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Sleep Deprived or Concussed? The Acute Impact of Self-Reported Insufficient Sleep in College Athletes

Published online by Cambridge University Press:  09 July 2020

Kaitlin E. Riegler*
Affiliation:
Department of Psychology, The Pennsylvania State University, University Park, PA16802, USA
Erin T. Guty
Affiliation:
Department of Psychology, The Pennsylvania State University, University Park, PA16802, USA
Garrett A. Thomas
Affiliation:
Department of Psychology, The Pennsylvania State University, University Park, PA16802, USA
Peter A. Arnett
Affiliation:
Department of Psychology, The Pennsylvania State University, University Park, PA16802, USA
*
*Correspondence and reprint requests to: Kaitlin Riegler, 372 Moore Building, The Pennsylvania State University, University Park, PA16802, USA. E-mail: [email protected]

Abstract

Objective:

Sleep deprivation is common among both college students and athletes and has been correlated with negative health outcomes, including worse cognition. As such, the current study sought to examine the relationship between sleep difficulties and self-reported symptoms and objective neuropsychological performance at baseline and post-concussion in collegiate athletes.

Method:

Seven hundred seventy-two collegiate athletes completed a comprehensive neuropsychological test battery at baseline and/or post-concussion. Athletes were separated into two groups based on the amount of sleep the night prior to testing. The sleep duration cutoffs for these group were empirically determined by sample mean and standard deviation (M = 7.07, SD = 1.29).

Results:

Compared with athletes getting sufficient sleep, those getting insufficient sleep the night prior to baseline reported significantly more overall symptoms and more symptoms from each of the five symptom clusters of the Post-Concussion Symptom Scale. However, there were no significant differences on objective performance indices. Secondly, there were no significant differences on any of the outcome measures, except for sleep symptoms and headache, between athletes getting insufficient sleep at baseline and those getting sufficient sleep post-concussion.

Conclusion:

Overall, the effect of insufficient sleep at baseline can make an athlete appear similar to a concussed athlete with sufficient sleep. As such, athletes completing a baseline assessment following insufficient sleep could be underperforming cognitively and reporting elevated symptoms that would skew post-concussion comparisons. Therefore, there may need to be consideration of prior night’s sleep when determining whether a baseline can be used as a valid comparison.

Type
Regular Research
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

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References

REFERENCES

American College Health Association. (2015). NCHA-ACHA II Spring 2015 Reference Group Data Report. Retrieved from http://www.acha-ncha.org/docs/NCHA-IIWEB_SPRING_2015_REFERENCE_GROUP_DATA_REPORT.pdf (accessed October 22, 2019)Google Scholar
Baglioni, C., Nanovska, S., Regen, W., Spiegelhalder, K., Feige, B., Nissen, C., … Riemann, D. (2016). Sleep and mental disorders: a meta-analysis of polysomnographic research. Psychological Bulletin, 142(9), 969990. doi: 10.1037/bul0000053 CrossRefGoogle ScholarPubMed
Bailey, C.M., Barth, J.T., & Bender, S.D. (2009). SLAM on the stand: how the sports-related concussion literature can inform the expert witness. The Journal of Head Trauma Rehabilitation, 24(2), 123130. doi: 10.1097/HTR.0b013e31819c1caa CrossRefGoogle ScholarPubMed
Beebe, D.W. (2011). Cognitive, behavioral, and functional consequences of inadequate sleep in children and adolescents. Pediatric Clinics of North America, 58(3), 649665. doi: 10.1016/j.pcl.2011.03.002 CrossRefGoogle ScholarPubMed
Belanger, H.G., & Vanderploeg, R.D. (2005). The neuropsychological impact of sports-related concussion: a meta-analysis. Journal of the International Neuropsychological Society, 11(4), 345357. doi: 10.1017/S1355617705050411 CrossRefGoogle ScholarPubMed
Benca, R.M., William, H., Thisted, R.A., & Gillin, J.C. (1992). Sleep and psychiatric disorders: a meta-analysis. Archives of General Psychiatry, 49, 651668.CrossRefGoogle ScholarPubMed
Benedict, R.H.B. (1997). Brief Visuospatial Memory Test-Revised: Professional Manual. Odessa, FL: Psychological Assessment Resource. Google Scholar
Brandt, J., & Benedict, R.H.B. (2001). Hopkins Verbal Learning Test-Revised (HVLT-R). Odessa, FL: Psychological Assessment Resources.Google Scholar
Broglio, S.P., & Puetz, T.W. (2008). The effect of sport concussion on neurocognitive function, self-report symptoms and postural control: a meta-analysis. Sports Medicine, 38(1), 5367. doi: 10.2165/00007256-200838010-00005 CrossRefGoogle ScholarPubMed
Bubu, O.M., Brannick, M., Mortimer, J., Umasabor-bubu, O., Sebastião, Y.V, Wen, Y., … Anderson, W.M. (2017). Sleep, cognitive impairment, and Alzheimer’s disease: a systematic review and meta-analysis. Sleep, 40(1), 118.CrossRefGoogle ScholarPubMed
Bucks, R.S., Olaithe, M., & Eastwood, P. (2013). Neurocognitive function in obstructive sleep apnoea: a meta-review. Respirology, 18(1), 6170. doi: 10.1111/j.1440-1843.2012.02255.x CrossRefGoogle ScholarPubMed
Buysse, D.J., Iii, C.F.R., Monk, T.H., Hoch, C.C., Yeager, A.L., & Kupfer, D.J. (1991). Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep, 14, 331338. doi: 10.1093/sleep/14.4.331 Google Scholar
Cegalis, J.A., & Cegalis, S. (1994). The Vigil/W Continuous Performance Test (manual). New York, NY: The Psychological Corporation.Google Scholar
Dosi, C., Figura, M., Ferri, R., & Bruni, O. (2015). Sleep and headache. Seminars in Pediatric Neurology, 22, 105112. doi: 10.1016/B978-0-12-804074-4.00011-X CrossRefGoogle ScholarPubMed
Driller, M.W., Mah, C.D., & Halson, S.L. (2018). Development of the athlete sleep behavior questionnaire: a tool for identifying maladaptive sleep practices in elite athletes. Sleep Science, 11(1), 3744. doi: 10.5935/1984-0063.20180009 CrossRefGoogle ScholarPubMed
Echemendia, R., & Julian, L.J. (2001). Mild traumatic brain injury in sports: neuropsychology’s contribution to a developing field. Neuropsychology Review, 11(2), 6988.CrossRefGoogle ScholarPubMed
Girschik, J., Fritschi, L., Heyworth, J., & Waters, F. (2012). Validation of self-reported sleep against actigraphy. Journal of Epidemiology, 22(5), 462468. doi: 10.2188/jea.JE20120012 CrossRefGoogle ScholarPubMed
Gosselin, N., Lassonde, M., Petit, D., Leclerc, S., Mongrain, V., Collie, A., & Montplaisir, J. (2008). Sleep following sport-related concussions. Sleep Medicine, 10(1), 3546. doi: 10.1016/j.sleep.2007.11.023 CrossRefGoogle ScholarPubMed
Grindel, S.H., Lovell, M.R., & Collins, M.W. (2001). The assessment of sport-related concussion: the evidence behind neuropsychological testing and management. Clinical Journal of Sport Medicine, 11(3), 134143. doi: 10.1097/00042752-200107000-00003 CrossRefGoogle ScholarPubMed
Hootman, J.M., Dick, R., & Agel, J. (2007). Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. Journal of Athletic Training, 42(2), 311319. doi: 10.1111/j.1600-0838.2006.00528.x Google ScholarPubMed
Iverson, G.L. (2007). Predicting slow recovery from sport-related concussion: the new simple-complex distinction. Clinical Journal of Sport Medicine, 17(1), 3137.Google ScholarPubMed
Iverson, G.L., Gardner, A.J., Terry, D.P., Ponsford, J.L., Sills, A.K., Broshek, D.K., & Solomon, G.S. (2017). Predictors of clinical recovery from concussion: a systematic review. British Journal of Sports Medicine, 51(12), 941948. doi: 10.1136/bjsports-2017-097729 CrossRefGoogle ScholarPubMed
Iverson, G.L., Silverberg, N.D., Mannix, R., Maxwell, B.A., Atkins, J.E., Zafonte, R., & Berkner, P.D. (2015a). Factors associated with concussion-like symptom reporting in high school athletes. Journal of the American Medical Association Pediatrics, 169(12), 11321140. doi: 10.1001/jamapediatrics.2015.2374 Google ScholarPubMed
Iverson, G.L., Silverberg, N.D., Mannix, R., Maxwell, B.A., Atkins, J.E., Zafonte, R., & Berkner, P.D. (2015b). Factors associated with concussion-like symptom reporting in high school athletes. JAMA Pediatrics, 169(12), 11321140. doi: 10.1001/jamapediatrics.2015.2374 CrossRefGoogle ScholarPubMed
Kontos, A.P., Elbin, R.J., Schatz, P., Covassin, T., Henry, L., Henry, L., Pardini, J., & Collins, M.W. (2012). A Revised Factor Structure for the Post-Concussion Symptom Scale: Baseline and Postconcussion Factors. The American Journal of Sports Medicine, 40(10), 23752384. doi: 10.1177/0363546512455400 CrossRefGoogle ScholarPubMed
Kostyun, R.O., Milewski, M.D., & Hafeez, I. (2015). Sleep disturbance and neurocognitive function during the recovery from a sport-related concussion in adolescents. American Journal of Sports Medicine, 43(3), 633640. doi: 10.1177/0363546514560727 CrossRefGoogle ScholarPubMed
Lim, J., & Dinges, D.F. (2012). A meta-analysis of the impact of short-term sleep deprivation on cognitive variables. Psychological Bulletin, 136(3), 375389. doi: 10.1037/a0018883.A CrossRefGoogle Scholar
Lo, J.C., Groeger, J.A., Cheng, G.H., Dijk, D.J., & Chee, M.W.L. (2016). Self-reported sleep duration and cognitive performance in older adults: a systematic review and meta-analysis. Sleep Medicine, 17, 8798. doi: 10.1016/j.sleep.2015.08.021 CrossRefGoogle ScholarPubMed
Lovell, M.R., Collins, M.W., Podell, K., Powell, J., & Maroon, J.C. (2000). ImPACT: Immediate Post-Concussion Assessment and Cognitive Testing. Pittsburgh, PA: NeroHealth Systems, LLC.Google Scholar
Makdissi, M., Davis, G., Jordan, B., Patricios, J., Purcell, L., & Putukian, M. (2013). Revisiting the modifiers: how should the evaluation and management of acute concussions differ in specific groups? British Journal of Sports Medicine, 47(5), 314320. doi: 10.1136/bjsports-2013-092256 CrossRefGoogle ScholarPubMed
Mastin, D.F., Bryson, J., & Corwyn, R. (2006). Assessment of sleep hygiene using the sleep hygiene index. Journal of Behavioral Medicine, 29(3), 223227. doi: 10.1007/s10865-006-9047-6 CrossRefGoogle ScholarPubMed
McClure, D.J., Zuckerman, S.L., Kutscher, S.J., Gregory, A.J., & Solomon, G.S. (2013). Baseline neurocognitive testing in sports-related concussions. The American Journal of Sports Medicine, 42(2), 472478. doi: 10.1177/0363546513510389 CrossRefGoogle ScholarPubMed
McCrory, P., Meeuwisse, W., Dvorak, J., Aubry, M., Bailes, J., Broglio, S., … Vos, P. E. (2017). Consensus statement on concussion in sport – the 5th international conference on concussion in sport. British Journal of Sports Medicine. Retrieved from http://bjsm.bmj.com/content/early/2017/04/26/bjsports-2017-097699.abstract Google Scholar
Merritt, V.C., Meyer, J.E., & Arnett, P.A. (2015). A novel approach to classifying postconcussion symptoms: the application of a new framework to the post-concussion symptom scale. Journal of Clinical and Experimental Neuropsychology, 37(7), 764775. doi: 10.1080/13803395.2015.1060950 CrossRefGoogle ScholarPubMed
Merritt, V.C., Meyer, J.E., Cadden, M.H., Roman, C.A.F., Ukueberuwa, D.M., Shapiro, M.D., & Arnett, P.A. (2016). Normative data for a comprehensive neuropsychological test battery used in the assessment of sports-related concussion. Archives of Clinical Neuropsychology, 32, 168183. doi: 10.1093/arclin/acw090 Google Scholar
Merritt, V.C., Rabinowitz, A.R., & Arnett, P.A. (2015). Injury-related predictors of symptom severity following sports-related concussion. Journal of Clinical and Experimental Neuropsychology, 37(3), 265275. doi: 10.1080/13803395.2015.1004303 CrossRefGoogle ScholarPubMed
Mihalik, J.P., Lengas, E., Register-Mihalik, J.K., Oyama, S., Begalle, R.L., & Guskiewicz, K.M. (2013). The effects of sleep quality and sleep quantity on concussion baseline assessment. Clinical Journal of Sport Medicine, 23(5), 343348. doi: 10.1097/JSM.0b013e318295a834 CrossRefGoogle ScholarPubMed
Mild Traumatic Brain Injury Committee. (1993). Definition of mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 8, 8687. doi: 10.1097/00001199-199309000-00010 CrossRefGoogle Scholar
O’Brien, L.M. (2011). The neurocognitive effects of sleep disruption in children and adolescents. Sleep Medicine Clinics, 6(1), 109116. doi: 10.1016/j.jsmc.2010.12.007 CrossRefGoogle Scholar
Parsons, J.T. (2014a). 2014–2015 NCAA sports medicine handbook. In The National Collegiate Athletic Associations. Indianapolis, IN. doi: 10.1136/bmj.319.7224.1582 CrossRefGoogle Scholar
Parsons, J.T. (2014b). Guideline 21 sport-related concussion. In 2014–2015 NCAA sports medicine handbook, (pp. 5664). Indianapolis, IN: The National Collegiate Athletic Association.Google Scholar
Putukian, M., Riegler, K., Amalfe, S., Bruce, J., & Echemendia, R. (2018). Preinjury and postinjury factors that predict sports-related concussion and clinical recovery time. Clinical Journal of Sport Medicine, 1. doi: 10.1097/JSM.0000000000000705 Google Scholar
Reynolds, C.R. (2002). Comprehensive Trail Making Test (CTMT). Austin, TX: Pro-Ed.Google Scholar
Riegler, K.E., Guty, E.T., & Arnett, P.A. (2019). Neuropsychological test performance in depressed and nondepressed collegiate athletes following concussion. Neuropsychology, 34(1), 6376. doi: 10.1037/neu0000582 CrossRefGoogle ScholarPubMed
Riemann, D. & Perlis, M.L. (2009). The treatments of chronic insomnia: a review of benzodiazepine receptor agonists and psychological and behavioral therapies. Sleep Medicine Reviews, 13(3), 205214. doi: 10.1016/j.smrv.2008.06.001 CrossRefGoogle ScholarPubMed
Ruff, R.M., Iverson, G.L., Barth, J.T., Bush, S.S., & Broshek, D.K. (2009). Recommendations for diagnosing a mild traumatic brain injury. Archives of Clinical Neuropsychology, 24(1), 310. doi: 10.1093/arclin/acp006 CrossRefGoogle ScholarPubMed
Silva, G.E., Goodwin, J.L., Sherrill, D.L., Arnold, J.L., Bootzin, R.R., Smith, T., … Quan, S.F. (2007). Relationship between reported and measured sleep times: the Sleep Heart Health Study (SHHS). Journal of Clinical Sleep Medicine, 3(6), 622630. doi: 10.5664/jcsm.26974 CrossRefGoogle Scholar
Silverberg, N.D., Berkner, P.D., Atkins, J.E., Zafonte, R., & Iverson, G.L. (2016). Relationship between short sleep duration and preseason concussion testing. Clinical Journal of Sport Medicine, 26(3), 226231. doi: 10.1097/JSM.0000000000000241 CrossRefGoogle ScholarPubMed
Smith, A. (1991). Symbol Digit Modalities Test. Los Angeles, CA: Western Psychological Services.Google Scholar
Stocker, R.P.J., Khan, H., Henry, L., & Germain, A. (2017). Effects of sleep loss on subjective complaints and objective neurocognitive performance as measured by the immediate post-concussion assessment and cognitive testing. Archives of Clinical Neuropsychology, 32(3), 349368. doi: 10.1093/arclin/acx003 Google ScholarPubMed
Taheri, M. & Arabameri, E. (2012). The effect of sleep deprivation on choice reaction time and anaerobic power of college student athletes. Asian Journal of Sports Medicine, 3(1), 1520. doi: 10.5812/asjsm.34719 CrossRefGoogle ScholarPubMed
Trenerry, M.R., Crosson, B., DeBoe, J., & Leber, W.R. (1989). Stroop Neuropsychological Screening Test. Odessa, FL: Psychological Assessment Resource.Google Scholar
Vaessen, T.J.A., Overeem, S., & Sitskoorn, M.M. (2015). Cognitive complaints in obstructive sleep apnea. Sleep Medicine Reviews, 19, 5158. doi: 10.1016/j.smrv.2014.03.008 CrossRefGoogle ScholarPubMed
Valovich McLeod, T.C., Fraser, M.A., & Johnson, R.S. (2017). Mental health outcomes following sport-related concussion. Athletic Training & Sports Health Care, 9(6), 271282. doi: 10.3928/19425864-20171010-03 CrossRefGoogle Scholar
Van Dongen, H.P.A, Maislin, G., Mullington, J.M., & Dinges, D.F. (2003). The cumulative cost of additional wakefulness: Dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep, 26(2), 117126. doi: 10.1093/sleep/26.2.117 CrossRefGoogle ScholarPubMed
Weschler, D. (1997). Weschler Adult Intelligence Scale-III. New York, NY: Psychological Corporation.Google Scholar