At this point, it should be no surprise that sleep is important for overall health and wellness. The
past few years of research have been exploring the links between sleep and physical wellness,
including athletic performance, injury risk, and tissue healing. Quality and consistency of sleep
is important on a day-to-day basis, but these factors become even more important in times of
acute and chronic injuries. Sleep deprivation and poor sleep quality is linked to fatigue,
irritability, and increased pain sensitivity; whereas restful and consistent sleep can aid in
emotional regulation, physical recovery, and memory. Whether you are acutely injured,
increasing training load, or trying to maintain your physical fitness, it may be time to consider
how your sleep is affecting your outcomes.
During sleep, collagen production and skeletal muscle protein synthesis increases, resulting in
increased tissue healing. In the event of injury, sleep can be disrupted due to anxiety and
discomfort, resulting in further tissue degradation and an inhibited healing response. When
recovering from a musculoskeletal injury such as a muscle strain or tendonitis, physical
therapists will apply appropriate loading strategies to help accommodate and stimulate muscle
strengthening and muscle fiber repair. During these periods of increased loading for
rehabilitation, sleep becomes very important to help rebuild damaged structures to improve
symptoms and function the next day.
In addition to strengthening and lengthening muscles, physical therapists will often utilize
neuromuscular re-education techniques to not only strengthen a joint, but also to reteach the
body how to move the joint in a pain-free, effective manner. Motor patterns, commonly called
“muscle memory”, originate within the brain to direct the muscles surrounding the affected area
on how to perform the desired movement. These motor pathways are strengthened during the
early aspects of sleep, which are correlated with increased slow-wave sleep phases, resulting in
the carry-over of new, functional learning into the next day. If sleep quality is disrupted, this can
result in reduced motor learning, or “muscle memory” creation, therefore prolonging the time it
takes to build new, healthier movement habits.
To improve your quality of sleep, some important factors include:
- Limit screen time 30 minutes before going to bed: blue light decreases melatonin, an
important chemical to induce sleep. - Reduce fluid intake 2 hours before bedtime: bathroom visits are a large reason for
disrupted sleep. - Limit sitting in bed for non-sleep and relaxation purposes: activities such as studying,
working, having stressful conversations, and schedule planning in bed can reduce your
brain’s association between sleep and bed. - Maintain a regular sleep schedule: consistency of sleep duration is more important than
the duration itself, meaning that it is better to consistently have 6 hours of sleep every
night instead of 10 hours one night then 4 hours the next. - Engage in regular exercise: aerobic exercise during the day can improve sleep duration,
resistance exercise can improve slow-wave sleep quality. - Reduce alcohol and nicotine consumption: alcohol consumption can impact sleep quality
for up to 1 week after consumption, resulting in frequent awakening throughout the night. - Avoid strenuous exercise within 4 hours of going to bed: gentle movement and light
aerobic activity is ok. - Turn the alarm clock around to reduce time checking during the night: checking the time
at night can increase anxiety and reduce quality of sleep.
If you are having difficulty with achieving good sleep quality, it may be time to consult with your
primary healthcare provider to help unlock a healthier, stronger you.
Resources:
https://pmc.ncbi.nlm.nih.gov/articles/PMC7785053/
https://pmc.ncbi.nlm.nih.gov/articles/PMC9424753/
https://www.sciencedirect.com/science/article/pii/S0896627302007663
https://www.cci.health.wa.gov.au/~/media/CCI/Mental-Health-Professionals/Sleep/Sleep—
Information-Sheets/Sleep-Information-Sheet—04—Sleep-Hygiene.pdf
