Should We Lose Sleep Over Sleep Disturbances After Sports-Related Concussion? A Scoping Review of the Literature
David J Stevens1, Alia Alghwiri, Sarah L Appleton
1Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia (Drs Stevens, Appleton, Prof Adams and Ms Bickley); Centre for Nutrition and Gastrointestinal Diseases, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia (Dr Stevens); School of Rehabilitation Sciences, University of Jordan, Amman, Jordan (Prof Alghwiri); School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia (Dr Rogers); Department of Neurosurgery, Northshore University Health System, Evanston, Illinois (Dr Plummer); Translational Neuropathology Laboratory, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia (Dr Plummer); Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa (Drs Grant and Holtzhausen); Department of Psychiatry, Alfred Health, Melbourne, Victoria, Australia (Dr Alvaro); Wakefield Sports and Exercise Medicine Clinic, Adelaide, South Australia, Australia (Dr Kennett); Respiratory and Sleep Service, Southern Adelaide Local Health Network, Bedford Park, South Australia, Australia (Prof Adams); and Sports Medicine Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar (Dr Holtzhausen).
Objective:
A single, severe traumatic brain injury can result in chronic sleep disturbances that can persist several years after the incident. In contrast, it is unclear whether there are sleep disturbances after a sports-related concussion (SRC). Considering growing evidence of links between sleep disturbance and neurodegeneration, this review examined the potential links between diagnosed SRCs and sleep disturbances to provide guidance for future studies.
Methods:
The scoping review undertook a systematic search of key online databases (Scopus, MEDLINE, SportDiscus, and Web of Science) using predetermined search terms for any articles that examined sleep after concussion. A screening criterion using agreed inclusion and exclusion criteria was utilized to ensure inclusion of relevant articles.
Design:
This scoping review is guided by the PRSIMA Scoping Review report.
Results:
Ten studies met the inclusion criteria, reporting on 896 adults who had experienced an SRC. Comparison with 1327 non-SRC adults occurred in 8 studies. Nine studies subjectively examined sleep, of which all but one study reported sleep disturbances after an SRC. Three studies objectively measured sleep, with 2 studies indicating large coefficients of variation of sleep duration, suggesting a range of sleep responses after an SRC. The only study to examine overnight polysomnography showed no differences in sleep metrics between those with and without an SRC. No studies examined interventions to improve sleep outcomes in people with concussion.
Conclusions:
This scoping review indicates preliminary evidence of sleep disturbances following an SRC. The heterogeneity of methodology used in the included studies makes consensus on the results difficult. Given the mediating role of sleep in neurodegenerative disorders, further research is needed to identify physiological correlates and pathological mechanisms of sleep disturbances in SRC-related neurodegeneration and whether interventions for sleep problems improve recovery from concussion and reduce the risk of SRC-related neurodegeneration.
Related Concept Videos
01:13Insufficient Sleep and Sleep Deprivation
Sleep deprivation is a more severe form of sleep loss...
01:18Nightmares and Night Terrors
Nightmares...
01:24Sleep-Wake Cycles
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
01:24Substance Use Disorders Affecting Sleep
Understanding the concepts of physical dependence,...