Insomnia and daytime sleepiness: risk factors for sports-related concussion

Abstract

Objective/Background: Poor quality and inadequate sleep are associated with impaired cognitive, motor, and behavioral components of sport performance and increased injury risk. While prior work identifies sports-related concussions as predisposing factors for poor sleep, the role of sleep as a sports-related concussion risk factor is unknown. The purpose of this study was to quantify the effect of poor sleep quality and insomnia symptoms on future sports-related concussion risk. Patients/Methods: 190 NCAA Division-1 athletes completed a survey battery, including the Insomnia Sleep Index (ISI) and National Health and Nutrition Examination Survey (NHANES) Sleep module. Univariate risk ratios for future sports-related concussions were computed with ISI and NHANES sleepiness scores as independent predictors. An additional multiple logistic regression model including sport, sports-related concussion history, and significant univariate predictors jointly assessed the odds of sustaining a concussion. Results: Clinically moderate-to-severe insomnia severity (RR = 3.13, 95% CI: 1.320-7.424, p = 0.015) and excessive daytime sleepiness two or more times per month (RR = 2.856, 95% CI: 0.681-11.977, p = 0.037) increased concussion risk. These variables remained significant and comparable in magnitude in a multivariate model adjusted for sport participation. Conclusion: Insomnia and daytime sleepiness are independently associated with increased sports-related concussion risk. More completely identifying bidirectional relationships between concussions and sleep requires further research. Clinicians and athletes should be cognizant of this relationship and take proactive measures-including assessing and treating sleepdisordered breathing, limiting insomnia risk factors, improving sleep hygiene, and developing daytime sleepiness management strategies-to reduce sports-related concussion risk and support overall athletic performance.

Daily Morning Blue Light Therapy for Post-mTBI Sleep Disruption: Effects on Brain Structure and Function

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A phenome-wide association study identifying risk factors for pediatric post-concussion syndrome

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“…39 The link, however, may also be attributable to poor psychomotor performance, reaction time, and postural control in sleep-deprived individuals, leading to increased mTBI incidence and severity. 40,41 The association between chronic inflammation and PCS is presently underreported. We identified an over three-fold increased risk of PCS associated with both previously diagnosed gastritis/duodenitis and chronic pharyngitis/nasopharyngitis.…”

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