Jane S. Chung
ORLANDO, Fla. — Young athletes with sports-related concussions who had poor sleep were more likely to experience greater symptom severity and a longer recovery compared with children who had good sleep, according to a presentation at the AAP National Conference & Exhibition.
“At the initial visit, those athletes in the poor sleep group were found to have nearly two times greater symptom severity compared with those athletes in the good sleep group,” Jane S. Chung, MD, FAAP, a pediatrics sports medicine physician at Texas Scottish Rite Hospital for Children and an assistant professor in orthopedics and pediatrics at the University of Texas Southwestern Medical Center, told Infectious Diseases in Children. “Those athletes found to have poor sleep quality also were more likely to take greater than 30 days for their symptoms to resolve compared with those athletes in the good sleep group, who tended to have their symptoms resolve in 0 to 14 days. These are very significant findings.”
Chung and colleagues reviewed prospectively collected data from participants aged younger than 19 years and diagnosed with a sports-related concussion between October 2015 and June 2017. The youth, enrolled in the North Texas Concussion Network Prospective Registry, were treated at one of four outpatient clinics in North Texas that specialize in concussion. The researchers reviewed medical records for sleep quality, measured by Pittsburgh Sleep Quality Index (PSQI) scores. Participants who had a composite PSQI score of less than 5 (out of a possible 21) were put into a good sleep quality group, and those with a score greater than 5 were put into a poor sleep quality group.
Chung and colleagues identified 356 participants who qualified for the study (50.6% girls; median age, 14.38 years), including 261 (73.3%) in the good sleep group and 95 (26.7%) in the poor sleep group. At the initial visit, children in the poor sleep group had a mean PSQI composite score of 8.7 and a total symptom score on the Sports Concussion Assessment Tool 3 (SCAT3) of 39.2 compared with scores of 2.6 and 20.4, respectively, in the good sleep group (P < .0001). Although both groups experienced improving symptoms at 3 months, the poor sleep group continued to have a higher mean PSQI composite score and total symptom score compared with the good sleep cohort (5.7 and 12.2 vs. 3 and 4.2; P < .0001).
Besides differences in symptom severity and time to resolution, the youth in the poor sleep cohort experienced more fatigue, drowsiness and trouble falling asleep — measured by the SCAT3 — at the initial visit and 3-month follow-up compared with the good sleep group. Girls were significantly more likely than boys to be in the poor sleep cohort (61.1% vs. 38.9%; P = .02).
“Pediatricians and health care providers who take care of athletes and concussions should evaluate and assess sleep quality. It will help them predict those athletes who may at risk for prolonged recovery by identifying those athletes with poor sleep quality,” Chung said. “Parents and coaches should emphasize the importance of good sleep quality in our young athletes. Sleep is not only good for physical and cognitive well-being, but it may play an important role in the brain’s recovery following a concussion. Pediatricians at well-child visits can also educate teenagers and children who play sports about good sleep habits, so that even before they have a concussion, they can start to incorporate healthy sleep habits.” – by Bruce Thiel
Chung J, et al. Association between sleep quality and recovery following a sport-related concussion in the pediatric population. Presented at: AAP National Conference & Exhibition; Nov. 2-6, 2018; Orlando, Fla.
Disclosure: Chung reports no relevant financial disclosures.