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Association between sleep difficulty and baseline concussion-like symptom burden in NCAA Division I athletes.

Mohammadi A, Lawton JT, Schussler E, Campbell TR. · Sleep health · 2026

This study examined 584 college athletes to see if sleep problems were linked to reporting more concussion-like symptoms (like headaches, dizziness, and confusion) before any injury occurred. Researchers found that athletes reporting more sleep difficulty also reported more concussion-like symptoms, but sleep difficulty was not associated with actual measured brain function on neurocognitive tests.
Takeaway: Consider an athlete's sleep quality when evaluating their baseline concussion symptom reports, since poor sleep alone can increase symptom complaints without indicating actual brain injury.
Abstract (source)

Objectives: To examine the association between sleep difficulty and baseline concussion-like symptom burden among NCAA Division I athletes and whether sleep difficulty is associated with neurocognitive performance.

Methods: This cross-sectional analysis included 584 NCAA Division I student-athletes. Sleep difficulty was assessed using the Athlete Sleep Screening Questionnaire Sleep Difficulty Score (SDS), and symptom burden using the 24-item SCOAT6 Symptom Evaluation. Symptom number was analyzed with multivariable negative binomial regression and symptom severity with multivariable linear regression using HC3 robust standard errors. Models adjusted for age, sex, sport type, and head-injury history. Sensitivity analyses excluded overlapping sleep-related symptoms and examined individual symptoms, symptom domains, head-injury strata, and neurocognitive outcomes.

Results: Each 1-point increase in SDS was associated with greater symptom number (n = 583; IRR = 1.127, 95% CI 1.086-1.169, P

Conclusions: Greater self-reported sleep difficulty was associated with greater baseline concussion-like symptom burden but not with assessed neurocognitive outcomes. Sleep difficulty should be considered a contextual factor when interpreting baseline concussion symptom reports.

Primary studyRecovery & Sleep
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