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Updated: Apr 5, 2026
A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
Relationship Between Short Sleep Duration and Preseason Concussion Testing
Noah D Silverberg1, Paul D Berkner, Joseph E Atkins
1*Division of Physical Medicine and Rehabilitation, Rehabilitation Research Program, University of British Columbia and GF Strong Rehab Centre, Vancouver, British Columbia, Canada; †Health Services and the Department of Biology, Colby College, Waterville, Maine; ‡Department of Psychology, Colby College, Waterville, Maine; §Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital, Harvard Medical School, and Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, Massachusetts; and ¶Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; Massachusetts General Hospital for Children Sports Concussion Program; and Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, Massachusetts.
Poor sleep before testing may affect concussion symptom reporting in athletes, especially girls. Clinicians should inquire about sleep duration and consider retesting if athletes slept poorly.
Area of Science:
- Sports Medicine
- Neuroscience
- Adolescent Health
Background:
- Preseason baseline testing is crucial for concussion management in athletes.
- Assessing cognition, symptoms, and balance is standard practice.
- The impact of sleep on baseline test results requires further investigation.
Purpose of the Study:
- To examine the relationship between sleep duration and baseline concussion test results in high school athletes.
- To determine if insufficient sleep affects cognitive performance and symptom reporting.
- To investigate potential sex differences in sleep's impact on these measures.
Main Methods:
- A cross-sectional observational study involving 2928 high school athletes (ages 13-18).
- Participants completed preseason Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and the Post-Concussion Symptom Scale.
- Athletes were grouped by sleep duration the night before testing; those with neurological issues or prior concussions were excluded.
Main Results:
- Sleep duration did not correlate with any ImPACT cognitive composite scores.
- Sleep duration, sex, and their interaction significantly affected symptom reporting on the Post-Concussion Symptom Scale.
- Insufficient sleep was linked to various postconcussion-like symptoms, with a more pronounced effect in girls.
Conclusions:
- Poor sleep the night before baseline testing can confound concussion symptom assessment.
- Adolescent girls may be more susceptible to reporting symptoms after insufficient sleep.
- Clinicians should assess athletes' sleep and consider deferring testing or retesting if sleep was inadequate.
