Background Sleep is important to elite athletes as it plays a key role in repair of cellular damage. In recent years, there has been increasing interest in the role of sleep in athletes.

Objectives The aim of this study is to give a systematic overview of what is known about the impact of sleep on sport injuries and injury recovery. The following questions will be addressed: 1. What is the prevalence of sleep disturbances in athletes? 2. What is the impact of sleep on injury risk? 3. What is the relationship between sleep and recovery after training and/or injury? 4. What is the influence of sleep and nutrition on recovery?

Design Systematic review

Methods Screening of PubMed, Web of Science, Cinahl and Cochrane Library on the keywords ‘athletic injuries’, ‘football’, ‘soccer’, ‘sleep deprivation’, ‘fatigue’, ‘circadian rhythm’, ‘insomnia’, ‘rehabilitation’, ‘recovery’, ‘prevention’ between January 1, 2002 and November 14, 2020; systematic review after assessment for methodological quality.

Results There is strong evidence that athletes in general are at high risk for a poor sleep duration and quality. In contrast to the expectations, most athletes (>85%) are mid-range to morning types and tend to pursue and excel in sports that match their chronotype.

Reduced sleep (<8h) is related with 1.7 more risk of having an injury and a negative effect on recovery after training. There is an increased proinflammatory state, which affects a person’s resistance to a simple infectious disease, and may affect an athlete’s training capacity and potential.

Sleep is also associated with recovery from injuries. Studies found that sleep affected concussion recovery time and an increased risk of a re-injury during rehabilitation.

Conclusion The importance of sleep remains a main issue in competitive sporters. Training and competition schedules should take sleep into account in order to avoid injuries and prolonged rehabilitation after injury.