Milewski · Journal of pediatric orthopedics 2014 · retrospective cohort study · n=112

Chronic lack of sleep is associated with increased sports injuries in adolescent athletes.

Cited 445 times in the scientific literature.

Level 3 - non-randomized controlled study

Retrospective cohort study correlating survey responses with athletic department injury records

PubMed 25028798 · doi:10.1097/BPO.0000000000000151 · record verified 2026-08-29

What was done

Researchers administered an online survey assessing sleep habits and training practices to student athletes in grades 7 to 12 at a combined middle/high school. A total of 112 athletes (54 male, 58 female; mean age 15 ± 1.5 years; 70% completion rate of 160 consented) completed the survey. Survey responses were retrospectively correlated with injury records maintained by the school's athletic department using multivariate analysis.

What was found

Hours of sleep per night and grade in school were identified as independent predictors of injury. Athletes who averaged <8 hours of sleep per night were 1.7 times more likely to have had an injury compared to those sleeping ≥8 hours (95% CI, 1.0–3.0; P=0.04). In addition, each higher grade level in school was associated with a 1.4-fold increase in the likelihood of injury (95% CI, 1.2–1.6; P<0.001).

Why it matters

This study provides early empirical evidence linking chronic insufficient sleep (<8 hours per night) to an increased risk of athletic injuries in adolescent athletes.

Limits

The study relies on a modest sample size from a single school setting, self-reported sleep metrics subject to recall bias, and a retrospective design that precludes establishing causality. Unmeasured confounders such as specific sport types, training intensity, and baseline fitness were not reported in the abstract.

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