TY - JOUR
T1 - Insomnia and daytime sleepiness
T2 - risk factors for sports-related concussion
AU - Raikes, Adam C.
AU - Athey, Amy
AU - Alfonso-Miller, Pamela
AU - Killgore, William D.S.
AU - Grandner, Michael A.
N1 - Funding information: The study was funded by an Innovations grant from the National Collegiate Athletic Association . Dr. Grandner is also supported by R01 MD011600. Drs. Raikes and Killgore are also supported by a US Army Medical Research and Materiel Command grant ( W81XWH-14-1-0571) to Dr. Killgore.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - 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: In this study, 190 NCAA Division-1 athletes completed a survey battery, including the Insomnia Severity 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 sleep-disordered 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.
AB - 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: In this study, 190 NCAA Division-1 athletes completed a survey battery, including the Insomnia Severity 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 sleep-disordered 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.
KW - College athletes
KW - Daytime sleepiness
KW - Insomnia severity index
KW - Relative risk
KW - Sleep quality
KW - Sports-related concussion
UR - http://www.scopus.com/inward/record.url?scp=85066096063&partnerID=8YFLogxK
U2 - 10.1016/j.sleep.2019.03.008
DO - 10.1016/j.sleep.2019.03.008
M3 - Article
C2 - 31132574
AN - SCOPUS:85066096063
SN - 1389-9457
VL - 58
SP - 66
EP - 74
JO - Sleep Medicine
JF - Sleep Medicine
ER -