Poor sleep raises injury risk in recreational runners

By Dr. Liji Thomas, MDReviewed by Lauren HardakerNov 13 2025

The way runners sleep, not just how much they train, can predict their likelihood of getting injured, highlighting sleep as an often-overlooked yet crucial tool for performance and injury prevention.

Study: Sleep Matters: Profiling Sleep Patterns to Predict Sports Injuries in Recreational Runners. Image credit: Dmitro Pravda/Shutterstock.com

Many people enjoy recreational running, but this sport is often associated with numerous injuries. Research indicates that sleep may be a potential contributing factor to such injuries. A recent study published in the journal Applied Sciences examines the predictive power of various sleep patterns for sports injuries in recreational runners.

The rising injury burden

With over 620 million people running frequently for fun worldwide, injuries related to running are on the rise. In the Netherlands, nearly 1.7 million people run for fun, with nine percent of the population above the age of 12 running weekly.

The health benefits of running include physical activity, a connection to better dietary habits, reduced stress, healthier aging, and increased life expectancy. Sports injuries are also more common, unfortunately, among runners, with over five injuries per 1,000 hours of running. This is double the national average of injuries incurred in all sports.

Thus, there are nearly 700,000 sports injuries among Dutch runners each year, making running the third-highest cause of injuries among all sports. This results in 210 million euros per year in healthcare costs in the Netherlands alone, with a broader economic impact of 250 million euros per year.

Thus, there is a great need to keep runners free of injury. Prior research has identified biological sex, a history of injury, body weight, intensive training, overtraining, poor diet, obsession with running, mental stress, and low mood as risk factors for sports injuries. The current study aimed to determine whether sleep is also a risk factor.

Sleep is a vital biological process that helps recharge the body and mind, enabling the sleeper to feel rested, alert, and refreshed. Good sleep is defined by its quality, adequate total duration, healthy sleep timings, perception of a good night's sleep, low sleep latency, high sleep efficiency, and a conducive sleep environment.

Sleep is similarly essential to an athlete’s health and performance, including recovery and adaptation from training and competition stress. Several existing reports have linked poor sleep to a higher risk of sports injuries overall, although the risk of bias was high for most such studies. Half of the studies failed to reveal significant associations between sleep quality and sports injuries.

Few studies have specifically explored the relationship between sleep and running-related injuries; however, those that exist suggest that adequate sleep is associated with a reduced risk of injury. The current study aimed to investigate the relationship between comprehensive sleep profiles and sports injuries in recreational runners.

Assessing runners' sleep patterns

The study included a survey of 425 Dutch recreational runners, 57% of whom were male. The average age of the runners was 45 years, and they had been running for an average of 12 years.

The runners’ sleep profiles were acquired and analyzed using latent profile analysis, which comprised combinations of sleep duration, sleep quality, and sleep issues. This produced four sleep profiles, which were used to identify the associated risk for self-reported sports injuries using binary logistic regression methods.

How sleep predicts injury

Four sleep profiles were identified using the latent profile analysis method:

• Steady sleepers (48%)
• Poor sleepers (37%)
• Efficient sleepers (8%)
• Fragmented sleepers (7%)

These profiles are concordant with “good sleepers” (adequate and continuous sleep), “poor sleepers” (too little sleep, waking up tired and with a low mood), “elite sleepers” (individuals who function well with shorter sleep), and “sleep fragmentation”, respectively, reported in existing literature.

About 60% of the participants reported a sports injury in the past year.

Women were more likely to have sleep issues than men. Body mass index showed a small positive correlation with injuries, although this relationship was not statistically significant in the full regression model. Sports injuries were predicted by two of the three sleep characteristics analyzed. That is, good sleep quality was associated with a reduced risk of injury, while more sleep problems were predictive of injury.

Among the sleep profiles, Poor Sleepers were more likely to have sports injuries than Steady Sleepers, at 80% increased risk. Thus, Poor Sleepers have a 68% probability of sports injury. Combining all the predictive factors in this study explained 5% of the variation in the risk of sports injury. Finally, the model accurately predicted injury 60% of the time.

In agreement with other research, the study revealed sleep to be a meaningful potential risk factor affecting injury risk in recreational running, in addition to numerous other factors, some of which were included in the current analysis. Recreational athletes often have to juggle numerous other commitments, which can increase their stress levels and heighten their need for restful and adequate sleep.

Thus, sleep in this group should be recognized as a priority for optimal performance rather than as an afterthought. Taking advantage of naps and introducing good sleep hygiene are important steps towards achieving this goal. The individual chronotype is also crucial in making practical sleep recommendations. Ultimately, addressing the various components of restorative sleep is crucial when seeking to improve sleep quality and reduce injury risk.

Why sleep habits matter

The study, along with other research, suggests that poor sleep is associated with a higher risk of sports injuries among recreational runners.

However, the cross-sectional design prevents establishing causal direction, meaning that poor sleep may precede injury, but injury may also impair sleep. It should be followed up by studies that use formal diagnostic methods for both sleep quality and sports injuries, both of which were self-reported in this study. The type and intensity of injuries would also be documented in such studies.

Interventions focusing on sleep duration and sleep quality may benefit running athletes’ health.

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