Poor Sleep: Impaired Musculoskeletal Healing
Poor sleep significantly impairs musculoskeletal recovery by disrupting endocrine, immune, and cellular processes essential for the repair of bones, tendons, ligaments, and muscles.
Hormonal Effects
Sleep deprivation reduces anabolic hormones such as testosterone and growth hormone, which are critical for protein synthesis, collagen formation, and tissue regeneration. Concurrently, cortisol levels increase, promoting tissue breakdown and slowing repair processes [de Sousa Nogueira Freitas et al., 2020; Chennaoui et al., 2021; Stich et al., 2022; Kaczmarek et al., 2025].
Inflammatory Dysregulation
Inadequate sleep elevates pro-inflammatory cytokines, including IL-6 and TNF-α, prolonging inflammation and delaying the transition to proliferative and remodeling phases of healing. These inflammatory changes impair stem cell function necessary for tissue regeneration [Chennaoui et al., 2021; Morrison et al., 2022; Kaczmarek et al., 2025; Dáttilo et al., 2020].
Skeletal Muscle Recovery
In skeletal muscle, poor sleep reduces protein synthesis and slows tissue repair, increasing susceptibility to reinjury and muscle weakness [Chennaoui et al., 2021; Morrison et al., 2022; Kaczmarek et al., 2025; Yang et al., 2019; Dáttilo et al., 2020].
Bone Healing
Sleep deprivation disrupts circadian regulation of bone turnover, reduces osteoblast activity, and impairs bone remodeling, leading to slower fracture healing and decreased bone density. These effects can compromise long-term bone strength and recovery from musculoskeletal injury [Stich et al., 2022; Elkhenany et al., 2018; Swanson et al., 2017; Beetz et al., 2021].
Circadian Misalignment
Irregular sleep patterns further impair tissue-specific gene expression and regenerative capacity. Circadian misalignment contributes to slower musculoskeletal healing, increases the likelihood of chronic pain, and raises the risk of reinjury in bones, muscles, tendons, and ligaments [Chennaoui et al., 2021; Kaczmarek et al., 2025; Beetz et al., 2021; Lisman et al., 2022; Yeung et al., 2024].
References:
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