Decreased Sleep Is an Independent Predictor of In-Season Injury in Male Collegiate Basketball Players

Abstract

Background: Although decreased sleep has been associated with decreased performance, increased illness risk, and impaired well-being in athletes, the relationship between sleep and injury risk in collegiate athletes is unknown. Purpose/Hypothesis: To evaluate the independent effects of sleep duration and subjective well-being on in-season injury in male collegiate basketball athletes. We hypothesized that decreased sleep would be associated with an increased risk of in-season injury. Study Design: Cohort study; Level of evidence, 2. Methods: During 2 consecutive seasons, 19 male National Collegiate Athletic Association Division I basketball players reported mood, fatigue, stress, soreness, sleep duration (hours), and previous day’s training load every morning. Well-being measures were recorded on a scale from 0 (worst) to 5 (best), and all time-loss injuries were recorded by the team athletic trainer. Separate mixed-effects logistic regression models were used to evaluate the effects of sleep and subjective well-being on in-season injury, with adjustment for same-day training load and individual repeated measures. To determine the independence of sleep and well-being as predictors of injury, each well-being variable was included in a separate mixed-effects logistic regression model, with sleep and training load as covariates. Results: During the study period, 32 injuries were recorded. In the initial separate prediction models, in-season injury was significantly predicted by mood (odds ratio [OR], 0.50; 95% CI, 0.37-0.66), fatigue (OR, 0.44; 95% CI, 0.33-0.59), stress (OR, 0.57; 95% CI, 0.42-0.76), soreness (OR, 0.41; 95% CI, 0.32-0.54), and sleep duration (OR, 0.57; 95% CI, 0.49-0.66) ( P < .001 for all). In the multivariable models, sleep duration remained a significant, independent predictor in each of the subsequent multivariable models (OR, 0.52-0.69; P < .001 for all) as did soreness (OR, 0.65; 95% CI, 0.44-0.95; P = .024), whereas mood (OR, 1.2; 95% CI, 0.76-1.9; P = .43), fatigue (OR, 1.1; 95% CI, 0.65-1.9; P = .68), and stress (OR, 1.1; 95% CI, 0.75-1.5; P = .69) were no longer significant. Conclusion: Increased sleep duration is independently associated with a reduced risk of in-season injury in male collegiate basketball players, even after adjustment for training load and subjective well-being. The effects of mood, fatigue, and stress on injury were no longer evident after adjustment for the effect of sleep duration.

Decreased Sleep and Subjective Well-Being as Independent Predictors of Injury in Female Collegiate Volleyball Players

“…Our findings that well-being and injury risk are related also are in line with findings from our previous study in collegiate male basketball players, where it was found that subjective well-being variables were significant predictors of injury. 34 Our findings differ slightly, however, in that while that study found that soreness in male athletes was the only independent subjective well-being metric predictive of injury after adjusting for sleep duration, we found that both soreness and mood were independent predictors of injury in female athletes in the multivariable models. Nonetheless, the finding that worse subjective well-being is correlated with higher incidence of injury is consistent with prior research exploring this relationship.…”

“…Our findings are consistent with previous studies in elite athletes that found that decreases in sleep volume contribute to a higher risk of injury. 18 , 29 , 34 Specifically, we sought to reproduce previously published findings related to well-being and injury risk regarding collegiate men’s basketball athletes. With respect to sleep duration, our results are very similar, suggesting that these findings may be generalizable to other populations of collegiate athletes.…”

“…24,28,29,33 In athletes, impairments in subjective wellbeing and sleep quality contribute to increased risk of injury, 9,13,32 and increased sleep duration is independently associated with a reduced risk of in-season injury in male collegiate division I basketball players. 34 Taken together, these findings suggest that lower sleep duration and well-being both increase the risk of injury in athletes. However, few studies have attempted to study the interaction of sleep and well-being on injury risk, and these limited data should be replicated in female athletes.…”

“… 24 , 28 , 29 , 33 In athletes, impairments in subjective well-being and sleep quality contribute to increased risk of injury, 9 , 13 , 32 and increased sleep duration is independently associated with a reduced risk of in-season injury in male collegiate division I basketball players. 34 …”

Comparison of sleep between youth elite amateur athletes and professional athletes

“…Sleep deprivation can also harm cognitive functions like such as judgement and decision-making; increase the risk of exercise-related injurie; allow for the development of recurrent upper airway infections and cause chronic pain; even lead to the creation of a vicious cycle related to sleep loss, impaired recovery; increased feelings of pain that themselves predispose athletes to sleep disturbances and delay recovery from a sports-related injury e.g. a concussion [10,13,[23][24][25][26]. The present study supports the earlier findings that sleeping-related problems are indisputably common among professional athletes [1,6].…”