Social, Cognitive, and Affective Neuroscience (SCAN) Lab, University of Arizona, Tucson, AZ, United States.
Department of Athletics, University of Arizona, Tucson, AZ, United States.
Sleep Med. 2019 Jun;58:66-74. doi: 10.1016/j.sleep.2019.03.008. Epub 2019 Mar 25.
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.
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.
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.
目的/背景：睡眠质量差和睡眠不足与运动表现的认知、运动和行为能力下降以及受伤风险增加有关。虽然先前的研究确定与运动相关的脑震荡是睡眠不佳的诱发因素，但睡眠作为运动相关脑震荡风险因素的作用尚不清楚。本研究的目的是量化睡眠质量差和失眠症状对未来运动相关脑震荡风险的影响。
患者/方法：在这项研究中，190 名 NCAA 一级联赛运动员完成了一份调查问卷，包括失眠严重程度指数（ISI）和国家健康和营养检查调查（NHANES）睡眠模块。使用 ISI 和 NHANES 嗜睡评分作为独立预测因子，计算未来运动相关脑震荡的单变量风险比。一个额外的多变量逻辑回归模型包括运动、与运动相关的脑震荡史和显著的单变量预测因子，共同评估脑震荡的可能性。
临床中度至重度失眠严重程度（RR=3.13，95%CI：1.320-7.424，p=0.015）和每月两次或更多次白天嗜睡（RR=2.856，95%CI：0.681-11.977，p=0.037）增加了脑震荡风险。这些变量在调整运动参与的多变量模型中仍然显著且具有可比性。
失眠和白天嗜睡与运动相关脑震荡风险增加独立相关。更全面地识别脑震荡和睡眠之间的双向关系需要进一步研究。临床医生和运动员应该意识到这种关系，并采取积极措施，包括评估和治疗睡眠障碍、限制失眠风险因素、改善睡眠卫生和制定白天嗜睡管理策略，以降低运动相关脑震荡风险并支持整体运动表现。
