during the control condition, whereas no significant temporal changes in HRV were observed during gaming. Trial registration The study was preregistered in the German Clinical Trials Registry on 05 June 2024 (ID: DRKS00034399).