Grier · Sleep health 2020 · cross-sectional survey · n=7576

Sleep duration and musculoskeletal injury incidence in physically active men and women: A study of U.S. Army Special Operation Forces soldiers.

Cited 60 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional survey assessing retrospective self-reported injury recall and sleep duration

PubMed 32061551 · doi:10.1016/j.sleh.2020.01.004 · record verified 2026-08-29

What was done

An electronic survey was administered to 7,576 soldiers from the United States Army Special Operations Command to assess self-reported sleep duration and musculoskeletal injury incidence over the preceding 12 months. Multivariable models adjusted for covariates, and age-stratified analyses (≤ 35 vs. > 35 years) were performed.

What was found

The sample was mostly men (95%) and aged ≤ 35 years (70%). Overall musculoskeletal injury incidence was 53% over the prior 12 months. After adjusting for covariates, soldiers who slept ≤ 4 hours were 2.35 times more likely (95% CI: 1.89–2.93, p < 0.01) to experience an injury compared to those who slept ≥ 8 hours. Older soldiers (> 35 years) exhibited significantly higher injury risk than younger soldiers across all sleep duration groups.

Why it matters

This study provides large-sample observational data linking very short sleep duration to an increased rate of musculoskeletal injuries in highly active tactical personnel, highlighting sleep as a potential target for injury mitigation strategies.

Limits

The study relied entirely on retrospective self-report for both sleep duration and injuries over a 12-month recall period, introducing potential recall and reporting bias. The cross-sectional design precludes establishing causality or the temporal sequence between sleep duration and injury. The population was 95% male military personnel, limiting generalizability to females and non-military active populations.

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