Lack of Sleep and Sports Injuries in Adolescents: A Systematic Review and Meta-analysis

J Pediatr Orthop. May/Jun 2019;39(5):e324-e333. doi: 10.1097/BPO.0000000000001306.


Background: Although sleep has been identified as an important modifiable risk factor for injury, the effect of decreased sleep on sports injuries in adolescents is poorly studied. The objective of this study was to quantitatively and qualitatively review published literature to examine if a lack of sleep is associated with sports injuries in adolescents and to delineate the effects of chronic versus acute lack of sleep.

Methods: PubMed (includes MEDLINE) and EMBASE databases were systematically searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they reported statistics regarding the relationship between sleep and sports injury in adolescents aged 19 years or younger published between January 1, 1997 and December 21, 2017. From these included studies, the following information was extracted: bibliographic and demographic information, reported outcomes related to injury and sleep, and definitions of injury and decreased sleep. A random effects model was then created to quantify the odds of injury with decreased sleep in adolescents.

Results: Of 907 identified articles, 7 met inclusion criteria. Five studies reported that adolescents who chronically slept poorly were at a significantly increased likelihood of experiencing a sports or musculoskeletal injury. Two studies reported on acute sleep behaviors. One reported a significant positive association between acutely poor sleep and injury, whereas the other study reported no significant association. In our random effects model, adolescents who chronically slept poorly were more likely to be injured than those who slept well (OR, 1.58; 95% CI, 1.05-2.37; P=0.03).

Conclusions: Chronic lack of sleep in adolescents is associated with greater risk of sports and musculoskeletal injuries. Current evidence cannot yet definitively determine the effect of acute lack of sleep on injury rates.

Level of evidence: Level IV-systematic review of level II studies and one level IV study.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Athletic Injuries / epidemiology*
  • Humans
  • Risk Factors
  • Sleep Deprivation / epidemiology*
  • Sports / statistics & numerical data