Acute Changes in Sleep Stages Following Concussion in Collegiate Athletes: A Pilot Study.

Context: Sleep has been suggested to be a modifier of recovery following a concussion and is associated with greater symptomatology and number of days until symptom resolution. However, the physiological mechanism for why sleep disturbances occur remains poorly understood. Alterations in time spent in stages of a sleep cycle following a concussion may contribute to recovery.

Objective: The purpose of our study was to use a non-invasive, sensor-derived measure of sleep stages to determine differences between collegiate athletes with or without a concussion, acutely following injury (<72 hours).

Design: Case-control.

Setting: Division 1 collegiate athletics.

Participants: Division 1 Collegiate athletes diagnosed with a concussion were compared to healthy-matched controls based on health history, demographics and sport.

Interventions: Individuals in both groups were provided with and instructed to wear an OURA ring actigraphy device, nightly, within 72 hours of their concussion.

Main outcome measures: Differences in sensor-derived time spent in Light, Deep, rapid eye- movement (REM) sleep, time awake, and total sleep time between groups.

Results: A total of 18 athletes were included in our analyses (9 concussed, 9 controls) with an average age of 19.3+ 1.3 years. Individuals with a concussion spent less time in deep sleep (113.1±33.1 vs 134.4±51.1 minutes, p=0.03), and more time awake (90.22±30.0 vs 49.28±11.5 minutes, p=0.02) compared to individuals without a concussion. No significant differences were found for time spent in total sleep time, Light or REM sleep.

Conclusion: Acutely following concussion, individuals may demonstrate changes in sleep stages. Our results suggest that time spent in different stages of sleep may be a potential mechanism underlying recovery from concussion. Our results provide an important step in using wearable sensors to better understand sleep disturbances following concussion to help mitigate risk of a prolonged recovery.