Sleep and Recovery


One of the most common patient history findings that I always encounter in patients that present with chronic musculoskeletal and health issues, or repetitive acute injuries and niggles are that they are usually suffering from poor sleep.

The importance of sleep in terms of recovery, immunity and performance has been extensively researched throughout the years! (1-5) As such, in order to get the best out of your chiropractic treatments, one must understand the role of good quality sleep.

The National Sleep Foundation recommends that healthy adults (aged 26-64) need at between 7 and 9 hours of sleep per night. Babies, young children and teens will require more to support growth and development! (6)


Why is Sleep important?

Good quality sleep has been found to be crucial in many of our body processes.

  • Immunity – Sleep has been shown to be crucial in your body’s immune defence. (1,2,5,7) As it is crucial for the production and release of cytokines which are crucial for immune response, hence preventing illness.
  • Recovery – Athletes with poor sleep hygiene has been shown to be more prone to injuries, less adaptable to variations of training loads, as well as recover from their injuries slower than others. (3,4,5,8)
  • Performance – Similarly, in many settings, athletic performance have been shown to be extremely dependant on sleep quality. (3,5,9)
  • Mood and Cognitive function – Sleep research also pointed to a role in maintaining optimum cognitive function in many settings (infant and youth, sports, military and elderly)(10-13) as well as prevent mood disorders.


How do we improve Sleep Hygiene?

Regardless of which stage of life you are in, be it a busy career mom trying to juggle family and work, a fresh graduate trying to make a career or a teen trying to cope with studies and the anxiety of missing out on anything fun, try to learn to make sleep a priority!

Below is an excerpt taken from the National Sleep Foundation (14):

“Improving your sleep hygiene, which includes your bedroom setting and sleep-related habits, is an established way to get better rest. Examples of sleep hygiene improvements include:

  • Sticking to the same sleep schedule every day, even on weekends.
  • Practicing a relaxing pre-bed routine to make it easier to fall asleep quickly.
  • Choosing a mattress that is supportive and comfortable and outfitting it with quality pillows and bedding.
  • Minimizing potential disruptions from light and sound while optimizing your bedroom temperature and aroma.
  • Disconnecting from electronic devices like mobile phones and laptops for a half-hour or more before bed.
  • Carefully monitoring your intake of caffeine and alcohol and trying to avoid consuming them in the hours before bed. “

Should your poor sleep persist despite adopting the steps above, you may have other underlying medical condition/s that is affecting your ability to get a good night rest. The next step would be to consult a sleep physician to undergo further testing and examination to source out any potential pathology. You could refer to the Singapore Sleep Society website (15) for further information and contacts.

I hope this article enlightened you about the role of good quality sleep in your recovery. We at PhysioMed look forward to assist you in your quest for health.


Dr Han



  • Irwin, M.R. Sleep and inflammation: partners in sickness and in health. Nat Rev Immunol19, 702–715 (2019).
  • Elizabeth G. Ibarra-Coronado, Ana Ma. Pantaleón-Martínez, Javier Velazquéz-Moctezuma, Oscar Prospéro-García, Mónica Méndez-Díaz, Mayra Pérez-Tapia, Lenin Pavón, Jorge Morales-Montor, “The Bidirectional Relationship between Sleep and Immunity against Infections”, Journal of Immunology Research, vol. 2015, Article ID 678164, 14 pages, 2015.
  • Bird, Stephen P. PhD, CSCS1,2 Sleep, Recovery, and Athletic Performance: A Brief Review and Recommendations, Strength and Conditioning Journal: October 2013 – Volume 35 – Issue 5 – p 43-47 doi: 10.1519/SSC.0b013e3182a62e2f
  • Milewski, Matthew D., et al. “Chronic lack of sleep is associated with increased sports injuries in adolescent athletes.” Journal of Pediatric Orthopaedics2 (2014): 129-133.
  • Shona L. Halson (2008) Nutrition, sleep and recovery, European Journal of Sport Science, 8:2, 119-126, DOI: 10.1080/17461390801954794
  • Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health. 2015;1(1):40-43. doi:10.1016/j.sleh.2014.12.010
  • Luke A, Lazaro RM, Bergeron MF, Keyser L, Benjamin H, Brenner J, et al. Sports-related injuries in youth athletes: is overscheduling a risk factor? Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine. 2011 Jul;21(4):307-14
  • Silva, M-RG, and T. Paiva. “Poor precompetitive sleep habits, nutrients’ deficiencies, inappropriate body composition and athletic performance in elite gymnasts.” European Journal of Sport Science6 (2016): 726-735.
  • Tham EK, Schneider N, Broekman BF. Infant sleep and its relation with cognition and growth: a narrative review. Nat Sci Sleep. 2017;9:135-149. Published 2017 May 15. doi:10.2147/NSS.S125992
  • Yaffe, Kristine, Cherie M. Falvey, and Tina Hoang. “Connections between sleep and cognition in older adults.” The Lancet Neurology10 (2014): 1017-1028.
  • R. HASLAM (1982) Sleep loss, recovery sleep, and military performance, Ergonomics, 25:2, 163-178, DOI: 10.1080/00140138208924935
  • Walker, Matthew P. “The role of sleep in cognition and emotion.” Annals of the New York Academy of Sciences1 (2009): 168-197.



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