Sports Medicine Research: In the Lab & In the Field: Are Our Athletes Getting Enough Sleep? Their Brains Don’t Think So! (Sports Med Res)
Monday, December 23, 2013

Are Our Athletes Getting Enough Sleep? Their Brains Don’t Think So!

Baseline neurocognitive testing in sports-related concussions: The importance of a prior night’s sleep

McClure J, Zuckerman SL, Kutscher SJ, Gregory AJ, Solomon GS. The American Journal of Sports Medicine.2013; ahead of print.

Take Home Message: Athletes who reported sleeping fewer than 7 hours the night before concussion baseline testing performed worse on ImPACT and reported more symptoms.

Student-athletes have many demands on their time (e.g., school, work, socializing, sports), which can result in fragmented sleeping patterns that may negatively affect cognitive function. Athletes that do not get enough sleep before a baseline test could perform poorly resulting in an invalid test and thus making it even more difficult to determine safe return to play. However, no studies have investigated if the amount of sleep is influences ImPACT testing. Therefore, the authors evaluated if athletes who sleep less before baseline testing would perform worse on neurocognitive modules and report more symptoms compared with athletes that sleep more. Three thousand six hundred and eighty-six collegiate (10.3%) and high school (89.7%) athletes who had no excluding factors (e.g., valid ImPACT, no history of concussion, attention deficit disorder, attention deficit hyperactivity disorder, anxiety, depression, or learning disability) were separated in 3 categories based on sleep duration: short (less than 7 hours of sleep; 768 athletes), intermediate (7-9 hours of sleep; 2189 athletes), and long (more than 9 hours of sleep; 819 athletes). Among the three groups, athletes sleeping less than 7 hours performed worse on verbal memory (total memory percent score), visual memory (match memory percent score), and reaction time, but the authors found no differences with processing motor speed. Athletes in the short sleep group reported more frequent somatic (e.g., headache, dizziness, nausea), cognitive (e.g., fatigue, drowsiness, sleeping more), emotional (e.g., irritable, sadness, nervousness), and sleep (i.e., sleeping less, trouble staying asleep, trouble falling asleep) symptoms compared with the intermediate and long sleep groups. Intermediate sleep athletes also reported more sleep symptoms than the long sleep group.

Monitoring concussion signs and symptoms remains to be one of the most common ways to assess the progress of a concussion injury. The authors suggest that the amount of sleep can affect athletes’ baseline scores. Specifically, athletes sleeping fewer than 7 hours performed worse on 3 out of the 4 ImPACT composite scores and reported more symptoms at baseline. Though, it is not surprising that athletes with little sleep reported more sleep symptoms, the number of symptoms reported in the other 3 symptom categories are alarming. The authors suggest that sleep duration may influence an athlete’s baseline ImPACT scores. Other ImPACT modifying factors like depression, anxiety, and somatic pain may also be a result of chronically reduced sleep. Medical professionals should be aware of the amount of sleep that the athletes are reporting on their baseline neurocognitive exams. This complicated clinical scenario further highlights the importance of a multifaceted approach to monitoring athletes and making return to play decisions following a concussion injury.

Questions for Discussion: Prior to baseline testing do you tell your athlete to get a good night sleep? Do you think athletes believe a good night sleep is 7-9 hours? Should a self-reported sleep time of less than 7 hours indicate a possible invalid test?

Written by: Jane McDevitt, PhD
Reviewed by: Jeffrey Driban

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McClure DJ, Zuckerman SL, Kutscher SJ, Gregory AJ, & Solomon GS (2013). Baseline Neurocognitive Testing in Sports-Related Concussions: The Importance of a Prior Night's Sleep. The American Journal of Sports Medicine PMID: 24256713

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