The Role of Sleep in Injuries and Performance Among Elite Female Ice Hockey Players

Background: Sleep may play a vital role in recovery, performance, and injury prevention among elite athletes. Aim: To examine sleep patterns, recovery, and their associations with injuries and team performance among Swedish elite female ice hockey players. Methods: All 224 players registered in The Swedish Women’s Hockey League (SDHL) were invited to this research project during the 2023/2024 season, and 158 (71%) completed a questionnaire on sleep and recovery. All injuries that lead to absence from training or games were prospectively recorded by team medical staff. Data were analyzed descriptively and with chi-square (χ²) tests. Results: Thirty-two players (20.8%) reported insufficient sleep, and 19 (12.3%) rated their sleep quality as poor. Ten (6.5%) had used sleep medication during the past month, 13 (8.4%) slept less than seven hours per night, and 43 (27.9%) lacked sufficient rest and relaxation. No significant associations were found between sleep variables and injury incidence. However, players from top and bottom-ranked teams reported significantly lower sleep medication use than those from mid-ranked teams (p = 0.003). Top-ranked teams also had the highest proportion achieving at least seven hours of sleep per night (100%, p < 0.001). Inadequate sleep was primarily attributed to early or late training sessions, post-game stress, and dual work commitments. Conclusion: Sleep variables were not associated with injury incidence but were associated with team performance. Optimizing training schedules and reducing dual-career demands may enhance sleep and support performance in elite female ice hockey players. Trial registration: ClinicalTrials.gov (ID: NCT06351618).