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

Bahie Ezzat; Eugene Hrabarchuk; Michael Lemonick; Frederika Rentzeperis; Roshini Kalagara; Muhammad Ali; Matthew T Carr; Alexander J Schupper; Hanya M Qureshi; Sujay Ratna; Cole Brown; Gabriel Dara; Alex Gometz; Mark Lovell; Tanvir F Choudhri

doi:10.1097/JSM.0000000000001323

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

Clin J Sport Med. 2024 Dec 11. doi: 10.1097/JSM.0000000000001323. Online ahead of print.

Authors

Affiliations

¹ Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York.
² Department of Neurosurgery, University of Massachusetts Chan Medical School, Worcester, Massachusetts.
³ Concussion Management of New York, New York, New York; and.
⁴ Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania.

PMID: 39665644
DOI: 10.1097/JSM.0000000000001323

Abstract

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.