Youth Sports and Sleep: What the Research Shows About Injury

Last updated: October 2026

Fall sports bring early practices, late games, and weekend tournaments, often for athletes who are already short on sleep. In a study of 340 Swedish adolescent elite athletes, those who slept more than 8 hours on weekdays had lower odds of a new injury (von Rosen et al., 2017). Below is what the research shows about sleep in young athletes, where the evidence is thinner than often claimed, and where pillow height comes in.

Key takeaways

In 340 adolescent elite athletes, more than 8 hours of weekday sleep was linked to 61% lower odds of a new injury, an association with a wide confidence interval (von Rosen et al., 2017).
In adult athletes, a review of 12 prospective studies found only limited evidence linking poor sleep to injury (Dobrosielski et al., 2021).
A Pillowise fitting takes three measurements (shoulder width, neck circumference and neck length) and adds sleeping position and bed type to choose from seven sizes.

Are young athletes getting enough sleep?

Teens in general are short on sleep. In 2015 surveillance data, 72.7% of US high school students reported sleeping less than 8 hours on school nights (Wheaton et al., 2018).

Among the 340 Swedish adolescent elite athletes followed by von Rosen and colleagues, 19% did not get the recommended weekday sleep (von Rosen et al., 2017).

Is sleep linked to injury in youth sports?

In the same cohort, more than 8 hours of weekday sleep was linked to lower odds of a new injury, with an odds ratio of 0.39 (95% CI 0.16 to 0.99), which the authors report as a 61% reduction (von Rosen et al., 2017).

This is one cohort of elite athletes with self-reported sleep, and the upper end of the confidence interval is close to 1. The finding is an association, not proof that more sleep prevents injury.

What about adult athletes?

A systematic review of 12 prospective cohort studies found limited evidence of an association between poor sleep and injury in adult athletic populations (Dobrosielski et al., 2021).

The authors concluded the evidence does not support poor sleep as an independent risk factor for injury in adults. The youth and adult findings are worth keeping separate.

Does more sleep improve performance?

In a study at Stanford, 11 men's varsity basketball players extended their sleep by about 111 minutes a night. Sprint times improved from 16.2 to 15.5 seconds, and free throw and 3-point shooting each improved by about 9% (Mah et al., 2011).

The study had no control group and included one college team, so it shows what is possible rather than what to expect.

What does pillow height change overnight?

In a radiographic study of 16 adults, raising the pillow from 0 to 10 to 20 cm increased T1 slope and C2-7 Cobb angle while neck tilt decreased (Kim et al., 2015). A crossover study of 10 healthy participants paired with finite element modeling measured how heights from 110 to 170 mm shift pressure across the head and neck (Ren et al., 2016).

In a pilot EMG study of 15 adults lying on their side, the height matched to shoulder width produced the lowest neck and shoulder muscle activity (Jiao et al., 2025).

Why do generic pillows miss?

A standard contoured pillow, not fitted to the individual, performed no better than ordinary shapes in a randomized study of 106 side sleepers (Gordon et al., 2009). No single optimal pillow height can be specified, because it depends on four variables that differ from person to person: cervical alignment, body dimension, contact pressure, and muscle activity (Lei et al., 2021).

What we measure

Pillowise is a fitted cervical pillow that licensed healthcare providers measure and dispense, made in seven sizes.

Our sleep specialists take three measurements: shoulder width, neck circumference, and neck length. Combined with sleeping position and bed type, an algorithm identifies the best-fitting pillow from seven sizes.

Shoulder width is the measurement the EMG study found mattered most. A height matched to it produced the lowest neck and shoulder muscle activity during side sleeping (Jiao et al., 2025), and body dimension is what drives the individual optimum (Tian et al., 2025).

A systematic review of 11 studies covering 309 participants identified a 7 to 11 cm unloaded central height among the parameters supporting spinal alignment and sleep comfort (Radwan et al., 2021). The size is chosen from those three measurements plus sleeping position and bed type, rather than from a single stock height.

For tournament weekends, the Pillowise Travel is measured the same way as the Standard and Queen, in a smaller format to take with you on nights away from home.

Pillowise pillows are made from premium Dutch memory foam and certified to OEKO-TEX Standard 100, meaning every component has been tested against the standard's limits for harmful substances.

Scope

The sports studies measured sleep, injury, and performance, not pillows, and the pillow height research was conducted in adults. No study has tested whether a fitted pillow changes injury risk or performance in athletes of any age, and we make no such claim. The most recent systematic review found no clear advantage for any pillow type in chronic neck pain (Ghosh et al., 2025).

For providers

Preseason and sports physical visits are a natural time to ask young athletes how many hours they sleep on school nights and during tournament weekends.

For athletes with neck or shoulder complaints, asking which sleeping position they hold longest and what they sleep on, at home and away, gives useful context.

A fitted pillow extends the work of the visit into the hours between visits, alongside the exercise, manual therapy, and other care the provider is already delivering.

Common questions

How much sleep do teen athletes need?

In the Swedish study, the athletes who slept more than 8 hours on weekdays had lower odds of a new injury (von Rosen et al., 2017). The CDC uses under 8 hours on school nights as short sleep for ages 13 to 18 (Wheaton et al., 2018).

Does sleep prevent sports injuries?

The evidence is mixed. In adolescent elite athletes, more sleep was linked to fewer new injuries (von Rosen et al., 2017), while in adults a review found only limited evidence of a link (Dobrosielski et al., 2021). Neither shows that sleep prevents injury.

Can a pillow help athletes recover?

No study has tested that, and we make no such claim. A pillow fitting addresses head and neck height during sleep, which is a separate question from training recovery.

Is a contoured pillow from a store enough?

Not reliably. A standard contoured pillow, not fitted to the individual, performed no better than ordinary shapes in a randomized study of 106 side sleepers (Gordon et al., 2009), and no single optimal height can be specified because it depends on four variables that differ from person to person (Lei et al., 2021). A contour helps only if its height matches the person using it. That is what the fitting settles, in a provider's office.

Find a Pillowise provider or become one

Pillowise pillows are clinically measured and dispensed exclusively through licensed healthcare providers as part of broader sleep, posture, and recovery education.

To locate a Pillowise provider near you, visit: Find a Reseller

Licensed healthcare providers interested in offering Pillowise may register here: Become a Reseller

References

Dobrosielski, D. A., Sweeney, L., & Lisman, P. J. (2021). The association between poor sleep and the incidence of sport and physical training-related injuries in adult athletic populations: A systematic review. Sports Medicine, 51(4), 777-793. https://doi.org/10.1007/s40279-020-01416-3

Ghosh, S. K., Goyal, M., & Goyal, K. S. (2025). Effect of pillow on pain, disability and sleep quality in patients with chronic neck pain: A systematic review. Rehabilitación, 59(3), 100922. https://doi.org/10.1016/j.rh.2025.100922

Gordon, S. J., Grimmer-Somers, K., & Trott, P. (2009). Pillow use: The behaviour of cervical pain, sleep quality and pillow comfort in side sleepers. Manual Therapy, 14(6), 671-678. https://doi.org/10.1016/j.math.2009.02.006

Jiao, R., Xiao, W., Wang, M., Yu, S., & Li, H. (2025). The impact of pillow height on neck muscle activity: A pilot study. Sleep and Breathing, 29(1), 40. https://doi.org/10.1007/s11325-024-03219-6

Kim, H. C., Jun, H. S., Kim, J. H., Ahn, J. H., Chang, I. B., Song, J. H., & Oh, J. K. (2015). The effect of different pillow heights on the parameters of cervicothoracic spine segments. Korean Journal of Spine, 12(3), 135-138. https://doi.org/10.14245/kjs.2015.12.3.135

Lei, J.-X., Yang, P.-F., Yang, A.-L., Gong, Y.-F., Shang, P., & Yuan, X.-C. (2021). Ergonomic consideration in pillow height determinants and evaluation. Healthcare, 9(10), 1333. https://doi.org/10.3390/healthcare9101333

Mah, C. D., Mah, K. E., Kezirian, E. J., & Dement, W. C. (2011). The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep, 34(7), 943-950. https://doi.org/10.5665/sleep.1132

Radwan, A., Ashton, N., Gates, T., Kilmer, A., & VanFleet, M. (2021). Effect of different pillow designs on promoting sleep comfort, quality, & spinal alignment: A systematic review. European Journal of Integrative Medicine, 42, 101269. https://doi.org/10.1016/j.eujim.2020.101269

Ren, S., Wong, D. W.-C., Yang, H., Zhou, Y., Lin, J., & Zhang, M. (2016). Effect of pillow height on the biomechanics of the head-neck complex: Investigation of the cranio-cervical pressure and cervical spine alignment. PeerJ, 4, e2397. https://doi.org/10.7717/peerj.2397

Tian, S., Yao, C., Wang, Y., Cao, X., Sun, Y., Wang, L., & Fan, Y. (2025). The individualized optimal pillow height and neck support design for side sleepers. Medical and Biological Engineering and Computing, 63(2), 535-544. https://doi.org/10.1007/s11517-024-03204-x

von Rosen, P., Frohm, A., Kottorp, A., Fridén, C., & Heijne, A. (2017). Too little sleep and an unhealthy diet could increase the risk of sustaining a new injury in adolescent elite athletes. Scandinavian Journal of Medicine & Science in Sports, 27(11), 1364-1371. https://doi.org/10.1111/sms.12735

Wheaton, A. G., Jones, S. E., Cooper, A. C., & Croft, J. B. (2018). Short sleep duration among middle school and high school students, United States, 2015. MMWR. Morbidity and Mortality Weekly Report, 67(3), 85-90. https://doi.org/10.15585/mmwr.mm6703a1