“The results provide compelling evidence that sleep is an essential but often overlooked component of injury prevention,” says lead author Jan de Jonge, PhD, a work and sports psychologist at Eindhoven University of Technology in the Netherlands.
Runners tend to focus on mileage, equipment and nutrition, but forget that sleep is one of the body’s most powerful recovery tools, says Dr. de Jonge.
Your Sleep Pattern May Predict Your Risk of Running Injury
The study used survey data from a mix of new and experienced recreational runners. The average participant had been a runner for 12 years. Investigators collected data on how many hours participants slept and how often they experienced symptoms such as difficulty falling asleep, waking up frequently at night, or waking up not feeling refreshed.
Using this information, researchers identified four distinct sleep profiles:
- Steady sleepers (48 percent of runners) These runners consistently slept seven hours or more. They were “slightly above average” in terms of sleep quality and tended to experience fewer sleep problems like nighttime awakenings or insomnia.
- Poor sleepers (37 percent of runners) These people slept less than other participants and regularly experienced sleep problems such as difficulty falling asleep, waking up frequently during the night, or not getting enough rest after waking up.
- Effective sleepers (8 percent of runners) These people slept about the same as regular sleepers, but reported the highest quality sleep and woke up feeling well-rested.
- Fragmented sleepers (7 percent of runners) These runners had an average sleep time and reported fairly good sleep quality, but they had more sleep disturbances than regular sleepers, particularly waking up during the night.
The researchers also collected information on all injuries in the past year that were caused or developed while running and required runners to adjust their running or take unscheduled days off.
Main conclusions of the study:
- Sixty percent of the runners in the study had suffered a running injury in the past year.
- Poor sleepers had significantly higher risks of injury; they were 1.78 times more likely to report an injury than other groups.
- How much sleep a person gets isn’t the whole story. The trio of short sleep, disrupted sleep, and poor sleep quality appears to be the most important factor.
- In absolute terms, runners in the poor-sleeping group had a 68 percent chance of sustaining an injury within a year.
Why does poor sleep increase the risk of running injury?
Although the results show that running injuries and lack of sleep are linked, the study does not prove that poor sleep is actually the cause of running injuries.
But this conclusion “absolutely” makes sense, says Josh Hayes, PT, director of sports medicine at Banner Physical Therapy in Gilbert, Arizona.
“Running is a high-load activity and therefore requires the necessary strength and recovery to ensure the body can tolerate this repetitive activity,” says Hayes, who was not involved in the study.
“The overall conclusion of these findings is consistent with the idea that sleep is extremely important for rest and recovery, and that poor sleep—whether behavioral or due to an underlying sleep disorder—could prevent adequate healing in the same way that poor sleep disrupts our immune system and cognitive processes,” says Neal Walia, MD, a sleep specialist at UCLA Health in California, who was not involved in the study.
“One theory is that if a person develops early minor damage without proper healing and continues to strain, it could make that problem worse and become a full-blown injury,” says Dr. Walla. “It’s similar to the fact that if someone is suffering from a minor ankle sprain, returning to activity too soon can make the situation worse because your body doesn’t have time to heal.”
Sleep promotes tissue repair via growth hormone, de Jonge points out, so poor sleep could hinder recovery and therefore increase the risk of injury.
Poor sleep can also increase your risk of injury in other ways, says de Jonge, including:
- Stimulates inflammation and weakens healing ability, making runners prone to overuse injuries.
- Increasing fatigue, which lowers endurance and pain threshold, leading to overwork
- Increased stress and mood issues, which could negatively impact concentration and recovery compliance.
- Slow reaction time and impair coordination, which could increase missteps
Naps can help recovery
If you’re a runner or play other sports that require significant strength and cardiovascular effort, there’s some evidence to suggest that getting more sleep on a regular basis could improve your performance, says de Jonge.
Napping is another option for getting more sleep or to compensate for a lack of sleep, he says.
“Daytime naps ranging from 20 to 90 minutes maximum, between 1 p.m. and 4 p.m., can also be used strategically when needed. Short naps can help minimize the effects of sleep inertia. [the temporary feeling of grogginess when you wake up from deep sleep]while longer naps can allow running athletes to complete a full sleep cycle, promoting deeper recovery,” says de Jonge.
Although a brief 20-minute nap may be more effective when the next task is short and involves frequent decision-making, a longer nap may protect against muscle damage, especially before more demanding activities, he says.
In addition to improving total sleep duration, naps have been shown to restore performance deficits to baseline levels after nights when you don’t get enough sleep, says de Jonge.
Should you avoid running after a bad night’s sleep?
One night of poor sleep shouldn’t stop you from running as planned.
Although fatigue after a rough night can decrease your motivation to exercise and make you feel like you have to work harder to achieve the same pace, there’s no reason to skip your run from an injury risk standpoint, says de Jonge.
If your sleep changes from good to poor, talk to your doctor
Physically active people generally tend to sleep better, but exercise alone isn’t a magic bullet, says de Jonge.
“If someone runs regularly but still has trouble sleeping, that’s a sign that other aspects of sleep hygiene may need attention,” he says.
If you’ve always been a good sleeper and suddenly find your sleep quality has taken a nosedive, it could be a sign that training load, recovery, or behavioral factors are out of balance, says Hayes.
Walia agrees that if you can’t get good sleep consistently, you may need to reduce the intensity of your workout.
“It may also be helpful to discuss this with a healthcare professional, especially if there are signs of a sleep-related disorder, such as sleep apnea or untreated insomnia,” he says.
How do you know if you’re getting enough sleep?
Unless you have a sleep disorder, your body is usually able to tell you how much sleep you need. Most people need seven to nine hours a night, says Walia.
“A good way to assess this is to consistently go to bed early enough that you can wake up naturally right before or near your alarm,” he says.
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