Sleep critical prior to baseline concussion testing

Sport-related concussions have become a significant concern in recent years. Research showing the long-term dangers of concussions and the effects of repetitive sub-concussive blows that can occur in football has parents of these athletes concerned.

Many sports teams are partnering with sports medicine programs and hospitals to perform baseline concussion testing for the athletes. These tests are critical if an athlete suffers a concussion.

Simple physical exam tests can be unreliable for determining if the athlete’s brain has completely returned to normal. Doctors can compare the results of baseline neurocognitive testing performed before the season to the results from the second test after a brain injury. Only when the results have returned to their baseline values should doctors clear that athlete to play.

Recent media reports have described professional athletes admitting that they intentionally perform poorly on baseline tests to be cleared for play sooner after an injury. Many team doctors have heard similar stories among high school and college athletes.

A study presented recently at the American Orthopaedic Society for Sports Medicine’s Annual Meeting suggests that sleep could be another concern when athletes take these baseline neurocognitive tests.

Jake McClure and others at Vanderbilt University Medical School gathered the results of baseline concussion testing for 3686 high school and college athletes with no prior history of concussions. They categorized the athletes into three groups based on the amount of sleep each athlete got the night before the test – less than seven hours, seven to nine hours and greater than nine hours.

The researchers found that three scores seem to be affected by a lack of sleep. The athletes who obtained less than seven hours of sleep had poorer scores for reaction time, verbal memory and visual memory.

The relationship between sleep and neurocognitive performance deserves more study. Is a lack of sleep just the night before the test more harmful than chronic sleep deprivation? Do other physical or emotional issues that might affect sleep impact the scores? It seems clear, though, that parents, coaches and doctors should encourage athletes to try to sleep well the night before these tests, at least.

“Understanding an athlete’s total health picture, including sleep patterns may help lead to more accurate concussion testing and allow for fewer individuals to be returned to play earlier than necessary,” McClure concluded.

We have a long way to go to make serious progress in preventing concussions. However we can decrease the chance of recurrent concussions. We can also lessen the possibility of worse brain injuries occurring from second blow before the athletes’ brains have returned to normal.

Baseline concussion testing is critical to those efforts. Making these tests available to all teams, leagues, schools and athletes is the first step. Getting athletes to take them seriously and perform as well as possible is another vital step. Now we know that we should encourage these kids to sleep enough as well.

Note: This post also appears as an article I wrote for Be Active Your Way Blog.
 

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