Lifetime Concussion History, Sleep Quality, And Pain Interference Following A Collegiate Athlete Career

Concussions (CONCs) are a significant concern in National Collegiate Athletic Association (NCAA) sports, raising questions about their potential acute and intermediate effects on former NCAA athlete well-being. Previous research has characterized the acute and long-term effects of CONCs on health outcomes, but the intermediate impact of CONCs on sleep quality and pain interference after a collegiate career is unknown. PURPOSE: To evaluate the association of lifetime diagnosed CONC history on sleep quality and pain interference among former NCAA athletes. METHODS: Former NCAA athletes (n=2455) enrolled in the Concussion, Assessment, Research and Education Consortium between 2014-2020 were re-evaluated within five years of leaving college. The Pittsburgh Sleep Quality Index (PSQI) assessed sleep quality, and the 4-item Patient-Reported Outcomes Measurement Information System Pain Interference assessment quantified if pain affected activities of daily living. Summary statistics (counts [%’s], medians [interquartile ranges]) were used to describe the sample. Two separate multivariable binary logistic regression models were used assess differential odds of a PSQI total score ≥ 5, and Pain Interference t-score ≥ 54 with lifetime diagnosed CONC history (0 [referent], 1-2, 3+) adjusting for sport contact exposure category (no- [referent], low-, high-exposure), years of sport participation (≤ 4 [referent], 5-8, 9-14, 15+), sex (female [referent], male), and race (White [referent], non-White). Adjusted Odds Ratios (ORAdj.) with resulting 95% confidence intervals (95% CI) not crossing 1.00 were deemed statistically significant. RESULTS: Overall, the median PSQI total score was 5.0 (4.0) and the median Pain Interference t-score was 41.1 (11.1). Odds of PSQI total score ≥ 5 were higher in former student-athletes who reported 1-2 CONCs (ORAdj.= 1.35; 95% CI=1.12-1.62), and 3+ CONCs (ORAdj.= 1.53; 95% CI=1.03-2.26). Conversely, CONC history was not associated with differential odds of a Pain Interference score of ≥ 54. CONCLUSIONS: Our findings indicate CONC history is associated with poor sleep quality, but not pain interference; therefore, future work may consider identifying interventions to attenuate the effects of CONC history on sleep quality. Supported by NCAA and DoD Award# W81XWH-14-2-0151