Nature and Science of Sleep (Apr 2023)
Electroencephalographic Changes in Sleep During Acute and Subacute Phases After Sports-Related Concussion
Abstract
David J Stevens,1 Sarah Appleton,1 Kelsey Bickley,1 Louis Holtzhausen,2– 4 Robert Adams1,5 1Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia; 2Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; 3Section Sports Medicine, Faculty of Health Science, University of Pretoria, Pretoria, South Africa; 4Department of Exercise and Sport Science, University of the Free State, Bloemfontein, South Africa; 5Respiratory and Sleep Services, Southern Adelaide Local Health Network, Bedford Park, South Australia, AustraliaCorrespondence: David J Stevens, Sleep Health, Flinders Health and Medical Research Institute, Flinders University, Level 2a, 5 Laffer Dve, Bedford Park, South Australia, 5041, Australia, Tel +61 7306 1816, Email [email protected]: Little is known about sleep after a concussion, a form of mild traumatic brain injury. Given the importance of sleep for both maintaining brain health and recovery from injury, we sought to examine sleep acutely and subacutely after concussion.Methods: Athletes who experienced a sports-related concussion were invited to participate. Participants underwent overnight sleep studies within 7 days of the concussion (acute phase), and again eight-weeks after the concussion (subacute phase). Changes in sleep from both the acute and subacute phases were compared to population normative values. Additionally, changes in sleep from acute to subacute phase were analysed.Results: When compared to normative data, the acute and subacute phases of concussion showed longer total sleep time (p < 0.005) and fewer arousals (p < 0.005). The acute phase showed longer rapid eye movement sleep latency (p = 0.014). The subacute phase showed greater total sleep spent in Stage N3% (p = 0.046), increased sleep efficiency (p < 0.001), shorter sleep onset latency (p = 0.013), and reduced wake after sleep onset (p = 0.013). Compared to the acute phase, the subacute phase experienced improved sleep efficiency (p = 0.003), reduced wake after sleep onset (p = 0.02), and reduced latencies for both stage N3 sleep (p = 0.014) and rapid eye movement sleep (p = 0.006).Conclusion: This study indicated sleep during both the acute and subacute phases of SRC was characterised by longer and less disrupted sleep, along with improvements in sleep from the acute to subacute phases of SRC.Keywords: mild traumatic brain injury, somnolence, neural trauma, nocturnal activity
