Context Poor sleep is common in collegiate student-athletes and is associated with heterogeneous self-reported complaints at baseline. However, the long-term implications of poor sleep at baseline have been less well studied. Objective To examine the implications of insufficient sleep at baseline, as well as factors such as symptom reporting and neurocognitive performance at baseline associated with insufficient sleep, for the risk of sport-related concussion (SRC). Design Cross-sectional study. Setting Undergraduate institution. Patients or Other Participants Student-athletes (N = 614) were divided into 2 groups based on the hours slept the night before baseline testing: sufficient (>7.07 hours) or insufficient (=5.78 hours) sleepers. Athletes who went on to sustain an SRC during their athletic careers at our university were identified. Main Outcome Measure(s) Four symptom clusters (cognitive, physical, affective, and sleep) and headache were examined as self-reported outcomes. Four neurocognitive outcome measures were explored: mean composite of memory, mean composite of attention/processing speed, memory intraindividual variability (IIV), and attention/processing speed IIV. Results Insufficient sleepers at baseline were nearly twice as likely (15.69%) as sufficient sleepers (8.79%) to go on to sustain an SRC. Insufficient sleepers at baseline, whether or not they went on to sustain an SRC, reported a higher number of baseline symptoms than did sufficient sleepers. When compared with either insufficient sleepers at baseline who did not go on to incur an SRC or with sufficient sleepers who did go on to sustain an SRC, the insufficient sleep group that went on to incur an SRC performed worse at baseline on mean attention/processing speed. Conclusions The combination of insufficient sleep and worse attention/processing speed performance at baseline may increase the risk of sustaining a future SRC. Key Points - Insufficient sleep at baseline was associated with an increased risk of prospectively sustaining a sport-related concussion. - Athletes who reported insufficient sleep at baseline and went on to experience a sport-related concussion performed worse on baseline attention/processing speed tasks than either sufficient sleepers who went on to experience a concussion or insufficient sleepers who did not. - Screening for sleep difficulties at baseline can aid in early identification and referral to treatment for athletes experiencing sleep difficulties, thereby potentially reducing the risk of sustaining a sport-related concussion.
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