In this blog, I am going speak about the importance of sleep and why it is crucial we prioritise good sleep on a regular basis. I will discuss the relationship between sleep and numerous other phenomenons. This is for education purposes only – please consult a clinician or physiotherapist to have your injury assessed first!

Sleep takes up a lot of our time so you can probably guess that it is very important.

It is a natural, recurring physiological phenomenon that takes up roughly a third of our entire lives. Think about it; we sleep, we wake, and we repeat this process daily. Sleep can be categorised into two distinct states that we switch between throughout the night – REM sleep and non-REM sleep. REM means rapid eye movement. When our body falls into REM sleep, we are the most relaxed and in the deepest stage of sleep. This is arguably the most important stage to be in to fully allow our bodies to recover and re-charge.

It is believed that sleep helps the facilitation of learning and memory, energy conservation, the synthesis of crucial macromolecules (e.g., proteins and cholesterol) and the recovery for numerous bodily processes. Poor sleep duration can also have a negative impact on immune function, tissue healing, cardiovascular health and mental state. Nowadays you will hear a lot of people use the phrase “I will sleep when I am dead” or “no rest for the wicked” but actually, this will backfire. Eventually that lack of sleep and poor sleep quality will turn into illnesses, injuries and other issues.

In recent years, we have seen a decline in sleep quality and sleep duration and is unfortunately expected to decline further because of lifestyle and behavioural changes. Insomnia, difficulty to fall sleep, is now thought to be present in up to 30% of adults worldwide. This a very large statistic. If you look at the US for example the average sleep duration is 7.18 hours and around 33% of the country’s population sleep for less than 6 hours per night. Short sleep has been associated with a 12% increase in mortality, meaning shorten your life.

Sleep and pain?

It is very well documented within the current body research that sleep and pain have a close link. It is thought that over 66% of individuals living with chronic pain struggle with their sleep. But this is difficult to determine what came first, creating the “chicken or egg” scenario. If people are in pain, then they will be not sleeping, equally if they have poor sleep, then their pain will be higher.

More recent studies have found that sleep disturbances are actually a stronger predictor of pain, more so than pain is on sleep. Meaning that if an individual struggles with sleep disturbances, they are more likely to develop chronic pain or feel pain more intensely. For example, a study completed by Andersen et al in 2018 looked at individuals with knee osteoarthritis, had one group sleeping for more than 6 hours and the other sleeping for less. They found that the group that slept for longer had a lower pain score at their 6-month follow up appointment than the opposing group.

A survey done by Dunietz et al in 2018 examined the relationship between sleep disturbances, pain and anxiety across a 3-year period in adults aged 65+. Unsurprisingly, the individuals that struggled sleeping had a 24-28% higher pain level rating. What it also showed is that anxiety symptoms will affect sleep duration and quality, having a knock on effect on experiences of pain by up to 17%.

Sleep and injury risk?

As mentioned before we cannot fully prevent an injury from occurring but we can certainly reduce the risk of one. Optimising sleep can improve all aspects of training and recovery, and if we can train better and recover harder then surely we are less likely to become injured?

A study completed by Milewski et al in 2014 looked at young athletes aged 12-18 and found that those who slept for a duration less than 8 hours per night had an injury risk greater than 1.7 as opposed to those who slept for longer than 8 hours per night. Another study by Von Rosen et al in 2017 found the same relationship between sleep and injured young athletes. Those young athletes who slept for more than 8 hours per night reduced their injury risk by 61%. What was interesting is if an athlete increases their training load and intensity, as well as their sleep becomes poor, there risk for injury practically doubles.

No one likes to be injured or out of action, and it certainly can become expensive if you regularly get injured so if prioritising a minimum of 8 hours sleep per night can reduce the risk of that, it seems like a no-brainer.

Sleep and diet/body?

The foods we eat can have an impact on the quality of our sleep and the duration of it. Datillo et al in 2011 found that reduced sleep could negatively impact recovery and favour muscle loss, secondary to decreases in anabolic hormones. Another study by Nedeltcheva et al in 2010 also found a similar thing. The individuals involved were placed on a calorie restriction for two weeks with one group sleeping 8.5 hours per night and the other sleeping 5.5 hours per night. Both groups lost on weight as per the goal, but the group that slept longer lost more.

A further study by Ness et al in 2019 also demonstrated that reducing your sleep to 5 hours per night for a minimum of 5 nights in a row, can negatively impact your insulin sensitivity. What was even more interesting was they got the participants to then sleep for 10 hours two nights in a row, and that did not reserve the effects.

Individuals that sleep less than 6 hours have been found to be more likely to have diabetes, cardiovascular disease and obesity. So if we can sleep well to not only maintain good health but achieve a great physique.

Sleep and exercise?

It is a given that exercise can improve your sleep. We have all been through a tough gym session or a hard run, got back and felt absolutely shattered. Exercise makes us tired. Although the exact mechanisms are unknown, Chennaoui et al in 2015 suggested that benefits of exercise on sleep seems to positively impact deep sleep and total sleep time.

As far as parameters go, completing a bout of exercise at a high intensity, frequency and duration may have more of an effect on sleep. However, there will be a dose-relationship with too little exercise having no effect and too much having a reverse effect. Litleskare et al in 2018 had a group of individuals participate in aerobic and anaerobic exercise, including weight training and found that it had a positive impact on sleep as the individuals sleep quality increased as well as the duration.

Now the effects of exercise on sleep is not going to be the same everybody. A person`s fitness level, sport, age and other factors will all have a role to play too. There has been a controversy over recent years that if you exercise before going to bed could negative impact your sleep. However, Stutz et all in 2018 conducted a systematic review to determine whether this was the case. The group found that unless you are working at a greater intensity than 69% of your 1-rep-max or > 76% of maximum heart rate 2 hours or less before bed, it will not have an effect on your sleep duration or quality.

Should you use a sleep tracker?

These do not tend to offer much benefit. A sleep tracker can provide accurate data with regards to total sleep duration or how much time you spent in bed, but you probably do not need a tracker to tell you that. A routine that you follow daily could be much better. However, if using a sleep tracker keeps you accountable to sleeping 7-9 hours per night, then we are all for it!

Despite this, sleep trackers do not provide reliable information in relation to sleep quality. It has also been noted that upon waking and looking at your sleep scores, can have a negative impact on your mental state. So if you wake up and your sleep score is rated poor, but you feel great, I recommend that you listen to your body.

Best sleep position?

Nowadays there is a lot of TikTok videos, Instagram reels and so on about the best sleeping position. In truth, there is not a best sleeping position, other than the one that is most comfortable for you.

Most people will tend to sleep in their most favoured position, and that seems to be side-lying with knees bent and tucked up. Known as the fetal position. Despite everyone having a positional preference, we move 2-5 times per hour and roughly on average up to 32 times per night during a 7-8 hour sleep. So we naturally adopt different sleeping positions anyway.

Sleep positions matters sometimes, for example if someone has shoulder pain then it can be painful laying on that side. Therefore, you would change your sleeping position to prevent increasing pain. Or if someone has lower back pain then laying with pillows underneath their knees could help ease the pain. But overall, find a position that is best for you and get a good nights sleep!

Summary

As you have already gathered sleep is vastly important! Exercise has great benefits for sleep. My recommendation would be to exercise regularly using a method of preference for you, at a time of the day suitable for you and if it is an hour before bed because you have had a busy day then do not worry too much about it. Find what works best for you.

If you wish to track your sleep you can do, it would not be detrimental if you didn`t. There is no favoured sleeping position, other than the one that you like to sleep in. Get comfortable and get a good night’s sleep. If you can get a minimum of 8 hours sleep per night that can reduce the risk of injury and help to lose body fat and build muscle. Sleep is crucial to prevent health associated risks.

 

Below are some tips on how to improve your sleep duration and quality.

Stick to a routine before bed. Whether it is a weekday or the weekend, try to wake up and go to sleep at relatively the same times. Create a habit for yourself and your body.

Avoid alcohol or smoking prior to going to sleep. Although alcohol can help you fall asleep, it can negatively affect sleep quality and quantity. Similarly, nicotine in cigarettes can impair your ability to fall asleep and stay asleep.

Avoid caffeine 8 hours before bed. Caffeine takes a long time to clear from your system so it is probably best to avoid energy drinks, coffee, or soda after your lunch time meal.

Avoid large meals and excess fluid intake 1.5-2 hours before going to bed. There nothing more frustrating than getting up during the night to go to toilet, keeping your eyes shut to not lose sleep – we have all been there!

Avoid napping. If you struggle falling asleep at night, it may be useful to eliminate your midday naps.

Create the right environment. Make sure your room is cool, dark, and free from electronics. Minimize phone use and TV usage 1-2 hours before bed.

Develop a relaxing routine. A hot shower, writing things down in a journal, or reading a book might help you relax and wind down.

Spend time in the sun. Aim for at least 30-60 minutes, especially in the morning. This will set you up for the day.

Save your bed for sleep/night time only. If you cannot sleep at night, do not just stay in bed. Find something to help you relax in a different part of your home.

Exercise daily. Participate in at least 30-60 minutes of exercise a day

Thank you for reading this. Please contact us with any questions that you may have or give us your feedback with your thoughts.