Poor Sleep May Have Ill Effect on Baseline Concussion Assessment

teen child phone bed sleep
teen child phone bed sleep
Girls reported more symptoms of concussion after a poor night's sleep.

Poor sleep may impact baseline and post-injury concussion testing, data indicate, ultimately confounding post-concussion assessments.

Preseason and baseline assessments are an integral part of comprehensive concussion management, but how these assessments are affected by other factors, like sleep, is unknown.

In order to examine the affect of sleep on symptoms and cognitive testing, researchers led by Noah D. Silverberg, PhD, of the University of British Columbia screened a large sample of 2928 student athletes aged 13 to 18 years who completed preseason testing. Those with developmental problems, a history of neurological or psychiatric problems, recent concussion, or 3 or more prior concussions were excluded.

Ultimately, participants were separated into 4 groups based on their pre-testing sleep duration. The researchers found that sleep was not related to any Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) cognitive composite scores; however sleep duration, sex, and sleep duration by sex were found to have effects on the Post-Concussion Symptom Scale. Sleep duration appeared to have a significant effect on symptom reporting, especially in girls. Results of supplementary analyses showed that insufficient sleep was associated with a range of post-concussive symptoms.

The authors suggest that clinicians routinely ask athletes how they slept the night before testing and to consider delaying assessment or retesting athletes until after a sufficient night’s sleep.


Silverberg ND, Berkner PD, Atkins JE, Zafonte R, Iverson GL. Relationship Between Short Sleep Duration and Preseason Concussion Testing. Clin J Sport Med. 2016;26(3):226-31.