Effect of Sleep Duration and Concussion History on Neurocognitive Testing Symptoms for Post-injury States.

OBJECTIVE

Evaluate the influence of sleep duration and concussion history on postconcussion symptoms in adolescent athletes.

DESIGN

Observational retrospective study using the Immediate Post-Concussion Assessment and Cognitive Testing and Post-Concussion Symptom Scale (PCSS). Multivariable linear regression assessed sleep hours against 22 PCSS symptoms, controlling for demographic and health variables.

SETTING

Urban concussion centers in Colorado and Florida, 2009 to 2019.

PARTICIPANTS

11 564 student-athletes aged 12 to 22, categorized by concussion history.

INTERVENTIONS: Analysis of sleep duration and concussion history in relation to neurocognitive and psychiatric symptom severity.

MAIN OUTCOME MEASURES: Primary outcomes included neurocognitive, psychiatric, and total symptom scores. Secondary outcomes were specific PCSS symptoms.

RESULTS

Among 5349 student-athletes, 2671 (49.9%) had no prior concussions and 2678 (50.1%) had 1 or more. For those without prior concussions, sleep was negatively associated with age (β = -0.18, 95% confidence interval [CI], -0.22 to -0.13, P < 0.0001), vomiting (β = -0.22, 95% CI, -0.38 to -0.05, P = 0.012), and difficulty concentrating (β = -0.11, 95% CI, -0.19 to -0.35, P = 0.005). In athletes with a history of concussion, less sleep correlated with decreased age (β = -0.11, 95% CI, -0.14 to -0.07, P < 0.0001), headache (β = -0.065, 95% CI, -0.12 to -0.01, P = 0.031), irritability (β = -0.08, 95% CI, -0.15 to -0.01, P = 0.021), and difficulty concentrating (β = -0.08, 95% CI, -0.15 to -0.01, P = 0.031) but increased sensitivity to light (β = 0.10, 95% CI, 0.001-0.137, P = 0.048), numbness/tingling (β = 0.15, 95% CI, 0.04-0.26, P = 0.008), and feeling slowed down (β = 0.13, 95% CI, 0.05-0.21, P = 0.001).

CONCLUSION

Sleep duration and concussion history are associated with variations in postconcussion symptom severity among adolescent athletes. This data underscore the need for individualized management strategies based on sleep patterns and concussion history.