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. 2024 Jul 15;36(1):v36i1a16255.
doi: 10.17159/2078-516X/2024/v36i1a16255. eCollection 2024.

Concussion risk and symptomology severity in adolescents are associated with pre-season drowsiness and emotional complaints

D Stevens  1   2 , C Grant  2 , T Botha  3 , G Vosloo  4 , H Rossouw  4 , P De Jager  4 , L Holtzhausen  2   5   6
Affiliations

Concussion risk and symptomology severity in adolescents are associated with pre-season drowsiness and emotional complaints

D Stevens et al. S Afr J Sports Med. .

Abstract

Background: Concussions are an ever present risk for many sports. Underlying emotional disturbances and drowsiness are associated with worse post-concussion symptom scores. Yet, not study has examined associations of both emotional disturbances and drowsiness on concussion severity and symptomology.

Objectives: Examine the associations between baseline sleepiness, emotional complaints, and concussion risk and symptom severity in adolescent athletes.

Methods: A cohort of 626 adolescent athletes underwent baseline/pre-season concussion screening. Those who experienced a physician diagnosed concussion underwent follow up concussion symptomology assessment. Over 90% of players were seen within two weeks of the concussion incident. Linear regression examined for associations between concussion symptom scores and baseline drowsiness and baseline emotional symptoms. Logistic regression examined for association between each symptom and baseline drowsiness and baseline emotional symptoms.

Results: Of the 626 athletes that underwent baseline testing, 292 experienced a concussion. Of those 292 athletes, 174 (59.6%) reported baseline drowsiness and 183 (62.7%) baseline emotional symptoms. Baseline drowsiness and emotional complaints were associated with a 2.6 (95% confidence interval = 1.9 to 3.6) and 2.8 (95% confidence interval = 2.0 to 3.9) times greater odds of sustaining a concussion respectively. Increased symptomology after concussion was associated with both baseline drowsiness (unstandardised b = 4.6, p < 0.01) and baseline emotional complaints (unstandardised b = 6.0, p < 0.01).

Conclusion: Preseason drowsiness and emotional complaints in adolescent athletes are associated with higher risk of adverse clinical outcomes following concussion. Therefore, clinicians and coaches should be aware, and properly screen, for sleep and emotional problems as part of pre-season/baseline health screening.

Keywords: mental health; mild traumatic brain injury; sleep.

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Conflict of interest statement

Conflict of interest and source of funding: The authors declare no source of funding. DS receives salary from NeuroFlex Inc, Canada, however, this manuscript is independent of his work there. DS and LH report grants (Flinders Foundation) regarding concussion which is independent to this manuscript. GV, HR, PDJ, and LH are sports physicians, who treat concussion as part of their employment. RG and TB report no competing interests.

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