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Want Less Injuries? Get More Sleep!
Dr. Michael Bennett and his wife Kathy discuss the crucial importance of sleep for athletes and how chronic sleep deprivation significantly increases the risk of sports injuries, particularly in adolescent athletes. Citing recent studies, they emphasize that athletes who get less than eight hours of sleep are 1.7 times more likely to be injured. They also explore various strategies for improving sleep quality and quantity, including cognitive behavioral therapy techniques, nasal breathing, and environmental adjustments. Drawing on personal experiences and scientific insights, they underscore the vital role of sleep in overall health, immunity, and recovery from injuries.
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Want Less Injuries? Get More Sleep!
We’ve been having a great time discussing this next topic. As a family, we’ve spent years following our kids to school activities—especially sports—and we've seen several star athletes injured. Watching these youth sidelined has always been tough, especially knowing how hard they and their coaches worked.
While preparing for this episode, we came across a particularly impactful study titled "Chronic Lack of Sleep is Associated with Increased Sports Injuries in Adolescent Athletes" by Matthew Malki, David Scaggs, and others. It really hit home. During my senior year, I suffered a hip injury in the third game of the season. Despite hours of training and preparation, that injury affected my performance all year.
The study showed that adolescent athletes who slept less than eight hours per night were 1.7 times more likely to get injured compared to those who got eight or more hours. That's a staggering statistic when you consider the time, money, and effort invested into youth sports. It raises the question: how often are coaches and athletic trainers even talking to their athletes about sleep?
Although numerous studies have analyzed training-related injuries, this was the first to examine how sleep deprivation affects injury rates among young athletes. The researchers sent surveys and gathered over a hundred responses, then compared those with the trainers' injury logs. The results clearly linked insufficient sleep with a significantly higher injury risk.
Sleep Recommendations for Teenagers
So, what is the recommended amount of sleep for teens? According to the Sleep Foundation, teenagers need anywhere from eight to ten hours per night. Sleep is just as vital as hydration or nutrition—it improves mental resilience, stress response, reaction time, and overall performance.
Teens, however, often don’t get enough sleep, especially with irregular schedules. In our house, it's been a challenge to get our teenagers to maintain a healthy sleep schedule—especially since the pandemic. Getting to bed after midnight and sleeping late has become the norm, but this doesn’t align with the body’s natural rhythms.
Interestingly, the Sleep Foundation's 2015 guidelines were the first to set clear recommendations for adolescent sleep. Since then, experts like Matthew Walker and James Nestor have brought sleep and breathing back into public discussion. Podcasts like Joe Rogan’s have hosted them to highlight how these age-old fundamentals are often forgotten in our caffeinated, screen-driven, 24/7 culture.
The key takeaway is that teenagers—and all of us—need both quantity and quality sleep. Without it, even top athletes can’t function at their best.
The Healing Power of Sleep
When COVID-19 hit, we were all told to mask up and social distance—but no one mentioned sleep. Why weren’t we being told to follow the National Sleep Foundation’s guidelines on sleep duration? Without sufficient rest, we weaken our immune system—essentially opening the gates of our fortress to the enemy.
Let’s say you’re older than 18—you need seven to nine hours. If you’re younger, the need is even greater: eight to ten hours for teens, up to 17 hours for infants. If your kids, grandkids, or students aren’t getting those hours, their immune systems—and their athletic performance—are at risk.
Sleep is also crucial for healing. The body repairs itself during deep sleep, especially delta wave (non-REM stage 3) and REM sleep. These cycles make up about 30–40% of your total sleep. During this time, the brain releases growth hormone and prolactin to support tissue repair.
If someone has a narrow airway or can't breathe through their nose, and they're not getting enough sleep, it's a double whammy. They're more vulnerable to illness, injury, and prolonged healing.
Personal Anecdote: Concussion and Sleep
We have a son who returned to football as a senior after a long break. During a casual pass route in early practice, he stretched out for a catch, landed on his back, and hit his head hard. At first, he brushed it off, saying he saw stars. But weeks later, we began noticing unusual behavior: irritability, memory lapses, trouble speaking clearly, even getting lost driving home.
Eventually, we realized he’d suffered a concussion. His trainer implemented a recovery protocol that included logging his sleep and requiring additional hours of rest. What does that tell us? Sleep heals the brain. It heals the body. It’s not optional—it’s essential.
When a concussion occurs, the brain moves inside the skull, potentially causing micro-tears in ligaments, bleeding, or inflammation. These issues can only be resolved during deep sleep. The glymphatic system—which clears out waste like beta-amyloid proteins—only works during sleep. This is also why sleep apnea is linked to Alzheimer’s disease: the brain doesn’t get a chance to detoxify.
Improving Sleep Quality
When someone isn’t getting restful sleep because they can’t breathe properly at night, the result is fragmented sleep and delayed healing. For those of us treating chronic pain—especially TMJ, facial pain, and headaches—it’s critical to evaluate both sleep quality and airway health. Patients often ask, “When will I feel better?” And the answer depends largely on whether they are truly resting and regenerating at night.
One of the most effective ways to help these individuals is to address anatomical airway restrictions. This can include enlarging the nasal and throat airways by developing the dental arches. In my practice, we also work on managing BMI and reducing systemic inflammation. Many chronic pain patients have narrow airways and disrupted sleep. Their healing is slower because their body isn't spending enough time in deep, restorative sleep stages.
The American Academy of Sleep Medicine offers an excellent sleep diary tool. Patients can track sleep duration, awakenings, and medication use over a two-week period. This simple act of tracking often reveals just how fragmented their sleep is.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
When patients experience sleep maintenance insomnia—falling asleep easily but waking up at 3 a.m.—we recommend Cognitive Behavioral Therapy for Insomnia. Here’s how it works:
- If you’re not asleep within 15 minutes, get out of bed.
- Keep the lights off. Sit in a chair and engage in something boring—counting backwards from 1,000, for example.
- While still in bed, practice self-hypnosis. Speak to each part of your body with gratitude and give it permission to rest. For example: “Feet, thank you for helping me today. It’s time to sleep.”
This technique is simple, powerful, and calming. When I’ve practiced it, I often don’t remember getting past my knees before falling asleep.
Cathy shared a similar technique that involves progressive muscle relaxation. Starting from the feet and moving upward, tighten each muscle group for ten seconds and then release. Combined with slow, deep belly breathing, this relaxation method can help significantly.
Some people benefit from calm music or guided relaxation apps, but you don’t need technology to benefit. Your breath and your thoughts are enough.
Neurological Insights for Better Sleep
There’s a powerful neurological trick you can use to relax the nervous system: place your tongue gently between your teeth and hum. Just a low, soft hum—like a purring cat. This stimulates the vagus nerve, part of the parasympathetic (rest and digest) nervous system.
The vagus nerve influences:
- Heart rate
- Digestive function
- Salivation
- Even hormone regulation
When you hum, you activate the vocal cords—another branch of the vagus nerve—and initiate a relaxation response throughout your body.
So here’s a three-step method:
- Place your tongue gently between your teeth.
- Hum softly for 30 seconds to 1 minute.
- Belly breathe slowly and deeply.
This technique, combined with the progressive muscle relaxation Cathy mentioned, can be incredibly effective when practiced consistently before bedtime or upon nighttime awakenings.
Environmental Sleep Hygiene
Sleep hygiene is often overlooked. Make sure the room is completely dark. That means:
- No digital alarm clock lights.
- No glowing CO2 detectors.
- No window shades leaking in streetlight.
Even tiny amounts of light can interfere with melatonin production and shift you out of deep sleep stages.
If you wake up and can’t get back to sleep:
- Try the cognitive behavior therapy technique again.
- If still awake after 45 minutes total, consider a 3mg melatonin tablet (sublingual is best).
- Always check with your physician first.
- Avoid long-term melatonin use—it can reduce your brain’s natural production.
And finally, stop eating after 6:30 or 7:00 p.m. Insulin release from evening sugar spikes can inhibit melatonin and cause insomnia.
I love to snack with my teenage son in the evening—popcorn and soda—but I’ve noticed the direct effect it has on my sleep. The memories are great, but the sleep quality takes a hit.
Final Thoughts and Recommendations
If you treat patients with chronic pain or you’re a parent or coach of an athlete, ask about their sleep. Sleep deprivation is a major risk factor—not just for injuries, but for poor healing and chronic disease.
Use the Epworth Sleepiness Scale to screen for daytime fatigue. Talk to your dentist or physician. If your provider isn’t trained in airway-focused treatment or appliance therapy, refer them to Vivos Therapeutics to learn how they can offer lasting, non-surgical help for sleep-disordered breathing.
CPAP works for many, but it's often hard to sustain long-term. Vivos appliances offer a permanent structural solution by developing the jaws and nasal passages—great for kids and adults alike.
The goal is freedom. Freedom from fatigue. Freedom from injury. Freedom to heal.
And most importantly, don’t wait. Early screening and treatment can help your children—and yourself—get deeper, longer, more restorative sleep.
If we want to unleash the healing power of sleep, we must protect both the quantity and the quality of our rest. That’s where real recovery begins.
Take care, and until next time.
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The More Than Teeth newsletter delivers evidence-based insights directly to your inbox, exploring the critical connections between oral health and overall wellness. Michael Bennett , DDS, PhD shares his unique perspective as both a practicing dentist and pioneering researcher, translating complex medical concepts into practical advice you can implement immediately.
Unlike typical dental newsletters that focus solely on oral hygiene tips, our content delves deeper into how your mouth serves as a gateway to total body health. Each edition explores topics like sleep quality, breathing mechanics, nutrition, and how these factors interconnect with your dental health to influence your entire wellbeing.