Gao Burke, Dwivedi Shashank, Milewski Matthew D, Cruz Aristides I
Warren Alpert Medical School of Brown University.
Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA.
J Pediatr Orthop. 2019 May/Jun;39(5):e324-e333. doi: 10.1097/BPO.0000000000001306.
Although sleep has been identified as an important modifiable risk factor for injury, the effect of decreased sleep on sports injuries in adolescents is poorly studied. The objective of this study was to quantitatively and qualitatively review published literature to examine if a lack of sleep is associated with sports injuries in adolescents and to delineate the effects of chronic versus acute lack of sleep.
PubMed (includes MEDLINE) and EMBASE databases were systematically searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they reported statistics regarding the relationship between sleep and sports injury in adolescents aged 19 years or younger published between January 1, 1997 and December 21, 2017. From these included studies, the following information was extracted: bibliographic and demographic information, reported outcomes related to injury and sleep, and definitions of injury and decreased sleep. A random effects model was then created to quantify the odds of injury with decreased sleep in adolescents.
Of 907 identified articles, 7 met inclusion criteria. Five studies reported that adolescents who chronically slept poorly were at a significantly increased likelihood of experiencing a sports or musculoskeletal injury. Two studies reported on acute sleep behaviors. One reported a significant positive association between acutely poor sleep and injury, whereas the other study reported no significant association. In our random effects model, adolescents who chronically slept poorly were more likely to be injured than those who slept well (OR, 1.58; 95% CI, 1.05-2.37; P=0.03).
Chronic lack of sleep in adolescents is associated with greater risk of sports and musculoskeletal injuries. Current evidence cannot yet definitively determine the effect of acute lack of sleep on injury rates.
Level IV-systematic review of level II studies and one level IV study.
尽管睡眠已被确定为一个重要的可改变的损伤风险因素，但睡眠减少对青少年运动损伤的影响研究较少。本研究的目的是对已发表的文献进行定量和定性综述，以检验睡眠不足是否与青少年运动损伤相关，并描述慢性睡眠不足与急性睡眠不足的影响。
使用系统评价和Meta分析的首选报告项目（PRISMA）指南，对PubMed（包括MEDLINE）和EMBASE数据库进行系统检索。纳入1997年1月1日至2017年12月21日期间发表的、报告了19岁及以下青少年睡眠与运动损伤关系统计数据的研究。从这些纳入研究中，提取以下信息：文献和人口统计学信息、报告的与损伤和睡眠相关的结果，以及损伤和睡眠减少的定义。然后建立随机效应模型，以量化青少年睡眠减少时的损伤几率。
在907篇识别出的文章中，7篇符合纳入标准。5项研究报告称，长期睡眠不佳的青少年发生运动或肌肉骨骼损伤的可能性显著增加。2项研究报告了急性睡眠行为。一项报告称急性睡眠不佳与损伤之间存在显著正相关，而另一项研究报告无显著关联。在我们的随机效应模型中，长期睡眠不佳的青少年比睡眠良好的青少年更容易受伤（比值比，1.58；95%置信区间，1.05 - 2.37；P = 0.03）。
青少年慢性睡眠不足与运动和肌肉骨骼损伤的风险增加有关。目前的证据尚不能明确确定急性睡眠不足对损伤发生率的影响。
IV级——对II级研究和一项IV级研究的系统评价。
