Department of Kinesiology, Coastal Carolina University, Conway, South Carolina, USA.
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Am J Sports Med. 2020 Mar;48(4):991-999. doi: 10.1177/0363546520902701. Epub 2020 Feb 12.
Symptoms, cognition, balance, and other domains are commonly assessed at baseline testing as part of comprehensive preseason evaluations among collegiate student-athletes. Although approximately 27% of college students have at least 1 sleep disorder, researchers have yet to examine the role of a preexisting sleep disorder on preinjury baseline performance.
To compare athletes with and without a reported history of diagnosed sleep disorders on commonly used baseline concussion assessments.
Cross-sectional study; Level of evidence, 3.
A total of 666 National Collegiate Athletic Association student-athletes completed baseline measures including the Balance Error Scoring System (BESS), Brief Symptom Inventory-18 (BSI-18), Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Post-Concussion Symptom Scale (PCSS), Sport Concussion Assessment Tool-5th Edition (SCAT5), and Standardized Assessment of Concussion (SAC). There were 333 athletes with a history of diagnosed sleep disorders who were matched on age, sex, sport, and concussion history to 333 athletes with no history of diagnosed sleep disorders. Participants in both groups had a mean age of 19.89 ± 1.36 years and included 182 (54.7%) male athletes, and 126 (37.8%) reported a history of ≥1 concussions.
A series of 1-way analyses of covariance with Bonferroni corrections revealed significant group differences on the BESS (F = 8.88; < .01); BSI-18 somatization (F = 18.48; < .01), depression (F = 18.78; < .01), anxiety (F = 19.42; < .01), and global severity index (F = 27.18; < .01); PCSS (F = 29.42; < .01); SCAT5 symptom number (F = 28.79; < .01) and symptom severity (F = 31.74; < .01); and SAC (F = 4.36; = .037). Specifically, while the sleep disorder group did perform better on the BESS, they also reported higher symptoms on the BSI-18, PCSS, and SCAT5 and performed worse on the SAC. There were no group differences on ImPACT performance.
Collegiate student-athletes with diagnosed sleep disorders reported elevated affective and concussion symptoms at baseline that could affect the interpretation of postinjury impairments and symptoms. Based on the small effect sizes of our findings, however, the magnitude of these differences is of questionable clinical significance. Still, clinicians should consider diagnosed sleep disorders as reported during preparticipation sports physical examinations when interpreting baseline and postinjury concussion assessments.
在大学生运动员的综合季前评估中，症状、认知、平衡和其他领域通常在基线测试中进行评估。尽管约 27%的大学生至少有一种睡眠障碍，但研究人员尚未研究预先存在的睡眠障碍对受伤前基线表现的影响。
比较报告有或没有诊断性睡眠障碍史的运动员在常用的基线脑震荡评估中的表现。
横断面研究；证据水平，3 级。
共有 666 名美国大学生体育协会学生运动员完成了基线评估，包括平衡错误评分系统（BESS）、简明症状量表-18 项（BSI-18）、即刻脑震荡后评估和认知测试（ImPACT）、脑震荡后症状量表（PCSS）、运动脑震荡评估工具-第 5 版（SCAT5）和标准化脑震荡评估（SAC）。有 333 名有诊断性睡眠障碍史的运动员与 333 名无诊断性睡眠障碍史的运动员按年龄、性别、运动项目和脑震荡史进行匹配。两组参与者的平均年龄均为 19.89 ± 1.36 岁，包括 182 名（54.7%）男性运动员，126 名（37.8%）报告至少有 1 次脑震荡史。
一系列经 Bonferroni 校正的单因素协方差分析显示，BESS（F=8.88；<.01）、BSI-18 躯体化（F=18.48；<.01）、抑郁（F=18.78；<.01）、焦虑（F=19.42；<.01）和总体严重程度指数（F=27.18；<.01）、PCSS（F=29.42；<.01）、SCAT5 症状数（F=28.79；<.01）和症状严重程度（F=31.74；<.01）存在显著的组间差异；SAC（F=4.36；=.037）。具体而言，虽然睡眠障碍组在 BESS 上的表现更好，但他们在 BSI-18、PCSS 和 SCAT5 上的症状报告更高，在 SAC 上的表现更差。ImPACT 表现无组间差异。
有诊断性睡眠障碍的大学生运动员在基线时报告了更高的情感和脑震荡症状，这可能会影响对受伤后损伤和症状的解释。然而，基于我们发现的小效应量，这些差异的幅度存在临床意义的疑问。尽管如此，临床医生在解释基线和受伤后的脑震荡评估时，应考虑到参与运动前体检时报告的诊断性睡眠障碍。
