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

Adam C. Raikes, Amy Athey, Pamela Alfonso-Miller, William Killgore, Michael A. Grandner

Research output: Contribution to journalArticle

1 Citation (Scopus)

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: 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.

Original languageEnglish (US)
Pages (from-to)66-74
Number of pages9
JournalSleep Medicine
Volume58
DOIs
StatePublished - Jun 1 2019

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Sleep Initiation and Maintenance Disorders
Sports
Sleep
Athletic Performance
Nutrition Surveys
Athletes
Logistic Models
Sleep Apnea Syndromes
Causality
History
Odds Ratio
Wounds and Injuries
Research

Keywords

  • College athletes
  • Daytime sleepiness
  • Insomnia severity index
  • Relative risk
  • Sleep quality
  • Sports-related concussion

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Insomnia and daytime sleepiness : risk factors for sports-related concussion. / Raikes, Adam C.; Athey, Amy; Alfonso-Miller, Pamela; Killgore, William; Grandner, Michael A.

In: Sleep Medicine, Vol. 58, 01.06.2019, p. 66-74.

Research output: Contribution to journalArticle

Raikes, Adam C. ; Athey, Amy ; Alfonso-Miller, Pamela ; Killgore, William ; Grandner, Michael A. / Insomnia and daytime sleepiness : risk factors for sports-related concussion. In: Sleep Medicine. 2019 ; Vol. 58. pp. 66-74.
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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: 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.",
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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.

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