December 13, 2013

    Sleep Hygiene, the New Rehab Tool?

    Adolescent athletes who slept eight or more hours each night were 68 percent less likely to be injured.  With these staggering results, it is hard to ignore the effects of sleep on injuries, whether prevention or rehabilitation. After all, the same aspects that often lead to injury often must be addressed in recovery as well.

    Right now, we are seeing a female soccer player undergoing her second ACL rehabilitation in a year. She has worked extremely hard in both instances, but the sacrifices made during this second ordeal have been much greater. And by sacrifices, I do not mean some cliche, but real, objective sacrifices by committing the most valuable resource, time, by sleeping more

    She has made a commitment to 8.5 to 10 hours of sleep a night, made possible by dropping a class and limiting other endeavors to achieve greater sleep hygiene. It is a common word used amongst sleep experts or performance coaches, as hygiene refers to the practices performed for the preservation of health. These rituals are critical because sleep must be an actively pursued process, starting creating an optimal dark, cool environment, and ultimately a commitment that 8 hours is not fine, at least not for athletes.

    Rehabilitation is Performance

    The frustration of any rehabilitation is simple, but requires repeating; athletes start at a lower baseline in an array of facets; strength, quickness, confidence, the list goes on. So performance becomes a critical factor in the rehabilitation process to withstand competition. The performance mechanisms from sleep mainly come from an improved hormone profile (higher levels of growth hormone/testosterone) and a faster nervous system (motor programs are consolidated and signals move faster). As a result of these neuromuscular benefits from sleep, up to 32% faster reaction times can occur in athletes.

    Weak Explode

    A great colleague of Sparta, Cheri Mah, consults with many professional sports organization on sleep, and she conducted a 2010 study on college football players. The initial findings were that most athletes entered the study with sleep deficits or debt. The research encouraged sleep extension, pushing for up to 10 hours every night. The results were an improvement in average 20 yard shuttle from 4.71 sec to 4.61 sec and average 40 yard dash from 4.99 to 4.89. A similar study on basketball players reveled a 9% increase in free throws and 9.2% increase in three pointers.

    Reaction time is heavily supported by proprioception, an athlete’s awareness of movement by utilizing the body’s joint positioning system. Sport scientists and physicians often test proprioception by standing on one leg with the eyes closed, generally to assess the rehabilitation process for everything from ACL injuries to concussions. This postural sway test is now being used at Sparta on the force plate for the rehabilitation process. Anecdotally, we have begun to associate poor sleep hygienewith lower values of EXPLODE on the Sparta Signature, further strengthening this variable’s role in reactivity and stiffness.

    No Shortcuts

    Unfortunately, committing time to a subconscious process like sleeping is not usually a priority. A growing obsession here in Silicon Valley is biohacking, “Managing one’s own biology using a combination of medical, nutritional and electronic techniques.” Basically, looking for tricks to make your body more efficient; performing better with less effort or time. This efficiency is certainly important when you look at Mah’s research which we also recommend to all athletes:  9.5 hours of sleep a night.

    You can track the quality of sleep using apps and devices, attaining exceptional sleep quality in those 8 hours of sleep, but it is still short of the average athlete need of 9.5 hours, thus putting you into sleep debt. You could also take caffeine, but it won’t help the motor learning and neural plasticity improvements that occur through the night. The real interest from coaches should be the performance benefits and the confirmation that all things are connected, even your sleep hygiene. With training, as in sport, there is isolation in victory.


    American Academy of Pediatrics. “Lack of sleep tied to teen sports injuries.” ScienceDaily, 21 Oct. 2012. Web. 12 Dec. 2013.

    Mah CD, Mah KE, Kezirian EJ, Dement WC. The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep. 2011 Jul 1;34(7):943-50.

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