The influence of sleep duration and sleep-related symptoms on baseline
neurocognitive performance among male and female high school athletes.
Sufrinko A, Johnson EW, and
Henry LC. Neuropsychology. 2015.
[Epub Ahead of Print].
Home Message: Athletes who obtained less than 5 hours of sleep performed worse
on ImPact computerized neurocognitive testing than those who slept more.
Computerized neurocognitive testing is
the standard of care for assessing an athlete’s baseline neurocognitive
abilities, and later to assess an athlete’s ability to return to participation
following a concussion. There are many factors that can affect the validity of
computerized neurocognitive tests. For example, sleep deprivation can lead to neurocognitive
deficits; however, no one has determined their effect on computerized
neurocognitive testing. Therefore, Sufrinko and colleagues completed a study to
determine the effect of sleep deprivation and restriction on baseline
computerized neurocognitive tests. The authors include 7,150 high school
athletes (14-17 years old, 2,080 female) with no self-reported learning
disabilities or ADHD and no history of psychotropic medications. All athletes
underwent baseline computerized neurocognitive testing (ImPact) under the
supervision of a certified athletic trainer. Researchers assessed an athlete’s
sleep duration the night before testing using self-reported demographic information.
Athletes were classified into 1 of 3 groups: sleep restriction ≤
5 hours, typical sleep: 5.5 to 8.5 hours, and optimal sleep ≥ 9 hours). Overall,
athletes slept an average of 7.8 hours. Only 22% of athletes reported optimal
sleep of ≥ 9 hours and 4% reported sleep restriction. Male athletes slept more
than female athletes. Athletes with sleep restriction had worse total symptoms,
reaction time, visual motor speed, and verbal memory than those with typical
sleep. The results comparing typical sleepers to optimal sleepers were mixed
with typical sleepers performing worse on verbal memory and visual memory and
better on visual motor speed and reaction time. While these findings were
statistically significant the clinical relevance of these findings are unclear
since the differences between groups were small.
this study presents some interesting findings regarding athlete’s sleep
duration and performance on computerized
neurocognitive tests. As expected, the researchers’ data supported the concept
that athletes with restricted sleep the night prior to a computerized test
performed worse than those that did not. Clinicians should encourage their
athletes to get adequate sleep and may even be able to advise coaches and
support staff to organize team schedules in a way that will allow the athletes
to get enough sleep, but ultimately it is the athlete’s prerogative. Clinicians
may also wish to provide coaches and athletes with educational information
regarding the cognitive impact of sleep deprivation. If an athlete reports
severe sleep restriction, then the clinician could consider postponing baseline
testing until the athlete gets adequate sleep – although this may not be an
option after a concussion. It is important to keep in mind that sleep seemed to
have a small effect on test scores and the clinical relevance of this may be
minor. However, clinicians need to keep track of factors that influence test
scores because they may add up. A patient with a learning disability and poor
sleep may have a lower score than if they had just one factor. When using a
computerized neurocognitive test clinicians need to know their athletes’
demographic information, especially hours of sleep, and decide whether baseline
testing is appropriate and how these factors may influence test results after a
Questions for Discussion: Do you currently educate your athletes regarding sleep deprivation? Is sleep duration a factor
you have previously look at when assessing athletes’
neurocognitive test results?
Written by: Kyle Harris
Reviewed by:  Jeffrey Driban
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