Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and.
UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania.
Clin J Sport Med. 2021 Nov 1;31(6):481-487. doi: 10.1097/JSM.0000000000000860.
Sleep dysfunction (SD) is associated with a high symptom burden and lower neurocognitive performance after concussion and on baseline testing without injury. However, few studies have compared concussed athletes and controls with and without SD on clinical outcomes.
To evaluate differences in clinical outcomes among both concussed athletes and matched controls with and without SD.
Retrospective cross-sectional study.
Participants aged 12 to 20 years were recruited from a concussion clinic (n = 50 patients) and research registry/flyers (n = 50 healthy age-/sex-matched controls). Participants were categorized by self-reported SD into one of 4 groups: sport-related concussion (SRC) + SD, SRC only, SD only, and controls.
Post-Concussion Symptom Scale (PCSS), Vestibular/Oculomotor Screening (VOMS), and neurocognitive testing (Immediate Postconcussion Assessment Cognitive Test).
Compared with the SRC only group, the SRC + SD group performed worse on all neurocognitive domains, had a higher total symptom score, and endorsed more symptoms on most VOMS items. In addition, the SRC + SD group was at an increased likelihood of having at least 1 abnormal VOMS item compared with SRC only group. The SRC only group had neurocognitive test scores and symptom reports statistically similar to the SD only group.
Sleep dysfunction after concussion is related to worse neurocognitive performance and higher concussion symptom reporting. This study extended findings to suggest vestibular symptomology is worse among athletes with SD after injury compared to injured athletes without SD. Similar performances on concussion assessments for the SRC only and SD only groups suggest SD may appear similar to clinical presentation of concussion, even at baseline in the absence of SRC.
睡眠障碍（SD）与脑震荡后症状负担高和神经认知表现下降有关，在没有受伤的基线测试中也是如此。然而，很少有研究比较过有和没有 SD 的脑震荡运动员和对照组在临床结果上的差异。
评估有和没有 SD 的脑震荡运动员和匹配对照组在临床结果上的差异。
回顾性的横断面研究。
从脑震荡诊所（n=50 名患者）和研究登记处/传单（n=50 名年龄/性别匹配的健康对照者）招募了年龄在 12 至 20 岁的参与者。参与者根据自我报告的 SD 分为以下 4 组之一：运动相关性脑震荡（SRC）+SD、SRC 仅有、SD 仅有和对照组。
脑震荡后症状量表（PCSS）、前庭/眼动筛查（VOMS）和神经认知测试（即刻脑震荡后认知评估测试）。
与 SRC 仅有组相比，SRC+SD 组在所有神经认知领域的表现都更差，总症状评分更高，在大多数 VOMS 项目上报告的症状更多。此外，与 SRC 仅有组相比，SRC+SD 组更有可能出现至少 1 项异常的 VOMS 项目。SRC 仅有组的神经认知测试分数和症状报告与 SD 仅有组统计学上相似。
脑震荡后出现睡眠障碍与神经认知表现更差和更高的脑震荡症状报告有关。本研究扩展了研究结果，表明与无 SD 的脑震荡运动员相比，有 SD 的运动员在受伤后前庭症状学更差。SRC 仅有组和 SD 仅有组在脑震荡评估上的表现相似，这表明即使在没有 SRC 的情况下，SD 也可能表现出与脑震荡相似的临床特征。
