If you work with runners long enough—whether as a coach, trainer, physical therapist, athletic trainer, wellness practitioner or strength specialist—you’ve seen the pattern: Training is consistent until it isn’t. An ache turns into missed sessions. A missed week becomes a missed month. For recreational runners, an injury can be the single biggest disruptor of momentum, healthy habits and confidence.

A new study out of the Netherlands puts a sharper point on something many pros already suspect: Sleep isn’t just “nice to have” recovery; it may be part of the injury-risk picture, especially when sleep is consistently short, low quality and disrupted. Lead author Dr. Jan de Jonge frames the results as “compelling evidence,” arguing that, while it is not the only factor, it belongs in the conversation about prevention. For health and exercise professionals, the value here is practical: sleep is measurable, modifiable and often overlooked in the same client who is tracking mileage, heart rate zones and macros.

Inside the Study

The researchers ran a secondary analysis of survey data from 425 Dutch recreational runners, who were a mix of novice and experienced athletes, to see whether real-world sleep patterns were associated with self-reported running injuries. The sample was 57% men and 43% women, with a mean age of almost 45 and an average of nearly 12 years of running experience. About half trained with a running club, and four out of 10 trained with a running coach.

The injury definition the researchers used mattered because it set a threshold that went beyond minor soreness. Before answering, participants were given a standardized definition: “an injury, impairment or wound, whether or not associated with pain, caused by or developed during a run training” that led to restricted running or stoppage “for at least seven days or three consecutive scheduled training sessions.” Runners then reported whether they had experienced one or more such injuries in the past year.

Sleep was measured in three dimensions—duration, quality and problems—using short survey items. Sleep duration was reported as average hours per night; sleep quality was a single rating from “very bad” to “very good”; and sleep problems included questions about trouble falling asleep, waking during the night and waking tired/not well-rested.

Rather than examining each sleep variable in isolation, the researchers used a statistical approach to group runners into profiles based on how these sleep dimensions clustered together. (In plain language: they looked for common “types” of sleep patterns that show up in a real running population.)

Four Sleep Profiles Identified

The analysis produced four sleep profiles:

• Steady Sleepers (48%): average sleep duration, slightly above-average sleep quality and relatively fewer sleep problems
• Poor Sleepers (37%): relatively lower sleep duration, low sleep quality and relatively higher sleep problems
• Efficient Sleepers (8%): average sleep duration, high sleep quality and low sleep problems
• Fragmented Sleepers (7%): average sleep duration and slightly above-average sleep quality and sleep problems

Across the full sample, average sleep duration was 7.30 hours per night. The average sleep-quality rating was 3.64 on the study’s 1-to-5 scale, and the mean score for sleep problems was 1.60 on the study’s 1-to-3 scale.

Injury was common: Six out of 10 runners (60%) reported a running-related injury in the past year under the study’s definition. That aligns with the paper’s broader point that running is a high-participation sport with a high injury burden, including reported injury rates “up to 90%” in prior research.

The Key Finding: Poor Sleepers Reported More Injuries

Once the researchers grouped runners into those four sleep profiles, they used logistic regression to examine the relationship between sleep profile and injury while controlling for gender, age, body mass index (BMI), height and running experience.

Runners in the Poor Sleepers profile were significantly more likely to report injuries than runners in the Steady Sleepers group. The odds ratio was 1.78, which the researchers translated into injury probabilities: 68% for Poor Sleepers compared with 55% for Steady Sleepers. The Efficient Sleepers and Fragmented Sleepers profiles did not differ significantly from Steady Sleepers in this analysis.

Two other details are worth keeping in mind when you interpret those numbers with clients. First, the overall model explained 5% of the variance in sports injuries and its classification accuracy was 60%. That’s not a knock on sleep — it’s a reminder that injuries are multifactorial and rarely hinge on a single input. The researcher make that point directly in their discussion, noting the “multifactorial nature of sports injuries.” Second, even with the modest explained variance, the signal is clinically interesting because sleep is a lever many recreational runners are not actively pulling.

As Dr. de Jonge notes, “sleep tends to fall to the bottom of the list” for runners who are already focused on mileage, nutrition and recovery strategies. If you’ve ever tried to get a busy client to protect a bedtime, you know exactly what he means.

What This Study Does—and Does Not—Demonstrate

It is important to note that the design of this study wasn’t without limitations. This was a cross-sectional, self-report survey looking back over the past year, which limits causal conclusions. It is plausible that poor sleep contributes to injury risk, but it’s also plausible that pain, stress, illness or creeping overtraining disrupts sleep first, and injury follows, or that both reflect a bigger load-management problem.

The authors also note that the sample came from a single European country, and injuries were self-reported without formal medical diagnosis. Even with a standardized injury definition, the study did not account for injury type or severity. And the researchers caution that sleep disturbance may reflect underlying health or (over)training issues and “should not be considered solely as an independent risk factor for injury.”

For health and exercise professionals, that nuance is useful. Sleep is not a single-cause story; rather, it’s a screening and coaching opportunity. If sleep is off, something else may be off, too.

Practical Application for Health and Exercise Professionals

So, what do you do with this on Monday morning, when your client is training for a half marathon, juggling work and family, and proud of their 5 a.m. runs?

Start by treating sleep as a standard part of your injury-risk and recovery conversation, not a side note. The research team’s own takeaway is that sleep should be considered multidimensional — duration, quality and problems—because each dimension can carry different information. That’s a helpful blueprint for practice: You don’t need a lab to start getting better data.

One simple move is to borrow the structure of the study’s sleep questions for your intake or check-ins. Ask clients how many hours they sleep on average, how they rate sleep quality, and whether they regularly have trouble falling asleep, wake during the night, or wake tired/not well-rested. You’re not diagnosing a sleep disorder; rather, you’re identifying patterns that may change how you progress training, how aggressively you load strength work and how you sequence hard sessions.

From there, use sleep as a context filter for training decisions. The authors note that if someone is returning to running after an injury, adequate sleep duration and quality may be even more crucial for healing and tissue regeneration. If a client is ramping up mileage and their sleep is deteriorating, you have a rationale to adjust the plan, emphasize recovery and coordinate with other members of the care team.

When coaching your clients, stay anchored to consensus ranges and realistic habits. The researchers point to expert consensus recommendations of seven to nine hours of sleep per night for healthy adults and eight to 10 hours for teenagers. It also emphasizes that recreational runners may need as much, if not more, sleep than professional athletes, because they’re stacking training on top of work, school, home and social demands. That framing helps you talk to clients who assume “elite habits” mean doing more while sleeping less.

Dr. de Jonge is blunt about priorities: Sleep should be treated as “a performance priority, not an afterthought.” For many clients, that message may be better received when you connect it to the thing they care about most: consistency. Better sleep is not just “recovery.” It’s more uninterrupted training.

Finally, offer concrete, low-friction sleep supports. The basics of sleep hygiene are not a magic cure-all but should be viewed as a starting line. You can suggest simple strategies like avoiding caffeine after mid-afternoon, minimizing alcohol before bedtime, keeping a consistent schedule, building a calming bedtime routine, getting morning light exposure, reducing screen time before bed and creating a cool, dark, quiet sleep environment.

For clients who can’t immediately fix nighttime sleep, it might be worthwhile to discuss using naps and sleep extension as tools, as recreational runners may benefit from longer nighttime sleep or regular daytime naps. That gives you another practical coaching option: If a client is stuck at roughly seven hours of sleep a night during a high-demand training block, you can explore whether a consistent, strategic nap or earlier bedtime is feasible rather than simply pushing harder workouts.

There’s your takeaway: This study gives you a defensible reason to ask your clients better sleep questions and to take their answers seriously. When a client’s sleep profile looks like the study’s Poor Sleepers group, it’s a cue to zoom out: training load, stress, fueling, recovery and scheduling may all need attention. Sleep may be the most visible signal that the system is strained, and it’s often the easiest place to start making meaningful change.