American Thoracic Society
PATIENT EDUCATION | INFORMATION SERIES
www.thoracic.org
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How much sleep is enough?
The American Academy of Sleep Medicine (AASM) released
ocial guidelines on the amount of sleep needed to promote
optimal health and avoid health risks associated with sleep
deprivation. Table 1 shows general guidelines for sleep time by
age. However, each person may still have dierent sleep needs.
Table 1 – AASM Guidelines for Sleep Time by Age
Age
Recommended sleeping
hours per 24 hours
3 - 5 years 10 to 13 hours
6 - 12 years 9 to 12 hours
13 - 18 years 8 to 10 hours
18 - 60 years 7 or more hours
61 - 64 years 7 to 9 hours
65 years and older 7 to 8 hours
Research suggests that athletes may need more sleep
compared to people of the same age who are not active. If you
do not get your recommended hours per night, you will start
falling behind and gather a “sleep debt.” Depending on how
much sleep debt you have, it is hard to make up for lost sleep
with “catch-up” sleep because it adds up. For example, if you
lose an hour of sleep for each of ve days during the week,
then you are behind ve hours by the weekend and need to
sleep ve extra hours to “catch-up.”
How does sleep aect my athletic performance?
If you or your children are involved in sports or competitive
physical activities, sleep should be a top priority. Sleep has a
positive eect on speed, accuracy, and reaction time. Without
a good night’s sleep, you may notice that you are not able to
think clearly or react as quickly during your training or game.
You may be more sensitive, moody, or irritable which can
aect how well you get along with your teammates and coach.
Constant poor sleep can lead to depression or anxiety that
can aect your drive to practice and how well you do during
events. Getting less sleep before a game increases your risk of
getting injured during the event. Decreased sleep can increase
the chance of getting an infection such as a common cold
because it decreases how well your immune system works.
How does sleep aect my school or work performance?
Sleep is needed to remember the things you learned during
the day. This is especially important if you are student or need
to learn new job skills. Students who have trouble sleeping or
sleep less than what they really need do not perform as well as
students without sleep problems. So, it is important before a
big test to sleep well. After a good night’s sleep, you may notice
that you have more energy, can think more clearly, concentrate
better, recall information faster, and make fewer mistakes.
Why does being an athlete increase the chance
for poor sleep?
Training time and schedules are long and busy, especially
when taking part in training camps or preparing for
competitions. Some sports like swimming and ice skating
often involve early morning practices, which means early
morning wake up times and can lead to shortened sleep. Other
sports, like soccer and baseball, can go into late afternoon
and evening that aects the timing of bedtime. Some sports
can require long-distance travel with jet lag that can cause
tiredness, impaired sleep, confusion, and discomfort from
time zone jumps. The night before a big event, you may have
increased stress or anxiety that can cause diculty falling
asleep. If you are a student athlete, balancing studying and
training to be at your best level can be hard.
What are signs that you are not getting enough sleep?
Any of the following may signal you need more sleep:
feeling drowsy during the daytime,
Sleep and Performance
Am J Respir Crit Care Med Vol. 197, P13-P14, 2018
ATS Patient Education Series © 2018 American Thoracic Society
Sleep is essential to achieve the best state of physical and mental
health. Research suggests that sleep plays an important role in
learning, memory, mood, and judgment. Sleep aects how well
you perform when you are awake—both your daily work and
athletic performance. The amount of time you sleep as well as the
quality of your sleep are both important. If you or your child is an
athlete, it is even more important to regularly get a good night’s
sleep to allow your body to rest well and recover between periods
of exercise, as well as to decrease risk of injury.
American Thoracic Society
PATIENT EDUCATION | INFORMATION SERIES
www.thoracic.org
falling asleep easily in 5 minutes of lying down or being
inactive,
nding you need to “micro-sleep,” which are brief periods
of sleep while awake,
being irritable and having mood changes,
having diculty paying attention or concentrating on tasks,
taking longer to learn new information and tasks than you
expect,
getting sick frequently.
If you have any of these problems, review your sleep habits
and see if getting more sleep helps.
What are long term problems if you do not get enough
good sleep?
Long-standing poor sleep worsens medical conditions and
increases your chance of getting the following problems:
diabetes
high blood pressure or heart disease
obesity
stroke
be accident prone
depression and other mental health problems
What can you do to improve your sleep?
1. If you have trouble falling asleep, try having a small snack
containing tryptophan (TRIP-toe-fan), an amino acid that
causes sleepiness. Foods such as turkey and other meats,
seeds and nuts, sh, eggs, pastas, and warm milk can make
tryptophan more available to your brain and help make you
drowsy. Have your snack 1-2 hours before your bedtime and
do not each too much to avoid having an upset stomach
while lying in bed.
2. Stress can make it hard to sleep. A relaxing bedtime
routine with a cup of herbal tea (try chamomile, ginger, or
peppermint teas that do not have caeine) and clearing your
mind 30 minutes before you plan to sleep may be helpful. Try
deep breathing exercises to release stress and reduce tension.
3. Melatonin (MEL-a-toe-nin) is a hormone made by your
body to help balance your sleep-wake cycle. You can buy
melatonin at your local drug or health food store without a
prescription. Using melatonin when you cross time zones
can help with jet lag and falling asleep. Take it 2-3 hours
before you plan to sleep. Doses come in 0.3mg to 5mg.
Start small rst as most people do well with 1mg. Contact
your doctor for any questions.
4. Alcohol might make you feel sleepy but it is not good for
sleep. It interrupts your sleep rhythm and you can wake
up too early. It also relaxes your muscles so it can worsen
snoring and sleep apnea (APP-knee-ah). It can also lead to
extra bathroom trips because alcohol is a diuretic (makes
you urinate more like a water pill). You may not feel as
refreshed in the morning because you did not sleep soundly.
5. If you are tired mid-day, taking a short nap can be helpful.
Most people feel refreshed after 20 minutes of napping
because sleeping longer can leave you groggy. Avoid
napping late in the day because then it will make it hard to
fall asleep at night.
6. Practice other good sleep habits such as:
sleep in a cool, dark, quiet room without electronics
drink caeine (coee, tea, soda) only in the morning
because it is a stimulant that keeps you awake
have a regular bedtime and wake time
minimize very early or very late training sessions
when traveling across time zones, allow for 1 day per
time zone before competition to properly adjust
For further information on healthy sleep in children, teens,
and adults read the ATS Patient Information handouts at
www.thoracic.org/patients/. If you continue to have sleep
problems such as restless sleep or diculty going to sleep, talk
with your healthcare provider or a sleep specialist.
Authors: Hanna Hong, MD; Helena Schotland, MD; and Iris A
Perez, MD
Reviewers: Marianna Sockrider MD, DrPH; David Gozal, MD, MBA
This information is a public service of the American Thoracic Society.
The content is for educational purposes only. It should not be used as a
substitute for the medical advice of one’s healthcare provider.
Additional Resources:
American Thoracic Society
• www.thoracic.org/patients
Ocial ATS Statement: The Importance of Healthy Sleep
• www.atsjournals.org
Sleep Education – American Academy of Sleep Medicine
(AASM)
• www.sleepeducation.org
Centers for Disease Control and Prevention (CDC)
• www.cdc.gov/sleep
National Sleep Foundation
• https://sleepfoundation.org/sleep-topics/the-importance-
sleep-young-athletes-who-travel
R Action Steps
Sleep in a cool, dark and quiet room without electronics.
Drink caeine only during morning hours.
Keep a regular bedtime and regular wake up time. If you
nap, keep it under 20 minutes and avoid after the late
afternoon.
Avoid variable training times and try to avoid early morn-
ing or late evening training sessions.
When traveling across time zones, allow for 1 day before
competition per time zone crossed to adjust properly.
If you have poor sleep or extreme daytime tiredness, then
talk to your healthcare provider about being checked for
a possible sleep disorder.
Healthcare Provider’s Contact Number:
