A - 48 Acute Sleep Symptoms Are Associated With Delayed Recovery Metrics After Sport-Related Concussion

Abstract Purpose This study examined the impact of acute sleep disturbances on return-to-learn (RTL), symptom resolution (SR), and return-to-play (RTP) following sport-related concussion (SRC). Method A retrospective cohort study was conducted on adolescents (ages 14–18) presenting within 3 days of SRC at a regional sports concussion center between November 2017 and April 2022. Sleep symptoms were assessed via the Post-Concussion Symptom Scale, focusing on “trouble falling asleep” to classify patients. Outcome measures were the time to RTL, SR, and RTP (in days). Mann–Whitney U tests compared groups, and multivariable logistic regressions adjusted for overall symptom burden (PCSS score), sex, age, and family/personal history of migraines and psychiatric disease. Results Among 116 patients, 29 (25%) reported acute sleep symptoms. Patients with sleep symptoms took significantly longer to RTL (median = 4, IQR = 3–10) compared to those without sleep symptoms (median = 3, IQR = 2–4, p = 0.005). Similarly, the sleep symptoms group took longer to achieve symptom resolution (median = 15, IQR = 7–27 vs. median = 8, IQR = 3–20, p = 0.024) and longer time to RTP (median = 16, IQR = 11–29 vs. median = 13, IQR = 6–21, p = 0.005). In multivariable regressions, sleep symptoms were not an independent predictor of outcomes, but family history of migraines predicted longer RTL and number of prior concussions predicted longer RTP. Conclusions While acute sleep disturbances were linked to extended recovery times in univariate analyses, they did not independently predict outcomes after controlling for confounders. Further research is needed to clarify whether managing acute sleep symptoms can improve recovery trajectories following SRC.