Sleep and injury risk

NewsBot · Nov 2, 2019

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General health complaints and sleep associated with new injury within an endurance sporting population: A prospective study
R. Johnston
JSAMS; Article in Press

Objective
To examine the association between subjective health complaints, sleep quantity and new injury within an endurance sport population.

Design
Prospective cohort study.

Methods
Ninety-five endurance sporting participants were recruited from running, triathlon, swimming, cycling and rowing disciplines. Over 52-week period participants submitted weekly data regarding subjective health complaints (SHCs) (cardiorespiratory, gastrointestinal and psychological/lifestyle), sleep quantity, training load and new injury episodes. Applying a 7- and 14-day lag period, a shared frailty model was used to explore new injury risk associations with total SHCs and sleep quantity.

Results
92.6% of 95 participants completed all 52 weeks of data submission and the remainder of the participants completed ≥ 30 weeks. Seven-day lag psychological/lifestyle SHCs were significantly associated with new injury risk (Hazard ratio (HR) = 1.32; CI 95% = 1.01-1.72, p < 0.04). In contrast, cardiorespiratory (HR = 1.15; CI 95% = 0.99-1.36, p = 0.07) and gastrointestinal (HR = 0.77; CI 95% = 0.56-1.05, p = 0.09) SHCs were not significantly associated with new injury risk. New injury risk had a significant increased association with 14-day lag <7 hrs/day sleep quantity (HR = 1.51; CI 95% = 2.02-1.13, p < 0.01) and a significant decreased association with >7 hrs/day sleep quantity (HR = 0.63, CI 95% = 0.45-0.87, p < 0.01. A secondary regression analysis demonstrated no significant association with total SHCs and training load factors (Relative Risk (RR) = 0.08, CI 95% = 0.04-0.21, p = 0.20).

Conclusions
To minimise an increased risk of new injuries within an endurance sporting population, this study demonstrates that psychological/lifestyle subjective health complaints and sleep quantity should be considered. The study also highlights a lag period between low sleep quantity and its subsequent impact on new injury risk. No association was demonstrated between subjective health complaints, sleep quantity and training load factors.
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NewsBot · Nov 2, 2019

Related Thread:
Sleep Hygiene for Optimizing Recovery in Athletes

NewsBot · Feb 9, 2021

The Association Between Poor Sleep and the Incidence of Sport and Physical Training-Related Injuries in Adult Athletic Populations: A Systematic Review
Devon A. Dobrosielski, Lisa Sweeney & Peter J. Lisman
Sports Medicine (2021)

Background
The importance of achieving an adequate amount of sleep to optimize health and athletic performance is well recognized. Yet, a systematic evidence compilation of the risk for sport-related injury in adult athletic populations due to poor sleep does not exist.

Objective
To examine the association between poor sleep and sport and physical training-related injuries in adult athletic populations.

Data Sources
Electronic databases were searched using keywords relevant to sleep quantity and quality, and musculoskeletal injury and sport-related concussion (SRC).

Eligibility Criteria for Selecting Studies
Studies were included in this systematic review if they were comprised of adult athletic populations, reported measures of sleep quantity or quality, followed participants prospectively for injury, and reported an association between sleep and incidence of sport or physical training-related injury.

Study Appraisal
The methodological quality of each study was assessed using the Newcastle–Ottawa Scale for Cohort Studies.

Results
From our review of 12 prospective cohort studies, we found limited evidence supporting an association between poor sleep and injury in adult athletic populations. Specifically, there is (a) insufficient evidence supporting the associations between poor sleep and increased risk of injury in specific groups of athletic adults, including professional or elite athletes, collegiate athletes, elite or collegiate dancers, and endurance sport athletes; and (b) limited evidence of an association between poor sleep and increased risk of SRC in collegiate athletes.

Conclusions
The current evidence does not support poor sleep as an independent risk factor for increased risk of sport or physical training-related injuries in adult athletic populations. Given the methodological heterogeneity and limitations across previous studies, more prospective studies are required to determine the association between sleep and injury in this population.
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NewsBot · Feb 10, 2021

From LER:
Sleep Series Part I: Basics of Sleep and Its Role with Injury

NewsBot · Feb 22, 2021

Factors Associated With Lower Limb Injuries in Recreational Runners: A CrossSectional Survey Including Mental Aspects and Sleep Quality
Seyed Hamed Mousavi et al
Journal of Sports Science and Medicine (2021) 20, 203-214

Knowledge about prevalence and etiology of running-related injuries (RRIs) is important to design effective RRI prevention programs. Mental aspects and sleep quality seem to be important potential risk factors, yet their association with RRIs needs to be
elucidated. The aims of this study are to investigate the epidemiology of RRIs in recreational runners and the association of mental aspects, sleep, and other potential factors with RRIs. An internet-based questionnaire was sent to recreational runners recruited
through social media, asking for personal and training characteristics, mental aspects (obsessive passion, motivation to exercise),
sleep quality, perceived health, quality of life, foot arch type, and
RRIs over the past six months. Data were analyzed descriptively
and using logistic regression. Self-reported data from 804 questionnaires were analyzed. Twenty-five potential risk factors for
RRIs were investigated. 54% of runners reported at least one RRI.
The knee was the most-affected location (45%), followed by the
lower leg (19%). Patellofemoral pain syndrome was the most-reported injury (20%), followed by medial tibial stress syndrome
(17%). Obsessive passionate attitude (odds ratio (OR):1.35; 95%
confidence interval (CI):1.18-1.54), motivation to exercise
(OR:1.09; CI:1.03-1.15), and sleep quality (OR:1.23; CI:1.15-
1.31) were associated with RRIs, as were perceived health
(OR:0.96; CI:0.94-0.97), running over 20 km/week (OR:1.58;
CI:1.04-2.42), overweight (OR:2.17; CI:1.41-3.34), pes planus
(OR:1.80; CI:1.12-2.88), hard-surface running (OR:1.37;
CI:1.17-1.59), running company (OR:1.65; CI:1.16-2.35), and
following a training program (OR:1.51; CI:1.09-2.10). These factors together explained 30% of the variance in RRIs. A separate
regression analysis showed that mental aspects and sleep quality
explain 15% of the variance in RRIs. The association of mental
aspects and sleep quality with RRIs adds new insights into the
multifactorial etiology of RRIs. We therefore recommend that besides common risk factors for RRI, mental aspects and sleep be
incorporated into the advice on prevention and management of
RRIs.
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NewsBot · Mar 15, 2021

The athlete’s sleep paradox prompts us to reconsider the dose-response relationship of physical activity and sleep

NewsBot · May 20, 2021

How does sleep help recovery from exercise-induced muscle Injuries?
Mounir Chennaoui et al
May 18, 2021

Athletes and military personnel may experience sleep disturbances due to conditions of training and competitions or military missions/field operations. The risk of muscle injuries is greater for them when sleep duration decreases, and training load increases simultaneously, which can be exacerbated by fatigue. Accumulating evidence demonstrates that sleep extension improved performance, pain sensitivity and GH/IGF-I anabolic responses, which may be beneficial in accelerating recovery from muscle injuries.
Objectives
This narrative review describes the importance of sleep for the recovery/prevention of exercise-induced muscle injuries and provides perspectives on the transferability of currently available scientific evidence to the field. The first part presents the role of sleep and its interaction with the circadian system for the regulation of hormonal and immune responses, and provides information on sleep in athletes and soldiers and its relationship to injury risk. The second part is an overview of muscle injuries in sport and presents the different phases of muscle regeneration and repair, i.e. degeneration, inflammation, regeneration, remodeling and maturation. Part Three provides information on the deleterious effects of sleep deprivation on muscle tissue and biological responses, and on the benefits of sleep interventions. Sleep extension could potentially help and/or prevent recovery from exercise-induced muscle-injuries through increasing local IGF-I and controlling local inflammation.
Conclusions
Although the science of sleep applied to sport is still an emerging field, the current scientific literature shows many potential physiological pathways between sleep and exercise-related muscle injuries. More direct studies are needed to establish clear guidelines for medical personnel and coaches.
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NewsBot · Jun 17, 2021

Sleep and Injury Risk
Huang, Kevin DO; Ihm, Joseph MD
Current Sports Medicine Reports: June 2021 - Volume 20 - Issue 6 - p 286-290

Sleep has been found to have wide-ranging effects on sports performance and overall well-being. Recent research has found evidence relating chronic suboptimal sleep with the risk of musculoskeletal pain and sports injury. The amount of sleep that consistently has been found to be associated with increased risk of injury is ≤7 h of sleep, which when sustained for periods of at least 14 d has been associated with 1.7 times greater risk of musculoskeletal injury. However, it is unknown if sleep loss predisposes the athlete to specific types of musculoskeletal injuries. The role of sleep on musculoskeletal pain is important to understand as studies in both children and adults have found that suboptimal sleep more consistently predicts next-day pain as compared with pain predicting subsequent sleep loss. Despite the evidence that certain aspects of sleep behavior seem to increase the risk of musculoskeletal injury and pain, sleep should be considered as only a part of the athlete's overall health and well-being when assessing the athlete for risk of injury.
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