CINCINNATI (AP) — Carlos Alcaraz won the Cincinnati Open title in a little more than 20 minutes on Monday after top-ranked Jannik Sinner was forced to retire because of illness during the first set.

Meeting in the final for the fourth time this year and first since Wimbledon, Sinner fell behind 5-0 in the first set with nine unforced errors. He was seen with an icepack on his head during a break and retired after playing just 22 minutes.

Sinner, who turned 24 on Saturday, was on 12-match winning streak and had won 26 straight matches on hard courts. He was bidding to become the first player to win back-to-back men’s Cincinnati Open titles since Roger Federer in 2014 and '15.

Alcaraz, who is ranked No. 2, now holds a 9-5 advantage in his matchups with the Italian.

Sinner won in four sets at Wimbledon while the Spaniard won a five-set thriller at the French Open and in straight sets in the Rome Masters in May.

It was only the third time the top two men's players have met in the Cincinnati Open final, the last being No. 2 Novak Djokovic and No. 1 Alcaraz in 2022 and No. 1 Federer and No. 2 Djokovic in 2012.

The Cincinnati Open is considered a tuneup for the U.S. Open, which begins Sunday in New York. The last two years, both the men’s and women’s Cincinnati Open champions went on to win the final Grand Slam tournament of the year.

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AP tennis: https://apnews.com/hub/tennis