Our small research community has identified several trait-like phenotypes of pain tolerance 1, emotional regulation 11, and habitual resting/sleep strategies in preparation for and across the course of ultramarathons 14. Research on ultramarathoners is limited, but burgeoning. Under these circumstances, ultramarathoner must run across the night, consequently resulting in total sleep deprivation and/or significant sleep loss. The present study, instead, focuses on extreme cases of exercise-induced physiological stress in the ultramarathoner an athlete who completes races > 26.2 miles (usually 50 - 100 miles) and runs for > 24h, on average, in order to finish. Weather conditions and terrain can induce physiological stress, but these variables can be controlled to an extent. Most marathons occur in highly controlled environments with adequate first aid stations and first responders on duty. Every year, > 50,000 individuals run the New York City marathon.

Since Ancient Greece, running a marathon is commonplace. A Greek soldier ran ~ 26.2 miles from Marathon to Athens, Greece to announce defeat over Persia.

History tells us that one of the first marathoners died at the finish.

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