Examination of clinical sleep difficulties in college student-athletes.

BACKGROUND: Due to the rising concern of inadequate sleep, critical analysis is needed for the presence of sleep problems in diverse populations. Research has shown that college athletes may be one such population at risk for sleep disturbances. Poor sleep may lead to physiological, psychological, and cognitive deficits that can impact college athletes academically and athletically. This investigation was performed to examine the relationship of age, sex, and history of concussion on sleep disturbance in college athletes. METHODS: A total of 191 collegiate athletes between the ages of 18-26 from a single academic NCAA institution in the Rocky Mountain region of the USA, consented to participate in the study. Participants completed a demographic questionnaire and the Athlete Sleep Screening Questionnaire (ASSQ). Results were analyzed using SPSS Version 27. RESULTS: Primary results revealed that female athletes reported higher sleep disturbance scores when compared to males (U=3643.0, P=0.016). Self-reported sleep disturbances when traveling for sport were higher for females (X(1) = 23.800, P<0.001). Males were also less likely to report daytime dysfunction when traveling for sport (X(1) =22.988, P<0.001). Sleep disturbance had a significant association with age (X(1) =4.145, P=0.042), with older participants (20+ years of age) reporting greater sleep disturbance. Concussion history did not associate with sleep disturbance in the present study. CONCLUSIONS: Results suggest that sophomore or older female may be at higher risk for sleep disturbances. Clarifying sex-specific sleep health and understanding the role of age and academic class is crucial to enhance and personalize interventions.

The effects of sleep disturbance and chronotype on baseline vestibular/ ocular motor screening in collegiate athletes.

Background: The vestibular/ocular motor screening (VOMS) is a clinically validated screening tool for concussion management. Multiple factors have been known to influence VOMS performance such as preexisting migraine and mood disorders. Poor sleep is an another important variable that warrants investigation as a modifier on the VOMS that may need to be considered during administration. Aim: This study aims to examine whether self-reported sleep difficulties significantly modify baseline VOMS symptom provocation in collegiate athletes. Methods: A total of 191 collegiate student-athletes completed a pre-season baseline VOMS and the 16-item Athlete Sleep Screening Questionnaire (ASSQ) before the start of their respective sport season. The ASSQ was used to establish sleep health variables consisting of hours of sleep per night, sleep difficulties when traveling for sport, chronotype (e.g., morning or evening person), and a sleep disturbance score (SDS) category of none, mild, and moderate + severe. Results: Those who reported sleep disturbances when traveling for sport on that respective ASSQ item had higher pre-test VOMS symptoms (P < 0.001) and symptom provocation on convergence (P = 0.015), horizontal vestibular ocular reflex (VOR) (P = 0.008), and vertical VOR (P = 0.039). There were worse pre-test symptoms (P = 0.015) and provocation on horizontal VOR (P = 0.046) in the moderate + severe SDS group than no SDS. The moderate + severe SDS group reported worse symptom provocation on the horizontal (P = 0.018) and vertical VOR (P = 0.010), and VMS (P = 0.017). No differences were found on VOMS symptom provocation for hours of sleep or chronotype. Conclusions: These results show agreement with previous symptom and neurocognitive data in that sleep difficulties among collegiate athletes may have an important role in the interpretation of baseline concussion testing. It may be beneficial to utilize sleep assessments with baseline concussion testing when using the VOMS as the clinical concussion measurement modality. Relevance for Patients: The addition of sleep assessment may aid sports medicine practitioners in properly interpreting baseline VOMS scores. Pre-season baseline testing may need to be delayed if athletes report with poor sleep in the acute period prior.

Postinjury anxiety and social support among collegiate athletes: a comparison between orthopaedic injuries and concussions.

CONTEXT: When an athlete is injured, the primary focus of the sports medicine team is to treat the physical effects of the injury. However, many injured athletes experience negative psychological responses, including anxiety, regarding their injury. OBJECTIVE: To compare the anxiety and social support of athletes with concussions and a matched group of athletes with orthopaedic injuries. DESIGN: Cross-sectional study. SETTING: Athletic training room. PATIENTS OR OTHER PARTICIPANTS: A total of 525 injuries among athletes from 2 Big Ten universities were observed. Of these, 63 concussion injuries were matched with 63 orthopaedic injuries for the athlete's sex, sport, and time loss due to injury. MAIN OUTCOME MEASURE(S): Clinical measures included the State-Trait Anxiety Inventory (which measures both state and trait anxiety) and the modified 6-item Social Support Questionnaire. RESULTS: The group with concussions relied on their family for social support 89% of the time, followed by friends (78%), teammates (65%), athletic trainers (48%), coaches (47%), and physicians (35%). The group with orthopaedic injuries relied on their family for social support 87% of the time, followed by friends (84%), teammates (65%), athletic trainers (57%), coaches (51%), and physicians (36%). We found no differences for the State-Trait Anxiety Inventory (t = -1.38, P = .193) between the concussed and orthopaedic-injury groups. Social Support Questionnaire scores were significant predictors for postinjury state anxiety. Specifically, increased scores were associated with decreased postinjury state anxiety (ß = -4.21, P = .0001). CONCLUSIONS: Both the concussed athletes and those with orthopaedic injuries experienced similar state and trait anxiety and relied on similar sources of social support postinjury. However, athletes with orthopaedic injuries reported greater satisfaction with support from all sources compared with concussed athletes. In contrast, concussed athletes showed more significant predictor models of social support on state anxiety at return to play.

The management of sport-related concussion: considerations for male and female athletes.

Sport-related concussion continues to be a centerpiece of attention in the field of sports medicine. The benefit to using neurocognitive testing when managing concussion will be documented in this review. In addition to providing critical objective information on the neurocognitive status of the concussed athlete, research data will be provided on the pre- and post-concussion neurocognitive profiles of concussed male and female athletes. Specifically, an overview of research will be presented on the epidemiology of male and female concussion rates, as well as concussion outcomes including symptoms and cognitive function post-injury. Finally, a clinician's perspective on managing sports-related concussion will be presented focusing on three factors regarding sex differences: risk factors, clinical presentation, and management.

Does a 20 minute cognitive task increase concussion symptoms in concussed athletes?

OBJECTIVE: The purpose of the present study was to examine if concussion symptoms worsened immediately (i.e. 20 minutes) following performance on a computerized neurocognitive test. RESEARCH DESIGN: Cross-sectional study; Level of evidence, 2. METHODS AND PROCEDURES: A total of 165 athletes with a concussion participated in the study. Participants completed the Immediate Post-concussion Assessment and Cognitive Test (ImPACT) and Post-concussion Symptom Scale (PCSS) at baseline, 3 and 10 days post-concussion. Participants completed a second PCSS following the ImPACT test at 3 and 10 days post-injury. MAIN OUTCOMES AND RESULTS: Athletes with a concussion exhibited greater symptoms post-neurocognitive test 3 days post-concussion on headache (p = 0.01), nausea (p = 0.03), dizziness (p = 0.03), sadness (p = 0.005), mentally foggy (p= 0.002) and visual problems (p = 0.007). Athletes with a concussion demonstrated increased symptoms on sadness (p = 0.00) and difficulty remembering (p = 0.03) at 10 days post-injury. Athletes also demonstrated neurocognitive impairments in verbal memory (p = 0.009) and slower reaction time (p = 0.01) 10 days post-concussion and visual memory (p = 0.000) and motor processing speed (p = 0.000) impairments at 3 days post-injury. CONCLUSION: The current study suggests that there may be an increase in concussion symptoms following a 20-minute cognitive task. Thus, it illustrates the need for clinicians to make sure they are symptom free with both physical and cognitive testing.