JMIR Publications

ABSTRACT

Background:

Competitive esports combine sustained digital interaction, time pressure, social evaluation, uncertainty, and performance consequences, but reported psychophysiological responses vary across markers and protocols.

Objective:

To examine how objective and semi-objective psychophysiological markers have been linked to competitive digital contexts, player behavior, and performance, and to conduct outcome-specific quantitative syntheses where the registered feasibility criteria were met.

Methods:

PubMed, Web of Science, Scopus, ACM Digital Library, PsycINFO, and IEEE Xplore were searched from inception through 9 July 2026, followed by backward and forward citation searching. Peer-reviewed empirical reports were eligible when they examined ranked or structured competitive esports and included at least one objective or semi-objective psychophysiological marker. Two reviewers independently screened records and applied design-specific JBI critical-appraisal tools. Evidence was mapped and synthesized using SWiM-informed methods. Random-effects models with restricted maximum likelihood and Hartung-Knapp inference were used for aligned heart-rate and cortisol contrasts.

Results:

Forty-seven eligible reports were grouped into 40 non-overlapping report families. Review-level overall concern was low for one family, moderate for 19, and high for 20. The evidence map contained 63 report-family-by-domain rows across eight marker domains. The most common inferential questions were acute reactivity (n=16 family-domain rows), expertise or group differences (n=11), predictive modelling (n=10), and within-match dynamics (n=9). Three report families contributed aligned resting/pre-game versus during-competition heart-rate data; the pooled mean difference was +25.95 bpm (95% CI +6.78 to +45.11; P=.028; I²=73.2%; prediction interval −74.03 to +125.92). Six report families contributed cortisol data; the pooled post/pre ratio was 1.16 (95% CI 0.79-1.69; P=.365; I²=87.2%; prediction interval 0.43-3.12). Certainty was rated very low for both pooled estimates.

Conclusions:

Current evidence characterizes context-dependent user responses within digitally mediated performance rather than a unitary psychophysiological effect of esports. The aligned heart-rate subset indicated higher mean heart rate during competition, whereas the cortisol synthesis did not provide precise evidence of a consistent postcompetition increase. Physiological measures should therefore be interpreted in relation to the competitive digital event, task demand, behavioral outcome, and measurement window. Clinical Trial: PROSPERO CRD420261443790