Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-23T13:21:53.423Z Has data issue: false hasContentIssue false
  • English
  • Français

The Impact of Sleep on the Relationship between Soccer Heading Exposure and Neuropsychological Function in College-Age Soccer Players

Published online by Cambridge University Press:  26 February 2020

Cara F. Levitch Open the ORCID record for Cara F. Levitch [Opens in a new window] ,
Eric McConathey ,
Maral Aghvinian ,
Mark Himmelstein ,
Michael L. Lipton  and
Molly E. Zimmerman
Cara F. Levitch*
Affiliation:
Department of Psychology, Fordham University, Bronx, NY, USA
Eric McConathey
Affiliation:
Department of Psychology, Fordham University, Bronx, NY, USA
Maral Aghvinian
Affiliation:
Department of Psychology, Fordham University, Bronx, NY, USA
Mark Himmelstein
Affiliation:
Department of Psychology, Fordham University, Bronx, NY, USA
Michael L. Lipton
Affiliation:
The Gruss Magnetic Resonance Research Center, Bronx, NY, USA Departments of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA Psychiatry & Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA The Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
Molly E. Zimmerman
Affiliation:
Department of Psychology, Fordham University, Bronx, NY, USA
*
*Correspondence and reprint requests to: Cara F. Levitch, MA, Department of Psychology, Fordham University, 441 East Fordham Road, Dealy 226, Bronx, NY10458. Tel: 718-817-3835; Fax: 718-817-3785. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Soccer is the most popular sport worldwide and is the only sport where athletes purposely use their head to deflect the ball during play, termed “heading” the ball. These repetitive head impacts (RHI) are associated with worse neuropsychological function; however, factors that can increase risk of injury following exposure to such head impacts have been largely unexamined. The present study provided a novel examination of the modifying role of sleep on the relationship between RHI exposure and neuropsychological function in college-age soccer players.

Methods:

Fifty varsity and intramural college soccer players completed questionnaires assessing recent and long-term heading exposure, a self-report measure of sleep function, and a battery of neuropsychological tests.

Results:

A high level of recent heading exposure was significantly associated with poorer processing speed, independent of concussion history. With reduced sleep duration, a high level of recent heading exposure was related to worse sustained attention. However, with greater hours of sleep duration, heading exposure was related to preserved neuropsychological outcome in sustained attention.

Conclusions:

We replicated our earlier finding of an association between recent head impact exposure and worse processing speed in an independent sample. In addition, we found that sleep may serve as a risk or protective factor for soccer players following extensive exposure to head impacts. Ultimately, this study furthers the understanding of factors impacting neuropsychological function in soccer players and provides empirical support for sleep interventions to help ensure safer soccer play and recovery from injury.

Keywords

Brain injuriesSleepRisk factorsSoccerCognitionRepetitive head impacts
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 26 , Issue 7 , August 2020 , pp. 633 - 644
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Archer, T., Ricci, S., Massoni, F., Ricci, L., & Rapp-Ricciardi, M. (2016). Cognitive benefits of exercise intervention. La Clinica Terapeutica, 167(6), e180–e185. doi: 10.7417/CT.2016.1965Google ScholarPubMed
Beck, A.T., Epstein, N., Brown, G., & Steer, R.A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897.CrossRefGoogle ScholarPubMed
Beck, A.T., Steer, R.A., & Brown, G.K. (1996). Beck Depression Inventory-II. San Antonio, 78(2), 490–498.Google Scholar
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), 345–357. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16209414CrossRefGoogle ScholarPubMed
Belanger, H.G., Vanderploeg, R.D., & McAllister, T. (2016). Subconcussive blows to the head: A formative review of short-term clinical outcomes. The Journal of Head Trauma Rehabilitation, 31(3), 159–166. doi: 10.1097/htr.0000000000000138CrossRefGoogle ScholarPubMed
Belenky, G., Wesensten, N. J., Thorne, D. R., Thomas, M. L., Sing, H. C., Redmond, D. P., Russo, M.B., & Balkin, T. J. (2003). Patterns of performance degradation and restoration during sleep restriction and subsequent recovery: A sleep dose-response study. Journal of Sleep Research, 12(1), 1–12. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12603781CrossRefGoogle ScholarPubMed
Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society., Series B, 57(1), 289–300.Google Scholar
Bloomfield, I. L., Espie, C. A., & Evans, J. J. (2010). Do sleep difficulties exacerbate deficits in sustained attention following traumatic brain injury? Journal of the International Neuropsychological Society, 16(1), 17–25. doi: 10.1017/S1355617709990798CrossRefGoogle ScholarPubMed
Brown, F.C., Buboltz, W.C. Jr., & Soper, B. (2002). Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. Behavioral Medicine, 28(1), 33–38.CrossRefGoogle ScholarPubMed
Buysse, D.J., Reynolds, C.F., Monk, T.H., Berman, S.R., & Kupfer, D.J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/2748771CrossRefGoogle ScholarPubMed
Carpenter, J.S., & Andrykowski, M.A. (1998). Psychometric evaluation of the Pittsburgh Sleep Quality Index. Journal of Psychosomatic Research, 45(1), 5–13. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/9720850CrossRefGoogle ScholarPubMed
Catenaccio, E., Caccese, J., Wakschlag, N., Fleysher, R., Kim, N., Kim, M., Buckley, T.A., Stewart, W.F., Lipton, R.B., Kaminski, T., & Lipton, M.L. (2016). Validation and calibration of HeadCount, a self-report measure for quantifying heading exposure in soccer players. Research in Sports Medicine, 24(4):416–425.CrossRefGoogle ScholarPubMed
Chan, L.G., & Feinstein, A. (2015). Persistent sleep disturbances independently predict poorer functional and social outcomes 1 year after mild Traumatic Brain Injury. The Journal of Head Trauma Rehabilitation, 30(6), E67–E75. doi: 10.1097/HTR.0000000000000119CrossRefGoogle ScholarPubMed
Dalmasso, C., Broet, P., & Moreau, T. (2005). A simple procedure for estimating the false discovery rate. Bioinformatics, 21(5), 660–668. doi: 10.1093/bioinformatics/bti063CrossRefGoogle ScholarPubMed
Delis, D.C., Kramer, J.H., Kaplan, E., & Holdnack, J. (2004). Reliability and validity of the Delis-Kaplan Executive Function System: An update. Journal of the International Neuropsychological Society, 10(2), 301–303. doi: 10.1017/S1355617704102191CrossRefGoogle ScholarPubMed
Di Virgilio, T.G., Hunter, A., Wilson, L., Stewart, W., Goodall, S., Howatson, G., Donaldson, D.I., & Ietswaart, M. (2016). Evidence for acute electrophysiological and cognitive changes following routine soccer heading. EBioMedicine, 13, 66–71. doi: 10.1016/j.ebiom.2016.10.029CrossRefGoogle ScholarPubMed
Dinges, D.F., & Powell, J.W. (1985). Microcomputer analyses of performance on a portable, simple visual RT task during sustained operations. Behavior Research Methods, Instruments, & Computers, 17(6), 652–655.CrossRefGoogle Scholar
Downs, D.S., & Abwender, D. (2002). Neuropsychological impairment in soccer athletes. The Journal of Sports Medicine and Physical Fitness, 42(1), 103–107. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11832883Google ScholarPubMed
Eime, R.M., Young, J.A., Harvey, J.T., Charity, M.J., & Payne, W.R. (2013). A systematic review of the psychological and social benefits of participation in sport for adults: Informing development of a conceptual model of health through sport. International Journal of Behavioral Nutrition and Physical Activity, 10(135), 1–14. doi: 10.1186/1479-5868-10-135Google ScholarPubMed
FIFA. (2007). FIFA Big Count 2006. Retrieved from www.fifa.com: http://resources.fifa.com/mm/document/fifafacts/bcoffsurv/bigcount.statspackage_7024.pdfGoogle Scholar
Fullagar, H.H., Skorski, S., Duffield, R., Hammes, D., Coutts, A.J., & Meyer, T. (2015). Sleep and athletic performance: The effects of sleep loss on exercise performance, and physiological and cognitive responses to exercise. Sports Medicine, 45(2), 161–186. doi: 10.1007/s40279-014-0260-0CrossRefGoogle Scholar
Glickman, M.E., Rao, S.R., & Schultz, M.R. (2014). False discovery rate control is a recommended alternative to Bonferroni-type adjustments in health studies. Journal of Clinical Epidemiology, 67(8), 850–857. doi: 10.1016/j.jclinepi.2014.03.012CrossRefGoogle ScholarPubMed
Janssen, I., & Leblanc, A.G. (2010). Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity, 7(40), 1–16. doi: 10.1186/1479-5868-7-40CrossRefGoogle ScholarPubMed
Koerte, I.K., Ertl-Wagner, B., Reiser, M., Zafonte, R., & Shenton, M.E. (2012). White matter integrity in the brains of professional soccer players without a symptomatic concussion. Journal of the American Medical Association, 308(18), 1859–1861. doi: 10.1001/jama.2012.13735CrossRefGoogle ScholarPubMed
Levitch, C.F., Zimmerman, M.E., Lubin, N., Kim, N., Lipton, R.B., Stewart, W.F., Kim, M., & Lipton, M.L. (2018). Recent and long-term soccer heading exposure Is differentially associated with neuropsychological function in amateur players. Journal of the International Neuropsychological Society, 24, 147–155. doi: 10.1017/S1355617717000790CrossRefGoogle ScholarPubMed
Lim, J. & Dinges, D.F. (2010). A meta-analysis of the impact of short-term sleep deprivation on cognitive variables. Psychological Bulletin, 136(3), 375–389. doi: 10.1037/a0018883CrossRefGoogle ScholarPubMed
Lipton, M.L., Ifrah, C., Stewart, W.F., Fleysher, R., Sliwinski, M.J., Kim, M., & Lipton, R.B. (2017). Validation of HeadCount-2w for estimation of two-week heading: Comparison to daily reporting in adult amateur player. Journal of Science and Medicine in Sport, 21(4):363–367. doi: 10.1016/j.jsams.2017.08.008CrossRefGoogle ScholarPubMed
Lipton, M.L., Kim, N., Zimmerman, M.E., Kim, M., Stewart, W.F., Branch, C.A., & Lipton, R.B. (2013). Soccer heading is associated with white matter microstructural and cognitive abnormalities. Radiology, 268(3), 850–857. doi: 10.1148/radiol.13130545CrossRefGoogle ScholarPubMed
Luke, A., Lazaro, R.M., Bergeron, M.F., Keyser, L., Benjamin, H., Brenner, J., d’Hemecourt, P., Grady, M., Philpott, J., & Smith, A. (2011). Sports-related injuries in youth athletes: Is overscheduling a risk factor? Clinical Journal of Sport Medicine : Official Journal of The Canadian Academy of Sport Medicine, 21(4), 307–314. doi: 10.1097/JSM.0b013e3182218f71CrossRefGoogle ScholarPubMed
Mah, C.D., Mah, K.E., Kezirian, E.J., & Dement, W.C. (2011). The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep, 34(7), 943–950. doi: 10.5665/SLEEP.1132CrossRefGoogle ScholarPubMed
Mahmood, O., Rapport, L.J., Hanks, R.A., & Fichtenberg, N.L. (2004). Neuropsychological performance and sleep disturbance following traumatic brain injury. The Journal of Head Trauma Rehabilitation, 19(5), 378–390. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15597029CrossRefGoogle ScholarPubMed
Maruff, P., Thomas, E., Cysique, L., Brew, B., Collie, A., Snyder, P., & Pietrzak, R. H. (2009). Validity of the Cogstate brief battery: Relationship to standardized tests and sensitivity to cognitive impairment in mild traumatic brain injury, schizophrenia, and AIDS dementia complex. Archives of Clinical Neuropsychology, 24(2), 165–178. doi: 10.1093/arclin/acp010CrossRefGoogle ScholarPubMed
Matser, J.T., Kessels, A.G., Jordan, B.D., Lezak, M.D., & Troost, J. (1998). Chronic traumatic brain injury in professional soccer players. Neurology, 51(3), 791–796.CrossRefGoogle ScholarPubMed
Matser, J.T., Kessels, A.G., Lezak, M.D., Jordan, B.D., & Troost, J. (1999). Neuropsychological impairment in amateur soccer players. Journal of the American Medical Association, 282(10), 971–973. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10485683CrossRefGoogle ScholarPubMed
Matser, J.T., Kessels, A.G., Lezak, M.D., & Troost, J. (2001). A dose-response relation of headers and concussions with cognitive impairment in professional soccer players. Journal of Clinical and Experimental Neuropsychology, 23(6), 770–774. doi: 10.1076/jcen.23.6.770.1029CrossRefGoogle ScholarPubMed
Milewski, M.D., Skaggs, D.L., Bishop, G.A., Pace, J.L., Ibrahim, D.A., Wren, T.A., & Barzdukas, A. (2014). Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. Journal of Pediatric Orthopaedics, 34(2), 129–133.CrossRefGoogle ScholarPubMed
Mollayeva, T., Thurairajah, P., Burton, K., Mollayeva, S., Shapiro, C.M., & Colantonio, A. (2016). The Pittsburgh Sleep Quality Index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis. Sleep Medicine Reviews, 25, 52–73. doi: 10.1016/j.smrv.2015.01.009CrossRefGoogle ScholarPubMed
Moore, R.D., Lepine, J., & Ellemberg, D. (2017). The independent influence of concussive and sub-concussive impacts on soccer players’ neurophysiological and neuropsychological function. International Journal of Psychophysiology, 112, 22–30. doi: 10.1016/j.ijpsycho.2016.11.011CrossRefGoogle ScholarPubMed
Nédélec, M., Halson, S., Abaidia, A.-E., Ahmaidi, S., & Dupont, G. (2015). Stress, sleep and recovery in elite soccer: A critical review of the literature. Sports Medicine, 45(10), 1387–1400. doi: 10.1007/s40279-015-0358-zCrossRefGoogle ScholarPubMed
Reitan, R., & Wolfson, D. (1985). The Halstead-Reitan neuropsychological test battery: Therapy and clinical assessment. Tucson, AZ: Neuropsychological Press.Google Scholar
Rutherford, A., Stephens, R., Fernie, G., & Potter, D. (2009). Do UK university football club players suffer neuropsychological impairment as a consequence of their football (soccer) play? Journal of Clinical and Experimental Neuropsychology, 31(6), 664–681. doi: 10.1080/13803390802484755CrossRefGoogle Scholar
Rutherford, A., Stephens, R., Potter, D., & Fernie, G. (2005). Neuropsychological impairment as a consequence of football (soccer) play and football heading: preliminary analyses and report on university footballers. Journal of Clinical and Experimental Neuropsychology, 27(3), 299–319. doi: 10.1080/13803390490515504CrossRefGoogle ScholarPubMed
Samuels, C. (2008). Sleep, recovery, and performance: The new frontier in high-performance athletics. Neurologic Clinics, 26(1), 169–180. doi: 10.1016/j.ncl.2007.11.012CrossRefGoogle ScholarPubMed
Schwartz, J., & Simon, R.D. Jr. (2015). Sleep extension improves serving accuracy: A study with college varsity tennis players. Physiology & Behavior, 151, 541–544. doi: 10.1016/j.physbeh.2015.08.035CrossRefGoogle ScholarPubMed
Spiotta, A.M., Bartsch, A.J., & Benzel, E.C. (2012). Heading in soccer: Dangerous play? Neurosurgery, 70(1), 1–11; discussion 11. doi: 10.1227/NEU.0b013e31823021b2CrossRefGoogle ScholarPubMed
Stewart, W.F., Kim, N., Ifrah, C.S., Lipton, R.B., Bachrach, T.A., Zimmerman, M. E., Kim, M., & Lipton, M.L. (2017). Symptoms from repeated intentional and unintentional head impact in soccer players. Neurology, 88(9), 901–908. doi: 10.1212/WNL.0000000000003657CrossRefGoogle 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), 15–20. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22461961CrossRefGoogle ScholarPubMed
Towns, S.J., Silva, M.A., & Belanger, H.G. (2015). Subjective sleep quality and postconcussion symptoms following mild traumatic brain injury. Brain Injury, 29(11), 1337–1341. doi: 10.3109/02699052.2015.1045030CrossRefGoogle ScholarPubMed
Tysvaer, A.T., & Lochen, E.A. (1991). Soccer injuries to the brain. A neuropsychologic study of former soccer players. The American Journal of Sports Medicine, 19(1), 56–60. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/2008931CrossRefGoogle Scholar
Ward, M.F., Wender, P.H., & Reimherr, F.W. (1993). The Wender Utah Rating Scale: An aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. American Journal of Psychiatry, 150(6), 885–890. doi: 10.1176/ajp.150.6.885Google ScholarPubMed
Wickens, C.D., Hutchins, S.D., Laux, L., & Sebok, A. (2015). The impact of sleep disruption on complex cognitive tasks: A meta-analysis. Human Factors, 57(6), 930–946. doi: 10.1177/0018720815571935CrossRefGoogle ScholarPubMed
Wilde, M.C., Castriotta, R.J., Lai, J.M., Atanasov, S., Masel, B.E., & Kuna, S.T. (2007). Cognitive impairment in patients with traumatic brain injury and obstructive sleep apnea. Archives of Physical Medicine and Rehabilitation, 88(10), 1284–1288. doi: 10.1016/j.apmr.2007.07.012CrossRefGoogle ScholarPubMed
Wiseman-Hakes, C., Murray, B., Moineddin, R., Rochon, E., Cullen, N., Gargaro, J., & Colantonio, A. (2013). Evaluating the impact of treatment for sleep/wake disorders on recovery of cognition and communication in adults with chronic TBI. Brain Injury, 27(12), 1364–1376. doi: 10.3109/02699052.2013.823663CrossRefGoogle ScholarPubMed
Witol, A.D., & Webbe, F.M. (2003). Soccer heading frequency predicts neuropsychological deficits. Archives of Clinical Neuropsychology, 18(4), 397–417. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14591454; http://ac.els-cdn.com/S0887617702001518/1-s2.0-S0887617702001518-main.pdf?_tid=8eb62168-e960-11e5-a08d-00000aacb35d&acdnat=1457903842_5942a80c15f6d8a960818e7c7affacc0CrossRefGoogle ScholarPubMed
Worthington, A.D., & Melia, Y. (2006). Rehabilitation is compromised by arousal and sleep disorders: Results of a survey of rehabilitation centres. Brain Injury, 20(3), 327–332. doi: 10.1080/02699050500488249CrossRefGoogle ScholarPubMed
Supplementary material: File

Levitch et al. supplementary material

Tables S1-S2

Download Levitch et al. supplementary material(File)
File 25.3 KB