Influence of Postconcussion Sleep Duration on Concussion Recovery in Collegiate Athletes. Clin J Sport Med 2020 Mar;30 Suppl 1:S29-S35
Date
03/07/2020Pubmed ID
32132474DOI
10.1097/JSM.0000000000000538Scopus ID
2-s2.0-85081291936 (requires institutional sign-in at Scopus site) 31 CitationsAbstract
OBJECTIVE: To determine whether decreased sleep duration postconcussion influences days to asymptomatic and assessment of performance throughout recovery.
DESIGN: Prospective.
SETTING: Institutional Clinical Research Laboratory.
PATIENTS: Four hundred twenty-three collegiate athletes were diagnosed with concussion.
INTERVENTIONS: Multidimensional concussion assessment battery was conducted at baseline, within 24 to 48 hours, daily [2-4 days postinjury (PI); symptoms only], once asymptomatic, and after return-to-play. The battery included the following: 22-item symptom checklist, Standardized Assessment of Concussion (SAC), Balance Error Scoring System (BESS), and computerized neurocognitive test [Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)].
MAIN OUTCOME MEASURES: We subtracted baseline sleep duration from 24 to 48 hours postconcussion sleep duration and categorized athletes into the following groups: shorter sleep (≤-1 hour), no change (>-1 hour, <+1 hour), and longer sleep (≥+1 hour). A 1-way analysis of variance (ANOVA) was conducted to compare days to asymptomatic and separate mixed-model ANOVAs to compare total symptom scores, SAC total scores, BESS total error scores, and ImPACT composite scores between sleep categories across time points (α = 0.05).
RESULTS: Sleep groups did not differ in days to asymptomatic. The shorter sleep group had greater symptom severity than no sleep change and longer sleep groups at 24 to 48 hours (shorter: 39.1 ± 20.7; no change: 25.1 ± 18.4, P = 0.007; longer: 25.7 ± 21.8, P = 0.004), and at 2 to 4 days PI (shorter: 21.8 ± 21.8; no change: 10.5 ± 10.8, P = 0.013; longer: 11.9 ± 14.2, P = 0.007), but did not differ at other time points (ie, asymptomatic and return-to-play). Participants with shorter sleep exhibited slower ImPACT reaction times at 24 to 48 hours (shorter: 0.68 ± 0.14; no change: 0.61 ± 0.09, P = 0.016; and longer: 0.62 ± 0.12, P = 0.028) and asymptomatic time points (shorter: 0.62 ± 0.11; no change: 0.56 ± 0.05; P = 0.015).
CONCLUSION: Postinjury sleep declines may be associated with symptom severity and worsened reaction time during initial stages of recovery or may be the result of the concussion itself. Clinicians should be aware of alterations in sleep duration and manage appropriately to mitigate initial symptom burden postconcussion.
Author List
Hoffman NL, Weber ML, Broglio SP, McCrea M, McAllister TW, Schmidt JD, CARE Consortium InvestigatorsAuthor
Michael McCrea PhD Professor in the Neurosurgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Analysis of VarianceAthletes
Athletic Injuries
Brain Concussion
Female
Humans
Injury Severity Score
Male
Post-Concussion Syndrome
Prospective Studies
Reaction Time
Recovery of Function
Return to Sport
Self Report
Sleep
Sleep Wake Disorders
Students
Time Factors
Universities
Young Adult