Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia (Drs Stevens, Appleton, Prof Adams and Ms Bickley); Centre for Nutrition and Gastrointestinal Diseases, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia (Dr Stevens); School of Rehabilitation Sciences, University of Jordan, Amman, Jordan (Prof Alghwiri); School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia (Dr Rogers); Department of Neurosurgery, Northshore University Health System, Evanston, Illinois (Dr Plummer); Translational Neuropathology Laboratory, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia (Dr Plummer); Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa (Drs Grant and Holtzhausen); Department of Psychiatry, Alfred Health, Melbourne, Victoria, Australia (Dr Alvaro); Wakefield Sports and Exercise Medicine Clinic, Adelaide, South Australia, Australia (Dr Kennett); Respiratory and Sleep Service, Southern Adelaide Local Health Network, Bedford Park, South Australia, Australia (Prof Adams); and Sports Medicine Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar (Dr Holtzhausen).
J Head Trauma Rehabil. 2022;37(3):E206-E219. doi: 10.1097/HTR.0000000000000701. Epub 2021 Jun 15.
A single, severe traumatic brain injury can result in chronic sleep disturbances that can persist several years after the incident. In contrast, it is unclear whether there are sleep disturbances after a sports-related concussion (SRC). Considering growing evidence of links between sleep disturbance and neurodegeneration, this review examined the potential links between diagnosed SRCs and sleep disturbances to provide guidance for future studies.
The scoping review undertook a systematic search of key online databases (Scopus, MEDLINE, SportDiscus, and Web of Science) using predetermined search terms for any articles that examined sleep after concussion. A screening criterion using agreed inclusion and exclusion criteria was utilized to ensure inclusion of relevant articles.
This scoping review is guided by the PRSIMA Scoping Review report.
Ten studies met the inclusion criteria, reporting on 896 adults who had experienced an SRC. Comparison with 1327 non-SRC adults occurred in 8 studies. Nine studies subjectively examined sleep, of which all but one study reported sleep disturbances after an SRC. Three studies objectively measured sleep, with 2 studies indicating large coefficients of variation of sleep duration, suggesting a range of sleep responses after an SRC. The only study to examine overnight polysomnography showed no differences in sleep metrics between those with and without an SRC. No studies examined interventions to improve sleep outcomes in people with concussion.
This scoping review indicates preliminary evidence of sleep disturbances following an SRC. The heterogeneity of methodology used in the included studies makes consensus on the results difficult. Given the mediating role of sleep in neurodegenerative disorders, further research is needed to identify physiological correlates and pathological mechanisms of sleep disturbances in SRC-related neurodegeneration and whether interventions for sleep problems improve recovery from concussion and reduce the risk of SRC-related neurodegeneration.
单次严重创伤性脑损伤可导致慢性睡眠障碍，这种障碍在事件发生后可持续数年。相比之下，目前尚不清楚运动相关性脑震荡（SRC）后是否存在睡眠障碍。鉴于睡眠障碍与神经退行性变之间关联的证据不断增加，本综述检查了确诊的 SRC 与睡眠障碍之间的潜在关联，为未来的研究提供指导。
本范围综述采用系统搜索方法，在 Scopus、MEDLINE、SportDiscus 和 Web of Science 等主要在线数据库中使用预定的搜索词，以查找任何检查脑震荡后睡眠的文章。采用既定的纳入和排除标准进行筛选标准，以确保纳入相关文章。
本范围综述遵循 PRSIMA 范围综述报告。
符合纳入标准的有 10 项研究，共报告了 896 名成年人经历过 SRC。8 项研究将 SRC 组与 1327 名非 SRC 成年人进行了比较。9 项研究主观检查了睡眠，除了一项研究外，所有研究均报告 SRC 后存在睡眠障碍。3 项研究客观测量了睡眠，其中 2 项研究表明睡眠持续时间的变异系数较大，提示 SRC 后存在一系列睡眠反应。唯一一项检查整夜多导睡眠图的研究显示，SRC 组与非 SRC 组的睡眠指标无差异。没有研究检查改善脑震荡患者睡眠结果的干预措施。
本范围综述表明 SRC 后存在初步的睡眠障碍证据。纳入研究中使用的方法学的异质性使得对结果达成共识变得困难。鉴于睡眠在神经退行性疾病中的中介作用，需要进一步研究以确定 SRC 相关神经退行性变中睡眠障碍的生理相关性和病理机制，以及针对睡眠问题的干预措施是否改善脑震荡恢复并降低 SRC 相关神经退行性变的风险。
