Analysis of the interaction between sleep quantity and sex in neurocognitive performance testing for sports-related concussion.

OBJECTIVE

Cognitive testing for sports-related concussion (SRC) has become a critical component in ensuring the health of adolescent athletes. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a validated tool for assessing SRC and guiding subsequent medical management; thus the effect of different variables on ImPACT scoring is of clinical relevance. The aim of this study was to evaluate the influence of sleep quantity and patient sex on the ImPACT performance of athletes at baseline and time points after SRC.

METHODS

A database containing ImPACT assessments from 11,563 high school athletes gathered from July 2009 to June 2019 in Florida and Colorado was queried. A retrospective analysis that included univariable and multivariable linear regression modeling was performed to evaluate sex and sleep effects on performance, both at baseline and after SRC injury. Patients self-reported the number of hours they slept the night before ImPACT assessment.

RESULTS

Multivariable analysis revealed that at baseline, sex and the number of hours of sleep the night before testing had a significant interaction effect with both the symptom score (p < 0.0001) and reaction time (p = 0.0145) ImPACT categories. At postinjury testing, only the symptom score (p = 0.0374) was significantly associated with sex and sleep quantity.

CONCLUSIONS

Sleep quantity and sex were found to be significantly associated with specific neurocognitive ImPACT composite scores. The results of this study underscore the need for further investigation into these variables in the context of SRC management to provide optimal and personalized treatment for young athletes.