BACKGROUND Symptoms, cognition, balance, and other domains are commonly assessed at baseline testing as part of comprehensive preseason evaluations among collegiate student-athletes. Although approximately 27% of college students have at least 1 sleep disorder, researchers have yet to examine the role of a preexisting sleep disorder on preinjury baseline performance. PURPOSE To compare athletes with and without a reported history of diagnosed sleep disorders on commonly used baseline concussion assessments. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS A total of 666 National Collegiate Athletic Association student-athletes completed baseline measures including the Balance Error Scoring System (BESS), Brief Symptom Inventory-18 (BSI-18), Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Post-Concussion Symptom Scale (PCSS), Sport Concussion Assessment Tool-5th Edition (SCAT5), and Standardized Assessment of Concussion (SAC). There were 333 athletes with a history of diagnosed sleep disorders who were matched on age, sex, sport, and concussion history to 333 athletes with no history of diagnosed sleep disorders. Participants in both groups had a mean age of 19.89 ± 1.36 years and included 182 (54.7%) male athletes, and 126 (37.8%) reported a history of ≥1 concussions. RESULTS A series of 1-way analyses of covariance with Bonferroni corrections revealed significant group differences on the BESS (F1,559 = 8.88; P < .01); BSI-18 somatization (F1,640 = 18.48; P < .01), depression (F1,640 = 18.78; P < .01), anxiety (F1,640 = 19.42; P < .01), and global severity index (F1,640 = 27.18; P < .01); PCSS (F1,424 = 29.42; P < .01); SCAT5 symptom number (F1,634 = 28.79; P < .01) and symptom severity (F1,634 = 31.74; P < .01); and SAC (F1,578 = 4.36; P = .037). Specifically, while the sleep disorder group did perform better on the BESS, they also reported higher symptoms on the BSI-18, PCSS, and SCAT5 and performed worse on the SAC. There were no group differences on ImPACT performance. CONCLUSION Collegiate student-athletes with diagnosed sleep disorders reported elevated affective and concussion symptoms at baseline that could affect the interpretation of postinjury impairments and symptoms. Based on the small effect sizes of our findings, however, the magnitude of these differences is of questionable clinical significance. Still, clinicians should consider diagnosed sleep disorders as reported during preparticipation sports physical examinations when interpreting baseline and postinjury concussion assessments.

中文翻译：

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诊断的睡眠障碍对大学运动员基线脑震荡症状，认知和平衡评估的影响。

背景技术症状，认知，平衡和其他方面通常在基线测试时进行评估，作为大学学生运动员进行的全面季前评估的一部分。尽管大约27％的大学生至少患有1种睡眠障碍，但研究人员尚未研究既存的睡眠障碍对受伤前基线表现的作用。目的在常规基线脑震荡评估中比较有和没有报道睡眠史诊断的运动员。研究设计横断面研究；证据等级，3。方法共有666名美国大学生体育协会学生运动员完成了基线测量，包括平衡误差评分系统（BESS），简要症状清单18（BSI-18），脑震荡后即时评估和认知测试（ImPACT），脑震荡后症状量表（PCSS），运动脑震荡评估工具第5版（SCAT5）和脑震荡标准化评估（SAC）。有333名具有诊断为睡眠障碍史的运动员，其年龄，性别，运动和脑震荡史与333名无诊断为睡眠障碍史的运动员相匹配。两组参与者的平均年龄为19.89±1.36岁，包括182名（54.7％）男运动员，并且126名（37.8％）的脑震荡≥1年。结果一系列用Bonferroni校正进行的协方差单向分析显示，BESS的组差异显着（F1,559 = 8.88； P <.01）；BSI-18躯体化（F1,640 = 18.48; P <.01），抑郁（F1,640 = 18.78; P <.01），焦虑（F1,640 = 19.42; P <.01）和总体严重性指数（ F1,640 = 27.18; P <.01）; PCSS（F1,424 = 29.42; P <.01）; SCAT5症状数（F1,634 = 28.79; P <.01）和症状严重程度（F1,634 = 31.74; P <.01）; 和SAC（F1,578 = 4.36; P = .037）。具体而言，虽然睡眠障碍组在BESS上表现较好，但他们在BSI-18，PCSS和SCAT5上也表现出较高的症状，而在SAC上表现较差。ImPACT的表现没有群体差异。结论被诊断为睡眠障碍的大学生运动员在基线时表现出较高的情感和脑震荡症状，这可能会影响伤后障碍和症状的解释。基于我们发现的小效应，这些差异的大小在临床上具有可疑的意义。仍然，