Sleep After Gymnastics-related Injury: Comparing Sleep Quality Between Injured And Uninjured Adolescent Athletes

PURPOSE: Sleep plays an important role in recovery after injury. Despite this, there is little knowledge on the impact of injury on sleep quality, specifically in an adolescent gymnast population. Our purpose was to compare sleep quality ratings between adolescent gymnasts seen for care after orthopedic injury and uninjured adolescent control athletes. We hypothesized that injured gymnasts would report worse sleep quality when compared to the sleep quality of uninjured adolescent athletes. METHODS: We conducted a case-control study of injured gymnasts and uninjured adolescent athletes. Sleep quality was measured via the Pittsburgh Sleep Quality Index (PSQI), a 19-item questionnaire evaluating sleep quality over the past month, that yields a global score of 0-21, with higher scores indicating worse sleep quality. Injured gymnasts completed the PSQI in clinic while seeking care for acute and chronic injuries, while uninjured athletes were evaluated at a pre-season evaluation. PSQI scores were compared using independent t-tests, multivariable linear regression analysis and Cohen's d calculations. Demographic and medical history characteristics were compared using independent t-tests and Chi-square analyses. RESULTS: We enrolled a total of 209 participants. Of those, N = 50 (24%) were injured gymnasts and N = 159 (58%) were uninjured controls. The gymnasts were significantly younger (14.4 ± 1.8 vs. 16.2 ± 1.2 year; p < 0.001) than the uninjured controls, but the proportion of female/male participants were similar between groups (84% vs. 88% female; p = 0.65). PSQI ratings were significantly higher for the injured gymnasts, with a medium effect size (4.9 ± 2.6 vs. 3.6 ± 3.0; p = 0.01; Cohen’s d = 0.42). After adjusting for the effect of age the injured gymnast group reported significantly worse sleep quality than the uninjured control group (β = 1.25; 95% CI = 0.18, 2.32; p = 0.02). CONCLUSIONS: We observed that injured gymnasts exhibited significantly higher PSQI ratings than uninjured control athletes, indicating that they experienced worsened sleep quality. This suggests that injury may result in reduced sleep quality in adolescents who participate in gymnastics, although further research is required to determine if this is a causal relationship and the influence of sleep on injury recovery. Supported by: Broncos Foundation