What is injury prevention, and how does it relate to sleep? Any efforts to prevent or reduce the severity of unintentional injuries can be considered injury prevention. You are likely already familiar with the idea if you’re an athlete, but injuries can happen to anyone.
In fact, a 2017 report from the CDC identified unintentional injuries as the leading cause of death in children, adolescents, and adults under 45 years old. Moreover, injuries from falls are the primary cause of accidental death in the elderly. Fatalities from injuries affect all age groups.
So how does this relate to sleep? When it comes to injury prevention, most injury prevention programs focus on things like maintaining good strength and flexibility, wearing protective equipment when applicable, and taking regular breaks. However, perhaps the biggest overlooked risk factor for injury is sleep deprivation. There is myriad evidence to suggest that sleep deprivation is strongly associated with a higher incidence of injuries (which we’ll look at momentarily), so getting enough sleep is a necessary injury prevention strategy.
Read on to learn about sleep debt and injury prevention, how sleep relates more broadly to pain management, and how to keep your sleep debt low to lessen the risk of injury.
Before we talk about the connection between sleep debt and injury prevention, let’s first define sleep debt. Sleep debt refers to the total number of hours of sleep you’ve missed compared to the amount you needed over the past 14 days. This is also known as acute sleep deprivation (whereas chronic sleep deprivation happens over a much longer period). Thankfully, it is possible to catch up on sleep debt by getting extra sleep.
In order to determine your current sleep debt, you first need to know your individual sleep need, which is a genetically determined trait (like height or eye color). Adults on average need about 8 hours and 10 minutes (give or take approximately 44 minutes) of sleep each night, though about 13.5% need nine hours or more. Unfortunately, according to the Centers for Disease Control and Prevention, nearly one-third of Americans report sleeping fewer than 7 hours each night, making sleep deprivation an alarming public health problem.
The RISE app will determine your sleep need and calculate your sleep debt every day based on your recent sleep data.
When you fail to get the sleep you need and rack up sleep debt, you become more prone to injuring yourself or others. We’re about to look at some common examples of sleep-related accidents, but keep in mind the conditions listed below are not exhaustive. Injuries are more common in certain situations, but they can happen to anyone. As we’re about to see, they are much more likely to happen when you’re sleep-deprived.
With this in mind, let’s consider how carrying sleep debt can result in injury to you (and others) in the following common cases.
Injury prevention is of vital importance among athletes, or anyone who exercises regularly, since injury can sideline your physical activity while you take the time to heal. Various studies have shown sleep deprivation to be associated with increased sports injuries. This makes sense, as sleep deprivation is well-known to impair motor and cognitive functions, each of which plays a role in athletic performance. By contrast, sleep extension (upward of 10 hours per night) can improve performance in sports.
Importantly, sleep in the days after vigorous exercise is crucial too. Even if you don’t injure yourself during an intense workout, the mere act of exercising creates many microscopic tears in your muscle tissues, making recovery sleep absolutely essential in order to stimulate muscle repair so your muscles can rebuild and become stronger. Sleep also accelerates physical recovery from inflammation and helps restock your energy.
An earlier version of the RISE app used by various professional sports teams, including the Chicago Bulls and the Miami Dolphins, in which 90% of players reported sleeping an additional hour each night, resulted in a 70% decrease in injuries.
Many work-related injuries can be traced to sleep deprivation. Highly fatigued workers are 70% more likely to be involved in a workplace accident than their co-workers and nearly twice as likely to die from a workplace injury.
Shift workers are particularly vulnerable to accidents resulting from disturbed sleep, especially since shifts occur at all hours of the day and can easily disrupt a person’s circadian rhythm. Sleep deprivation as well as circadian misalignment resulting from rotating shift work in nurses is associated with frequent lapses of attention, increased reaction time, and increased error rates on performance tasks. Additionally, overworked and sleep-deprived medical residents are 50% more likely to make a significant medical error with adverse effects.
Moreover, sleep deprivation can be a worse impairment to driving than alcohol consumption. A study compared 24 hours of wakefulness to a breath alcohol content (BrAC) of 22 micrograms per 100 milliliters (ml) (equivalent to a 0.05 BAC in the U.S.), which is the legal alcohol driving limit in Scotland. It found that sleep deprivation resulted in slower reaction times and reduced vehicle control than the 0.05 BAC.
In addition, it’s estimated that 7% of motor vehicle crashes and 16% of fatal car accidents in the U.S. happen as a result of drowsy driving.
A decline in sleep duration is associated with aging. Importantly, this does not mean older adults need less sleep than young adults, just that sleep becomes more difficult. As we saw earlier, falls are the leading cause of injury deaths among the elderly. Their short sleep duration and fragmented sleep makes such falls more likely, especially during nightly trips to the bathroom (triggering a sudden change in blood pressure). Fall prevention initiatives are important for the elderly, but getting sufficient sleep is a crucial part of this.
Sleep affects our experience of pain, whether from injury or illness. In fact, both pain and stress have been shown to be associated with sleep deprivation.
The problem goes both ways: Sleep deprivation exacerbates pain, and pain inhibits sleep, potentially causing even more sleep deprivation and creating a vicious cycle. That said, sleep impairments are a more reliable predictor of pain than pain is of sleep impairments. Recent experimental studies show sleep disturbances can impair important chronic pain management processes in the body. Without sleep, pain is felt more acutely. Sleep appears to be a sort of natural analgesic.
Untreated chronic pain can have devastating consequences, including an increased risk for suicide, making healthy sleep an important component of suicide prevention.
Contracting an illness is also more likely when sleep-deprived. Furthermore, sleep can help you recover from illness. During sleep, your body releases important cells for your immune system that help to reduce infection and inflammation.
For example, stroke patients trying to recover their spatial and temporal tracking skills were able to do so more quickly when they slept in between practice sessions.
Ironically, despite the healing effects of sleep, hospitals are one of the worst places to get the sleep you need. Patients are stuck indoors so they aren’t getting exposure to the strong circadian cue of sunlight. In addition, electric lighting is always on within the hospital, and there is constant beeping from machines, both of which further disrupt the circadian rhythms of those who have to spend the night. Thankfully, some hospitals are working to improve their lighting conditions.
We’ve seen how indispensable sleep is for injury prevention and health promotion, but how can we actually get more sleep? First, we need to know our individual sleep need so we can figure out our sleep debt. The RISE app determines your sleep need based on your sleep data, and it uses this information to calculate your sleep debt every day. Once you know how many hours of sleep you owe yourself, you can then employ the following strategies to catch up on those missed hours of sleep.
When you need extra sleep, one way to catch up is by adjusting your sleep schedule. Try going to bed a little earlier at night to help you catch up and lower your sleep debt.
You can also nap during the day to catch up on sleep, but the time of day and duration of your nap are important. The best time to take a nap is during your energy dip in the afternoon. The RISE app will show you your daily circadian rhythm peaks and dips, including your afternoon dip. If you opt to nap during your afternoon dip, try to keep it under 90 minutes so as not to interfere with your nightly sleep.
If the above steps are not enough to help you catch up on sleep, you can also sleep later than usual, whenever possible. Try not to sleep in more than an extra hour though, especially if you need to stick to a regular schedule, as this may throw off your sleep schedule and make it harder for you to fall asleep and wake up at your usual times that night and the next day.
Sleep hygiene is a set of sleep-promoting behaviors that includes things like getting physical activity during the day, being smart about light exposure, and sticking to a relatively consistent sleep, food, and exercise schedule. Good sleep hygiene will help you fall asleep faster at night and stay asleep throughout the night, both of which are crucial components of meeting our sleep need.
In addition to these behaviors, making your bedroom a sleep sanctuary is also a necessary component of good sleep hygiene. As much as possible, keep it cool, dark, and quiet. Use earplugs and an eye mask to help reduce noise and light.
If all of these strategies fail, consider talking to your health care provider about potential sleep disorders or other health problems that could be interfering with your sleep.
Injury prevention can take many forms, but a healthy sleep schedule may be the most effective way to prevent injury. However, getting enough sleep can be a real challenge with the various demands of our work, school, and personal schedules. This is where the RISE app can help.
The app will figure out your individual sleep need and use this to calculate your sleep debt. It also determines your circadian rhythm, or energy schedule, every day — including the times of your afternoon dip, energy peaks, and Melatonin Window. Additionally, it recommends appropriate activities aligned to your energy levels all throughout the day. Use the app along with the strategies listed above to catch up on sleep debt and prevent and recover from injury and illness.
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