Here’s a secret: there is a way for adolescent athletes (and athletes of all ages) to reduce injury risk, improve mental health, coordination, decision-making, mood and nearly every other aspect of athletic performance.
Except it’s not a secret. It’s sleep.
You were probably expecting a sexier, more exciting answer. But sleep continues to be an athlete’s best asset to building long-term health and peak athletic performance.
So why is it so hard to get adolescent athletes to do it?
Here’s a bit of data: A study of adolescent athletes found that the strongest predictor of injury was getting less than 8 hours of sleep per night. The study found that 65% of athletes who reported sleeping less than 8 hours per night were injured, compared with 31% of athletes who reported sleeping more than 8 hours per night.
The study found was that sleeping less than 8 hours per night increased injury risk by 1.7x, compared with athletes who slept 8 or more hours per night. For each additional grade in school, the risk of injury increased by 1.4x.1 As poor sleep habits persist over time, fatigue accumulates and increases injury risk as the athlete ages.
Every time I educate teens about the importance of sleep, I get bored stares. It gets worse when I mention they likely need 10+ hours each night as an athlete. This is when they just laugh in my face. (At least teens are honest.)
Although adolescent athletes need regular, high quality sleep, it’s not as simple as lecturing them and expecting them to do it. I think one of the difficulties in accepting sleep as the potent medicine that it is, is what I call “push through” culture.
Adolescent athletes have high standards for themselves, often to the point of toxic perfectionism. They internalize messages of #norestdays and #bettereveryday. They become adept at ignoring, or pushing through, the intuition that tells them to slow, rest, and sleep. While athletes are often rewarded (albeit for the short-term) for pushing through fatigue and foregoing sleep to add “productive” hours to their day, it sets them up for poor health and athletic performance in the long-term. It’s not worth it, but you don’t know until it’s too late.
Accepting sleep as a performance enhancer means loosening your grip on the ideal that doing more is always better. It means challenging “push through” culture, even while so many around us continue to set unhealthy examples.
Another problem is the factors that disrupt sleep, like overtraining, screen time, and hanging out in bed awake, are common and normalized.
Research shows that overtrained athletes are more at risk for disturbed sleep and sleep disorders. Overtraining often goes unrecognized in endurance sports due to the short-term performance enhancements that come along with it. The eventual crash of athletic performance and mental health is rarely publicized.
Phones also pose a risk to sleep, as blue light from screens disrupts melatonin production. Melatonin is a hormone that naturally causes drowsiness when it gets dark.
Even the common adolescent behavior of using one’s bed as a place to study and socialize disrupts the sensory link of being in bed and the body’s impulse to sleep.2
But there is good news. An athlete’s sleep can improve.
First, any underlying source of a sleep deficit/disorder should be addressed, like overtraining, depression, and anxiety. A trained health care professional can screen for and treat sleep disorders, like insomnia. An athlete should not face these issues without professional support.
Second, an athlete needs sleep hygiene education.
Sleep hygiene is establishing habits necessary for good sleep quality and daytime alertness.3 Sleep hygiene includes strategies like establishing a regular bedtime routine, avoiding stimulants before bed, and creating a calm sleep environment.4
Download this handout for more sleep hygiene strategies.
Remember, achieving healthy sleep comes from establishing healthy habits. Give it time. You won’t be perfect all the time, but chipping away at proven strategies will pay off.
In time, others will ask what your secret is.
Katie Noble is a Doctor of Physical Therapy, a journalist, and a runner. She enjoys empowering and supporting female runners with evidenced-based education.
- Milewski MD, Skaggs DL, Bishop GA, et al. Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. Journal of Pediatric Orthopaedics. 2014;34(2):129-133. doi:10.1097/bpo.0000000000000151
- Damour L. Caring for Herself. In: Untangled: Guiding Teenage Girls through the Seven Transitions into Adulthood. New York: Ballantine Books; 2017:248-249.
- Walsh NP, Halson SL, Sargent C, et al. Br J Sports Med 2021;55:356–368
- Charest, J. and Grandner, M.A. (2022) “Sleep and athletic performance,” Sleep Medicine Clinics, 17(2), pp. 263–282. Available at: https://doi.org/10.1016/j.jsmc.2022.03.006.
Dr. Katie Noble, PT, DPT, SCS 