@article{ref1,
title="Insomnia and daytime sleepiness: risk factors for sports-related concussion",
journal="Sleep Medicine",
year="2019",
author="Raikes, Adam C. and Athey, Amy and Alfonso-Miller, Pamela and Killgore, William D. S. and Grandner, Michael A.",
volume="58",
number="",
pages="66-74",
abstract="OBJECTIVE/BACKGROUND: Poor quality and inadequate sleep are associated with impaired cognitive, motor, and behavioral components of sport performance and increased injury risk. While prior work identifies sports-related concussions as predisposing factors for poor sleep, the role of sleep as a sports-related concussion risk factor is unknown. The purpose of this study was to quantify the effect of poor sleep quality and insomnia symptoms on future sports-related concussion risk. PATIENTS/METHODS: In this study, 190 NCAA Division-1 athletes completed a survey battery, including the Insomnia Severity Index (ISI) and National Health and Nutrition Examination Survey (NHANES) Sleep module. Univariate risk ratios for future sports-related concussions were computed with ISI and NHANES sleepiness scores as independent predictors. An additional multiple logistic regression model including sport, sports-related concussion history, and significant univariate predictors jointly assessed the odds of sustaining a concussion. <br><br>RESULTS: Clinically moderate-to-severe insomnia severity (RR = 3.13, 95% CI: 1.320-7.424, p = 0.015) and excessive daytime sleepiness two or more times per month (RR = 2.856, 95% CI: 0.681-11.977, p = 0.037) increased concussion risk. These variables remained significant and comparable in magnitude in a multivariate model adjusted for sport participation. <br><br>CONCLUSION: Insomnia and daytime sleepiness are independently associated with increased sports-related concussion risk. More completely identifying bidirectional relationships between concussions and sleep requires further research. Clinicians and athletes should be cognizant of this relationship and take proactive measures - including assessing and treating sleep-disordered breathing, limiting insomnia risk factors, improving sleep hygiene, and developing daytime sleepiness management strategies - to reduce sports-related concussion risk and support overall athletic performance.<br><br>Copyright © 2019 Elsevier B.V. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1389-9457",
doi="10.1016/j.sleep.2019.03.008",
url="http://dx.doi.org/10.1016/j.sleep.2019.03.008"
}