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The Effects of Sleep Quality and Sleep Quantity on Concussion Baseline Assessment

Mihalik, Jason P. PhD*,†,‡; Lengas, Eric MA*; Register-Mihalik, Johna K. PhD§; Oyama, Sakiko PhD; Begalle, Rebecca L. MS; Guskiewicz, Kevin M. PhD*,†,‡

Clinical Journal of Sport Medicine: September 2013 - Volume 23 - Issue 5 - p 343–348
doi: 10.1097/JSM.0b013e318295a834
Original Research
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Objective: Proper concussion assessment is imperative for properly caring for athletes who sustain traumatic brain injuries. Decreased sleep quality and sleep quantity affect cognition and may threaten the validity of clinical measures often used as a part of the concussion assessment. The purpose of this study was to determine if sleep quality or sleep quantity affects performance on clinical measures of concussion.

Design: Prospective cohort design.

Setting: Clinical research center.

Participants: One hundred fifty-five college student-athletes (57 females, 98 males; age = 18.8 ± 0.8 years; mass = 78.4 ± 19.6 kg; height = 177.4 ± 12.3 cm).

Interventions: We performed preseason baseline testing by using a well-accepted and multifaceted protocol inclusive of neurocognition, balance performance, and symptom reporting. Information related to sleep quality and sleep quantity was also collected during preseason baseline testing.

Main Outcome Measures: The CNS Vital Signs battery (computerized neurocognitive test), Sensory Organization Test (computerized dynamic posturography), and a Graded Symptom Checklist (symptom evaluation) were used.

Results: Subjects with a low sleep quantity the night before baseline reported both a greater number of symptoms and higher total symptom severity score. No clinically significant effects for sleep quality were observed.

Conclusions: Sleep-deprived athletes reporting for baseline testing should be rescheduled for testing after a normal night's sleep.

*Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;

Curriculum in Human Movement Science and the Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;

Injury Prevention Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;

§Clinical Research Unit, Emergency Services Institute, WakeMed Health and Hospitals, Raleigh, North Carolina; and

Department of Health and Kinesiology, University of Texas at San Antonio, San Antonio, Texas.

Corresponding Author: Jason P. Mihalik, PhD, Department of Exercise and Sport Science, The University of North Carolina, 313 Woollen Gymnasium, Campus Box 8605, Chapel Hill, NC 27599-8605 (jmihalik@email.unc.edu).

The authors report no conflicts of interest.

Received August 09, 2012

Accepted March 21, 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.