0928 Self-reported Insomnia and Daytime Sleepiness Are Better Predictors of Concussion Risk Than Prior Concussion History

Abstract

Introduction: Sport-related concussions (SRCs) are a significant public health concern. Identifying potentially modifiable risk factors for SRCs may lead to better prevention efforts. Sport performance and injury avoidance requires integrated cognitive, motor, and behavioral functioning that is susceptible to inadequate sleep duration and/or quality. The purpose of this study was to quantify collegiate athletes' relative risk of SRC based on self-reported sleep outcomes from a screening questionnaire, including insomnia severity and habitual daytime sleepiness. Method(s): 190 NCAA Division-1 athletes completed a battery of questionnaires that included the Insomnia Severity Index (ISI) and National Health and Nutrition Examination Survey (NHANES) Sleep module. SRC incidence was extracted from medical records at least one-year following survey completion. ISI total score and the sleepiness item from the NHANES were used as independent predictors of univariate relative risk ratios (RR) for future SRC. An additional multiple logistic regression model including sleep outcomes as well as past SRC history quantified the odds of sustaining a SRC. Result(s): Clinically significant self-reported insomnia severity (ISI>=15; RR=3.13, 95% CI: 1.320-7.424, p=0.015) and NHANESidentified daytime sleepiness occurring more than twice per month (RR=2.856, 95% CI: 0.681-11.977, p=0.037) were independently associated with increased SRC risk within an 8-month period following the survey. These effects remained comparable in magnitude after adjusting for SRC history.C. Conclusion(s): Sports-related concussion risk in collegiate athletes is significantly greater in individuals self-reporting insomnia or daytime sleepiness, even after accounting for concussion history (usually the strongest predictor of future risk). Clinicians and athletes need to be cognizant of the relationship between sleep and SRCs and to take proactive measures to improve sleep - quantitatively, qualitatively, or both - in order to reduce SRC risk as well as support and improve overall athletic performance.