Recovery
Systematic Review
2019
Sleep Hygiene for Optimizing Recovery in Athletes: Review and Recommendations
By Kenneth C. Vitale, Roberts Owens, Susan R. Hopkins and Atul Malhotra
International Journal of Sports Medicine, 40(8), pp. 535-543
Abstract
<h2>Abstract</h2> <p>Sleep is a fundamental biological process that plays an indispensable role in physiological recovery, cognitive function, and neuroendocrine regulation. For athletes, optimizing sleep represents one of the most potent yet frequently underutilized recovery strategies available. The present review examines the scientific evidence linking sleep quantity and quality to athletic performance, the mechanisms through which sleep deprivation impairs performance and recovery, and evidence-based strategies for improving <a href="/terms/sleep-hygiene/" class="term-link" data-slug="sleep-hygiene" title="sleep hygiene">sleep hygiene</a> in athletic populations.</p> <p>Empirical evidence consistently demonstrates that sleep restriction to less than seven hours per night significantly impairs muscular strength, reaction time, decision-making accuracy, and submaximal endurance performance. Conversely, sleep extension studies—in which athletes were encouraged to sleep up to 10 hours per night—documented improvements in sprint speed, accuracy, and mood in collegiate athletes [1]. These bidirectional effects highlight sleep as a powerful modifiable variable in athletic performance management.</p> <p>The mechanisms linking inadequate sleep to performance decrements include elevated cortisol, reduced growth hormone secretion, impaired muscle glycogen resynthesis, disrupted immune function, and heightened perceived exertion during exercise. Sleep deprivation also increases injury risk through degradation of motor coordination and attentional vigilance [2].</p> <p>Practical sleep hygiene strategies with demonstrated efficacy include consistent sleep-wake scheduling, pre-sleep light environment optimization, thermal management, and strategic napping. Evidence-based pharmacological and nutraceutical aids—including melatonin, magnesium, and tart cherry juice—may offer modest supplemental benefit. Implementation of individualized sleep management within athlete support programs is recommended.</p> <h3>References</h3> <p>[1] Mah CD, et al. The effects of sleep extension on the athletic performance of collegiate basketball players. <em>Sleep</em>. 2011;34(7):943–950.</p> <p>[2] Vitale KC, Owens R, Hopkins <a href="/terms/systematic-review/" class="term-link" data-slug="systematic-review" title="SR">SR</a>, Malhotra A. Sleep hygiene for optimizing recovery in athletes. <em>Int J Sports Med</em>. 2019;40(8):535–543.</p>Introduction
<h2>Introduction</h2> <p>Sleep constitutes approximately one-third of human life and serves as the principal period during which restoration of physiological homeostasis occurs. During sleep, anabolic hormones—including growth hormone and insulin-like growth factor-1—are released in pulsatile patterns that support tissue repair, <a href="/terms/muscle-protein-synthesis/" class="term-link" data-slug="muscle-protein-synthesis" title="protein synthesis">protein synthesis</a>, and immune function. The consolidation of motor memories laid down during waking practice also occurs predominantly during sleep, particularly during slow-wave (N3) and rapid eye movement (REM) stages, with important implications for skill acquisition and retention in athletic contexts [1].</p> <p>Despite the overwhelming evidence for sleep's importance to health and performance, surveys of elite and collegiate athletes consistently reveal that this population sleeps less than recommended and reports higher rates of sleep disturbance than age-matched non-athletes. Multiple contributing factors have been identified, including early morning training schedules, post-evening game arousal, travel across time zones, competitive anxiety, and the demands of academic or professional responsibilities concurrent with athletic careers [2].</p> <p>The relationship between sleep and athletic performance is bidirectional. Not only does insufficient sleep impair performance capacity, but intensive training loads may themselves disrupt sleep architecture by elevating core body temperature and circulating catecholamine concentrations that interfere with sleep onset. This creates a potential <a href="/terms/eccentric-contraction/" class="term-link" data-slug="eccentric-contraction" title="negative">negative</a> feedback cycle wherein heavy training disrupts sleep, impaired sleep reduces recovery quality, and compromised recovery necessitates reduced training quality or volume.</p> <p>Understanding this relationship has prompted growing interest in sleep as an active component of athlete recovery management, rather than a passive background condition. The present review synthesizes the current evidence base with the aim of providing evidence-informed recommendations for <a href="/terms/sleep-hygiene/" class="term-link" data-slug="sleep-hygiene" title="sleep hygiene">sleep hygiene</a> practices applicable to athletes across diverse sports and performance levels.</p> <h3>References</h3> <p>[1] Diekelmann S, Born J. The memory function of sleep. <em>Nat Rev Neurosci</em>. 2010;11(2):114–126.</p> <p>[2] Gupta L, Morgan K, Gilchrist S. Does elite sport degrade sleep quality? A <a href="/terms/systematic-review/" class="term-link" data-slug="systematic-review" title="systematic review">systematic review</a>. <em>Sports Med</em>. 2017;47(7):1317–1333.</p>Sleep and Athletic Performance
Sleep and Athletic Performance
Effects of Sleep Restriction
Experimental sleep restriction studies provide compelling evidence for sleep's causal role in physical performance. Acute total sleep deprivation (24–36 hours) impairs maximal strength output by 5–20%, reduces time-to-exhaustion during submaximal cycling, and significantly degrades anaerobic sprint performance on the Wingate test [1]. Chronic partial sleep restriction (5–6 hours per night over multiple nights) produces cumulative performance decrements that may equal or exceed those observed with acute total deprivation, yet are frequently unrecognized by the athlete due to subjective adaptation—a state in which individuals believe their performance is unimpaired despite objective deficits.
Reaction time is particularly sensitive to sleep loss, with even modest restriction (reducing sleep from 8 to 6 hours for two weeks) producing reaction time impairments equivalent to those induced by a blood alcohol concentration of 0.05% [2]. For athletes in contact sports, team sports, or any discipline requiring rapid decision-making, this degree of impairment carries both performance and safety implications.
Effects of Sleep Extension
The seminal sleep extension study by Mah and colleagues required collegiate basketball players to obtain a minimum of 10 hours in bed nightly for 5–7 weeks. Compared to habitual sleep conditions, sleep extension produced significant improvements in sprint times, shooting accuracy (free throw and three-point), reaction time, and self-rated mood and vigor [3]. Similar benefits from sleep extension have been reported in collegiate tennis players, swimmers, and football athletes.
These findings suggest that many competitive athletes are chronically under-slept relative to their recovery needs and that sleep extension—rather than sleep restriction—may represent an underexplored avenue for legitimate performance enhancement.
Cognitive and Motor Performance
Beyond physical output metrics, sleep deprivation profoundly impairs cognitive function—including attention, working memory, pattern recognition, and executive function—all of which are integral to sport performance. Athletes accumulating sleep debt also report elevated perceived exertion at fixed workloads, meaning that training feels harder and motivation to sustain effort is diminished, potentially undermining training quality over a prolonged period.
References
[1] Fullagar HH, et al. Sleep and athletic performance: the effects of sleep loss on exercise performance. Sports Med. 2015;45(2):161–186.
[2] Van Dongen HP, et al. The cumulative cost of additional wakefulness. Sleep. 2003;26(2):117–126.
[3] Mah CD, et al. The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep. 2011;34(7):943–950.