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. 2025 Jan 1;21(1):129-135.
doi: 10.5664/jcsm.11356.

Concussion history is associated with poor sleep quality in adolescent athletes: a cross-sectional study

Sarp Sahin  1   2 , Ashley L Erdman  1 , Alex Loewen  1 , Shane M Miller  1   3 , Jacob C Jones  1   3 , Jane S Chung  1   3 , Joseph Janosky  4 , Sophia Ulman  1   3
Affiliations

Concussion history is associated with poor sleep quality in adolescent athletes: a cross-sectional study

Sarp Sahin et al. J Clin Sleep Med. .

Abstract

Study objectives: Whereas previous research has primarily focused on the immediate effects of concussion within the first year postinjury, this study examines the persistent effects of concussion on subsequent sleep quality in adolescent soccer players.

Methods: This study used a cross-sectional design, recruiting a convenience sample of adolescent athletes from US Youth Soccer camps. Participants completed a self-reported questionnaire including the Pittsburgh Sleep Quality Index to assess their sleep quality. Athletes were also asked to report sport participation information, any past occurrence of concussion or knee injury, and any sport-related injury in the past 12 months. Independent samples t tests were performed to identify significant differences in Pittsburgh Sleep Quality Index scores between injured and noninjured participants.

Results: A total of 177 participants (103 male, 14.61 ± 1.88 years of age) were included in the analysis. The concussion injury group exhibited later bedtimes (difference: 0.32 ± 0.05 hours, P = .047), fewer hours of sleep (difference: 0.56 ± 0.11 hours, P = .015), and more frequent sleep disturbances (P = .012). Furthermore, these athletes reported lengthened sleep latency (difference: 2.55 ± 3.36 minutes, P = .016) and higher levels of daytime dysfunction (P = .041) following their concussion injuries. Moreover, athletes in the concussion injury group displayed worse sleep quality scores (difference: 0.42 ± 0.06, P < .001) and higher total Pittsburgh Sleep Quality Index scores (difference: 1.91 ± 0.41, P < .001). No significant differences were found based on past knee injury or sport-related injury in the past 12 months.

Conclusions: These findings suggest the need for targeted interventions aimed at improving sleep quality in adolescent athletes with a history of concussion.

Citation: Sahin S, Erdman AL, Loewen A, et al. Concussion history is associated with poor sleep quality in adolescent athletes: a cross-sectional study. J Clin Sleep Med. 2025;21(1):129-135.

Keywords: concussion; injury risk; pediatric; sleep disturbance; sport participation.

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Conflict of interest statement

All authors have seen and approved the manuscript. Work for this study was performed at Scottish Rite for Children. The authors report no conflicts of interest.

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