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Chronic Lack of Sleep is Associated With Increased Sports Injuries in Adolescent Athletes

Milewski, Matthew D. MD*; Skaggs, David L. MD, MMM; Bishop, Gregory A. MS; Pace, J. Lee MD; Ibrahim, David A. MD; Wren, Tishya A.L. PhD; Barzdukas, Audrius MEd

Journal of Pediatric Orthopaedics: March 2014 - Volume 34 - Issue 2 - p 129–133
doi: 10.1097/BPO.0000000000000151

Background: Much attention has been given to the relationship between various training factors and athletic injuries, but no study has examined the impact of sleep deprivation on injury rates in young athletes. Information about sleep practices was gathered as part of a study designed to correlate various training practices with the risk of injury in adolescent athletes.

Methods: Informed consent for participation in an online survey of training practices and a review of injury records was obtained from 160 student athletes at a combined middle/high school (grades 7 to 12) and from their parents. Online surveys were completed by 112 adolescent athletes (70% completion rate), including 54 male and 58 female athletes with a mean age of 15 years (SD=1.5; range, 12 to 18 y). The students’ responses were then correlated with data obtained from a retrospective review of injury records maintained by the school’s athletic department.

Results: Multivariate analysis showed that hours of sleep per night and the grade in school were the best independent predictors of injury. Athletes who slept on average <8 hours per night were 1.7 times (95% confidence interval, 1.0-3.0; P=0.04) more likely to have had an injury compared with athletes who slept for ≥8 hours. For each additional grade in school, the athletes were 1.4 times more likely to have had an injury (95% confidence interval, 1.2-1.6; P<0.001).

Conclusion: Sleep deprivation and increasing grade in school appear to be associated with injuries in an adolescent athletic population. Encouraging young athletes to get optimal amounts of sleep may help protect them against athletic injuries.

Level of Evidence: Level III.

*Elite Sports Medicine, Connecticut Children’s Medical Center, Farmington, CT

Children’s Orthopaedic Center, Children’s Hospital Los Angeles, Los Angeles

Harvard-Westlake School, The Institute for Scholastic Sport Science and Medicine, Studio City, CA

M.D.M.: Journal of Bone and Joint Surgery Sports Medicine Newsletter, Editorial Board; Royalties: Elsevier, Inc. D.L.S.: Grants: POSNA & SRS, Paid to Columbia University; Consulting fee or honorarium: Biomet; Medtronic; Board Membership: Growing Spine Study Group, Scoliosis Research Society, Growing Spine Foundation Medtronic Strategic Advisory Board; Consultancy: Biomet; Medtronic; Expert testimony: legal expert in medical med. Mal. Cases (<5% of income); Payment for lectures including service on speakers' bureaus: Biomet; Medtronic; Stryker; Patents: Medtronic (patent holder); Royalties: Wolters Kluwer Health - Lippincott Williams & Wilkins; Payment for the development of educational presentations: Stryker; Biomet, Medtronic; Other: Institutional support from Medtronic (fellowship program).

All other authors do not have anything to disclose.

Reprints: David L. Skaggs, MD, MMM, Children’s Orthopaedic Center, Children’s Hospital Los Angeles, 4650 Sunset Blvd, #69, Los Angeles, CA 90027. E-mail:

© 2014 by Lippincott Williams & Wilkins