General Health Complaints and Sleep Associated With New Injury Within an Endurance Sporting Population: A Prospective Study

J Sci Med Sport. 2020 Mar;23(3):252-257. doi: 10.1016/j.jsams.2019.10.013. Epub 2019 Nov 1.


Objectives: To examine the association between subjective health complaints, sleep quantity and new injury within an endurance sport population.

Design: Prospective cohort study.

Methods: Ninety-five endurance sporting participants were recruited from running, triathlon, swimming, cycling and rowing disciplines. Over 52-week period participants submitted weekly data regarding subjective health complaints (SHCs) (cardiorespiratory, gastrointestinal and psychological/lifestyle), sleep quantity, training load and new injury episodes. Applying a 7- and 14-day lag period, a shared frailty model was used to explore new injury risk associations with total SHCs and sleep quantity.

Results: 92.6% of 95 participants completed all 52 weeks of data submission and the remainder of the participants completed ≥30 weeks. Seven-day lag psychological/lifestyle SHCs were significantly associated with new injury risk (Hazard ratio (HR)=1.32; CI 95%=1.01-1.72, p<0.04). In contrast, cardiorespiratory (HR=1.15; CI 95%=0.99-1.36, p=0.07) and gastrointestinal (HR=0.77; CI 95%=0.56-1.05, p=0.09) SHCs were not significantly associated with new injury risk. New injury risk had a significant increased association with 14-day lag <7h/day sleep quantity (HR=1.51; CI 95%=2.02-1.13, p<0.01) and a significant decreased association with >7h/day sleep quantity (HR=0.63, CI 95%=0.45-0.87, p<0.01. A secondary regression analysis demonstrated no significant association with total SHCs and training load factors (Relative Risk (RR)=0.08, CI 95%=0.04-0.21, p=0.20).

Conclusions: To minimise an increased risk of new injuries within an endurance sporting population, this study demonstrates that psychological/lifestyle subjective health complaints and sleep quantity should be considered. The study also highlights a lag period between low sleep quantity and its subsequent impact on new injury risk. No association was demonstrated between subjective health complaints, sleep quantity and training load factors.

Keywords: Athlete; Endurance; Health complaints; Injury; Sleep.

MeSH terms

  • Adult
  • Athletes
  • Athletic Injuries / physiopathology*
  • Bicycling
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Physical Endurance*
  • Prospective Studies
  • Risk Factors
  • Running
  • Sleep*
  • Swimming
  • Water Sports
  • Workload