Sleep’s Effect on Athletic Performance and Injury Risk

by | Apr 2, 2021 | Anterior Cruciate Ligament Injury, Athletic, Physical Therapy / Medicine and Rehabilitation | 0 comments

A good night’s sleep affects every aspect of the time spent awake, from hunger control and cravings to cognitive function and emotion regulation. Both proper duration and good quality sleep are essential for peak performance in any activity. Current research shows that emphasizing and prioritizing healthy sleep habits in athletes allows them to reach their physical potential while minimizing injury and illness risk (1). While current general sleep recommendations suggest between 8-10 hours nightly for adolescents and 7-8 hour nightly for adults, individuals who are partaking in high-performance athletic training require additional  sleep for muscles to recover and rebuild (2). A study performed in 2013 examined the role of sleep in athletic performance and found that most elite athletes partaking in high intensity training (4-6 hours daily) required up to 10-12 hours of high quality sleep every night to continue peak performance and prevent injury (2). 

Numerous studies and experiments have been conducted to understand how and when sleep loss can predict athletic performance changes. One experiment conducted in 2017 took cyclists and divided them into groups: those allowed a full nights’ rest, and those who had restricted rest with an early rising time enforced. In just one night of lost sleep, the restricted cyclists had slower 3 km timed-trials than their well-rested counterparts compared to controlled time trials taken before sleep cycles had been altered (3). Another survey of almost 600 elite athletes found that sleep duration and quality in the days leading up to competition was an independent variable in determining the outcome of competition, outranking mood and practice preparedness in its ability to predict game results (4). 

Though the mechanisms behind this phenomenon  are not well understood, much evidence supports  that proper sleep can aid injury prevention. Because inadequate sleep reduces reflex time, injuries could be avoided in sports reliant on quick reflexes, such as soccer or field hockey by increasing sleep time and quality. One analysis found that not only are adolescents at a higher risk for injury  due  to  impaired reflexes and cognitive processing, yet they’re also more likely to partake in risk-related behaviors such as not wearing proper protective equipment, or not properly assessing the danger of any particular move (5). Limited sleep also limits the body’s time to actively repair and recover from training, thus increasing risk for stress related injuries (1). Sleep is also an essential tool for boosting the immune system. In many sports, shared equipment and close proximity allows for rapid transmission of viruses, especially during cold and flu seasons. A study conducted in 2009 found that participants with less than 7 hours of sleep were 2.94 times more likely to develop the common cold than those who got 8 or more hours of sleep each night (6). 

It is overwhelmingly clear that incorporating proper, high quality sleep is essential for full athletic performance. But what is “quality sleep”? Something so general is incredibly difficult to define simply or limit to a few factors. However, the National Sleep Foundation has defined a few variables which help determine whether or not sleep is ‘quality’: sleep latency (the time it takes for an individual to fall asleep), minutes spent awake due to sleep awakenings, and sleep efficiency should all be considered when discussing quality of sleep (7). Though many aspects of sleep quality vary as an individual ages, it’s agreed that for most of the population, a sleep latency time of <15 minutes, <5 minutes spent awake due to awakenings, and a sleep efficiency of >85% are all signifiers of good quality sleep (7). 

Though proper sleep is key for athletic performance, most athletes are not getting enough sleep. Barriers like training load, competition travel and anxiety, and academic pressure in adolescent athletes all contribute to the lack of sleep observed in athletes (1). However there are recommendations for improving sleep quality and duration. The Sleep Foundation recommends creating a sleep-sanctuary bedroom (by regulating room temperature, avoiding light disruption, and using aromatherapy), sleep schedule optimization (by waking up at the same time each morning and properly budgeting in sleep time), and developing sleep-inducing habits during the day (like exposure to sunlight in the morning and monitoring food and drug consumption times) (8). Incorporating these habits and prioritizing sleep can drastically alter the quality of exercise and physical performance athletes exhibit in addition to preventing sports injury.

Citations:

  1. Watson, A. M. (2017). Sleep and Athletic Performance. Current Sports Medicine Reports, 16(6), 413–418. https://doi.org/10.1249/jsr.0000000000000418
  2. ‌Bird, Stephen. (2013). Sleep, Recovery, and Athletic Performance: A Brief Review and Recommendations. Strength and Conditioning Journal. 35. 43-47. 
  3. Chase, J. D., Roberson, P. A., Saunders, M. J., Hargens, T. A., Womack, C. J., & Luden, N. D. (2017). One night of sleep restriction following heavy exercise impairs 3-km cycling time-trial performance in the morning. Applied Physiology, Nutrition, and Metabolism, 42(9), 909–915. https://doi.org/10.1139/apnm-2016-0698
  4. ‌Brandt, R., Bevilacqua, G. G., & Andrade, A. (2017). Perceived Sleep Quality, Mood States, and Their Relationship With Performance Among Brazilian Elite Athletes During a Competitive Period. Journal of strength and conditioning research, 31(4), 1033–1039. https://doi.org/10.1519/JSC.0000000000001551
  5. Wheaton, A., Olsen, E., Miller, G., & Croft, J. (2016). Sleep Duration and Injury-Related Risk Behaviors Among High School Students — United States, 2007–2013. Morbidity and Mortality Weekly Report,65(13), 337-341. doi:10.2307/24858002
  6. Cohen, S., Doyle, W. J., Alper, C. M., Janicki-Deverts, D., & Turner, R. B. (2009). Sleep Habits and Susceptibility to the Common Cold. Archives of Internal Medicine, 169(1), 62. https://doi.org/10.1001/archinternmed.2008.505
  7. ‌Ohayon, M., Wickwire, E. M., Hirshkowitz, M., Albert, S. M., Avidan, A., Daly, F. J., Dauvilliers, Y., Ferri, R., Fung, C., Gozal, D., Hazen, N., Krystal, A., Lichstein, K., Mallampalli, M., Plazzi, G., Rawding, R., Scheer, F. A., Somers, V., & Vitiello, M. V. (2017). National Sleep Foundation’s sleep quality recommendations: first report. Sleep Health, 3(1), 6–19. https://doi.org/10.1016/j.sleh.2016.11.006
  8. Suni, E. (2020, July 30). How to Sleep Better. Sleep Foundation. https://www.sleepfoundation.org/sleep-hygiene/healthy-sleep-tips

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