scholarly journals LACK OF SLEEP AMONG YOUTH ATHLETES IS ASSOCIATED WITH A HIGHER PREVALENCE OF SELF-REPORTED HISTORY OF ANXIETY AND DEPRESSION

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0008 ◽  
Author(s):  
Andrea Stracciolini ◽  
Caitlin M. McCracken ◽  
Matthew D. Milewski ◽  
Bill Meehan

Background: The importance of sleep in children, and the relationship to mental and physical health, is under recognized. The physical and emotional demands of sports participation may contribute positively and negatively to sleep quality and quantity. Aim: To investigate sleep duration, daytime sleepiness, and mental health in youth athletes. Hypotheses: 1. The majority of youth athletes will not meet the current age based recommendations for sleep duration. 2. Athletes not meeting the current sleep recommendation will have an increased prevalence of anxiety/depression, and have greater daytime sleepiness scores. Study Design: Cross-sectional study Methods: Questionnaire data were analyzed from an injury prevention evaluation (IPE) at a sports injury prevention center affiliated with a tertiary level pediatric medical center between April 2013 and February 2018. Reason for playing was coded into thematic categories. Fun related responses include: to have fun, to make friends, to be part of a team, enjoyment/love etc. Goal oriented reasons include: to win a championship, college or scholarship purposes, to compete to control my weight, to be strong etc. BMI was adjusted by age and sex using ranges recommended by the Center for Disease Control. Anxiety and or depression is measured by a clinician diagnoses but was self-reported by the participant. Homework was measured as total hours spent during weeknights and was measured by categories in three hour units; each category composed approximately 25% of participants. Main outcome measures included sleep duration, scores on daytime sleepiness scale, self-reported anxiety and, self-reported depression. Age, sex, BMI, reasons for playing sports (fun related versus goal oriented), hours of homework per week, and internet access were also analyzed. Results: 756 athletes, =18 years old (mean age 13.5±2.5 yrs.) were included; 56% (N=426) were female. Overall 39% (N= 296) of athletes were not getting the age recommended amount of sleep. Among athletes 6-12 years old, 26% were not meeting the sleep recommendation for age, compared to 45% of 13-18-year-old athletes (p<0.01). Female athletes (44% vs. 33%, p<0.01) and athletes with either depression and/or anxiety (62% vs. 37%, p<0.01) were less likely to meet sleep recommendations. Athletes also appeared less likely to meet the current sleep recommendation if they reported a prior sport-related injury (44% vs. 37%, p=0.05), goal-oriented reasons for playing sports (52% vs. 35%, p<0.01), night time internet access (51% vs. 28%, p<0.01), and as number of weeknight homework hours increase (0-3 hours (22%) compared to 11+ hours (64%); p<0.01). After adjusting for age, gender, injury history, nighttime internet access, and hours of homework per week, the odds of not meeting the recommended amount of sleep increased with age (OR=1.29, 95% CI, 1.2 -1.4, p<0.01). Athletes reporting past diagnoses of anxiety and/or depression had higher odds of not meeting the sleep recommendation (OR 1.92, CI 1.0 – 3.6, p<0.05) and increased daytime sleepiness (ß=2.83, 95% SE 0.7, p<0.01). Goal driven athletes had 1.63 the odds of not meeting the sleep recommendation (CI 1.1-2.4, p<0.05), but were not significantly different from their counterparts with regards to daytime sleepiness scale scores. When stratified by age group, the odds of not meeting the recommended amount of sleep increased among older athletes (OR=1.29, 95% CI, 1.2 -1.4, p<0.01). Middle-school athletes with a self reported history of anxiety and/or depression had a greater likelihood of not meeting the sleep recommendation (OR = 4.49,95% CI, 1.2 – 18.1, p<0.05) and also had higher daytime sleepiness scores (OR=3.19, 95% SE, 1.5, p<0.05). Only daytime sleepiness increased among high school aged athletes with anxiety/depression (ß=3.0, 95% SE, 0.8, p<0.01) Conclusions: Female athletes, those who play sports for goal-oriented reasons, and those with a history of anxiety/depression are at increased risk of not meeting current sleep recommendations. Among middle school aged athletes, self reported history of anxiety and or depression has an even larger impact on sleep.

Author(s):  
Andrea Stracciolini ◽  
Caitlin M. McCracken ◽  
William P. Meehan ◽  
Matthew D. Milewski

Purpose: To study mental health, sleep duration, and daytime sleepiness in young athletes. Methods: A cross-sectional questionnaire study was conducted. The main outcome measures included sleep duration and daytime sleepiness. Results: Study participants included 756 athletes with a mean age of 13.5 years. A total of 39% (n = 296/756) reported not meeting current sleep recommendations for age. Athletes >12 years and with a self-reported anxiety and/or depression history were less likely to meet sleep recommendations and showed higher daytime sleepiness (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] [1.2, 1.4], β [SE] = 3.06 [0.74], respectively). Athletes with goal-oriented reasons for playing versus enjoyment (52% vs. 35%, aOR = 1.70, 95% CI [1.12, 2.58]) were less likely to meet sleep recommendations. Night time internet access and weeknight homework hours were negatively associated with sleep recommendations (aOR = 1.68, 95% CI [1.68, 2.47] and aOR = 3.11, 95% CI [1.82, 5.3]) and positively associated with daytime sleepiness (β [SE] = 1.44 [0.45] and 2.28 [0.59]). Conclusions: Many young athletes are not meeting sleep recommendations. Associated factors include mental health, reasons for play, internet access, and homework demand.


2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0012 ◽  
Author(s):  
Matthew D. Milewski ◽  
Caitlin M. McCracken ◽  
Bill Meehan ◽  
Andrea Stracciolini

BACKGROUND Sleep duration and sport specialization have been shown to affect injury profile in young athletes. The interplay between training hours per week, and, multiple versus single sports participation on sleep hours in young athletes is unknown. Purpose/Objective To investigate associations between single sport participation and training volume, with sleep hours, in pediatric and adolescent athletes. METHODS Study design: Cross-sectional epidemiological study was conducted using electronic questionnaire data from an injury prevention evaluation (IPE) at a sports injury prevention center affiliated with a tertiary level pediatric medical center between April 2013 and February 2018. Data analysis included sports participation, previous injury history, training regimen, and sleeping habits. For each sport selected, athletes were asked about average number of practice hours for each sport and number of seasons training for the sport during the year. All athletes aged 11-18 years were included in the study. Main outcome measures include sleep duration, single sport, and training hours/seasons. Single sport athletes were defined as those athletes who listed participation in only one sport year-round. Binary measures were created to indicate 1)any participant that listed practicing > 10 hour/week for any sport during a season and 2) any participant that trains three or more seasons for any sport in which they participate. Multivariate regression models (M1, M2, M3) were created for soccer athletes to control for sport training differences while testing the independent effect of gender, age and sport training. Based on the results univariate linear regression of hours of sleep was stratified by age and gender and regressed by self-reported hours of practice per week, identification as single sport athlete, training three or more seasons for soccer. RESULTS There were 756 athletes, 11-18 years old, included (mean age 13.5±2.5 years; 56% female (N=426)). For female athletes, figure skating (46%, 11/24), dance (42%, 28/67), and gymnastics (25%, 12/47) lead the list for single sport athletes. In comparison, for male athletes, swimming (26%, 5/19), tennis (19%, 5/26) and soccer (13%, 16/120) lead the list. The overwhelming majority of gymnasts, dancers, and figure skaters (88% (38/43), 83% (54/66) and 83%, (20/24)) train = 3 seasons of the year. In comparison, for male athletes, tennis athletes (62%, 16/25) seem to train = 3 seasons of the year followed by soccer (41%, 49/119) and swimming (39%, 7/18). (Tables 1 and 2) Table 3 presents multivariate linear regression coefficient of weeknight hours slept by practice hours, gender, age and sport characteristics for soccer participants using three different models (M1, M2, M3). Younger athletes, ages 11-14 years, slept nearly an hour more than participants aged 15-18 years across all training types. Only female soccer athletes training = 3 seasons slept significantly less (ß -0.24, SE 0.12, 95%) than their male counterparts. Participants that practiced soccer > 10 hours/week slept significantly, and substantively, less than their peers practicing =3 or less hours/week (ß -0.61, SE 0.17, 95%). Table 4 presents all participants and sport type stratified by age and sex. Practicing more than 10 hours/week was significant in males ages 11-14 years. Middle school aged males, practicing > 10 hours/week for any sport in which they participate over the course of the year, slept over half an hour less than their peers that practiced fewer hours (ß -0.65, SE 0.2, 95%). CONCLUSIONS/SIGNIFICANCE Training volume appears to affect sleep in young athletes. Middle school male athletes practicing greater than 10 hours/week appear to sleep less than their peers. Anticipatory guidance surrounding training may help to improve sleep hygiene in pediatric and adolescent athletes. [Table: see text][Table: see text][Table: see text][Table: see text]


2017 ◽  
Vol 46 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Adam S. Tenforde ◽  
Allyson L. Parziale ◽  
Kristin L. Popp ◽  
Kathryn E. Ackerman

Background: While sports participation is often associated with health benefits, a subset of athletes may develop impaired bone health. Bone stress injuries (BSIs) are a common overuse injury in athletes; site of injury has been shown to relate to underlying bone health in female athletes. Hypothesis/Purpose: This case series characterizes the association of type of sports participation and anatomic site of BSIs with low bone mineral density (BMD), defined as BMD Z-score <–1.0. Similar to female athletes, it was hypothesized that male athletes who participate in running and sustain BSIs in sites of higher trabecular bone content would be more likely to have low BMD. Study Design: Cohort study; Level of evidence, 3. Methods: Chart review identified 28 male athletes aged 14 to 36 years with history of ≥1 lower-extremity BSI who were referred for evaluation of overall bone health, including assessment of lumbar spine, hip, and/or total body less head BMD per dual-energy x-ray absorptiometry. BMD Z-scores were determined via age, sex, and ethnicity normative values. Prior BSIs were classified by anatomic site of injury into trabecular-rich locations (pelvis, femoral neck, and calcaneus) and cortical-rich locations (tibia, fibula, femur, metatarsal and tarsal navicular). Sport type and laboratory values were also assessed in relationship to BMD. The association of low BMD to anatomic site of BSI and sport were evaluated with P value <.05 as threshold of significance. Results: Of 28 athletes, 12 (43%) met criteria for low BMD. Athletes with a history of trabecular-rich BSIs had a 4.6-fold increased risk for low BMD as compared with those with only cortical-rich BSIs (9 of 11 vs 3 of 17, P = .002). Within sport type, runners had a 6.1-fold increased risk for low BMD versus nonrunners (11 of 18 vs 1 of 10, P = .016). Laboratory values, including 25-hydroxy vitamin D, were not associated with BMD or BSI location. Conclusion: Low BMD was identified in 43% of male athletes in this series. Athletes participating in sports of running and with a history of trabecular-rich BSI were at increased risk for low BMD.


2016 ◽  
Vol 9 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Sarah Stone ◽  
Bobby Lee ◽  
J. Craig Garrison ◽  
Damond Blueitt ◽  
Kalyssa Creed

Background: Recently, female sports participation has increased, and there is a tendency for women to experience more symptoms and variable presentation after sport-related concussion (SRC). The purpose of this study was to determine whether sex differences exist in time to begin a return-to-play (RTP) progression after an initial SRC. Hypothesis: After initial SRC, female athletes (11-20 years old) would take longer to begin an RTP progression compared with age-matched male athletes. Study Design: Retrospective cohort study. Level of Evidence: Level 3. Methods: A total of 579 participants (365 males [mean age, 15.0 ± 1.7 years], 214 females [mean age, 15.2 ± 1.5 years]), including middle school, high school, and collegiate athletes who participated in various sports and experienced an initial SRC were included and underwent retrospective chart review. The following information was collected: sex, age at injury, sport, history of prior concussion, date of injury, and date of initiation of RTP progression. Participants with a history of more than 1 concussion or injury sustained from non–sport-related activity were excluded. Results: Despite American football having the greatest percentage (49.2%) of sport participation, female athletes took significantly longer to start an RTP progression after an initial SRC (29.1 ± 26.3 days) compared with age-matched male athletes (22.7 ± 18.3 days; P = 0.002). Conclusion: On average, female athletes took approximately 6 days longer to begin an RTP progression compared with age-matched male athletes. This suggests that sex differences exist between athletes, aged 11 to 20 years, with regard to initiation of an RTP progression after SRC. Clinical Relevance: Female athletes may take longer to recover after an SRC, and therefore, may take longer to return to sport. Sex should be considered as part of the clinical decision-making process when determining plan of care for this population.


2020 ◽  
Vol 29 (3) ◽  
pp. 1389-1403
Author(s):  
Jessica Brown ◽  
Kelly Knollman-Porter

Purpose Although guidelines have changed regarding federally mandated concussion practices since their inception, little is known regarding the implementation of such guidelines and the resultant continuum of care for youth athletes participating in recreational or organized sports who incur concussions. Furthermore, data regarding the role of speech-language pathologists in the historic postconcussion care are lacking. Therefore, the purpose of this retrospective study was to investigate the experiences of young adults with history of sports-related concussion as it related to injury reporting and received follow-up care. Method Participants included 13 young adults with history of at least one sports-related concussion across their life span. We implemented a mixed-methods design to collect both quantitative and qualitative information through structured interviews. Participants reported experiencing 42 concussions across the life span—26 subsequent to sports injuries. Results Twenty-three concussions were reported to a parent or medical professional, 14 resulted in a formal diagnosis, and participants received initial medical care for only 10 of the incidents and treatment or services on only two occasions. Participants reported concussions to an athletic trainer least frequently and to parents most frequently. Participants commented that previous experience with concussion reduced the need for seeking treatment or that they were unaware treatments or supports existed postconcussion. Only one concussion incident resulted in the care from a speech-language pathologist. Conclusion The results of the study reported herein shed light on the fidelity of sports-related concussion care management across time. Subsequently, we suggest guidelines related to continuum of care from injury to individualized therapy.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A261-A261
Author(s):  
Sirimon Reutrakul ◽  
Pamela Martyn-Nemeth ◽  
Laurie Quinn ◽  
Kirstie Danielson ◽  
Brett Rydzon ◽  
...  

Abstract Introduction Experimental and epidemiological data have linked insufficient sleep to increased diabetes risk. Women with a history of gestational diabetes (GDM) have a 7-fold greater risk of developing type 2 diabetes. This pilot study explored the feasibility of a sleep extension intervention in women with a history of GDM and short sleep, and the effects on glucose metabolism. Methods Women age 18–45 years with a history of GDM (at least 1 year postpartum) and actigraphy confirmed short sleep duration (&lt;7h/night) on weekdays were randomized at a ratio of 1 control (healthy living information) to 2 cases (6 weeks of “Sleep Extend” intervention: use of a Fitbit, weekly digital content, interactive tools, and coach delivered feedback in order to increase sleep duration). An oral glucose tolerance test (OGTT), 7-day actigraphy recording and questionnaires were obtained at baseline and 6 weeks (at the end of the intervention). Results Twelve women (mean (SD) age 40.3 (4.5) years) participated (n=8 Sleep Extend, n=4 control). Compared to baseline, nightly sleep duration increased in Sleep Extend group (+30.6 (48.8) minutes) but decreased in the control group (-6.8 (22.9) minutes). Both fasting and 2-h glucose levels from OGTT increased in both groups but were greater in the control group (Sleep extend vs. healthy living: fasting glucose +2.1 (9.8) vs. +12.8 (7.3) mg/dL; 2-h glucose +8.2 (21.9) vs. +20.0 (19.4) mg/dL). Self-reported sleep quality improved in both groups. When compared controls, Sleep Extend participants reported improved fatigue symptoms (Promis fatigue score change -5.1 (9.3) vs. 7.0 (1.0), p=0.008), and self-reported physical activity tended to increase (+1614 (3659) vs. -2900 (3922) MET-minutes/week). Combining all participants, an increase in sleep duration correlated with a decrease in fatigue (r= -.62, p=0.04) and anxiety symptoms (r= -.69, p=0.02). Conclusion Sleep extension through coaching and use of remote monitoring is feasible in women with a history of GDM. It appears to decrease fatigue and may improve glucose metabolism and physical activity. Support (if any) NIDDK P30 DK092949


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A240-A240
Author(s):  
Brant Hasler ◽  
Jessica Graves ◽  
Meredith Wallace ◽  
Stephanie Claudatos ◽  
Fiona Baker ◽  
...  

Abstract Introduction Growing evidence indicates that sleep characteristics predict later substance use and related problems during adolescence and young adulthood. However, most prior studies have assessed a limited range of sleep characteristics, studied only a narrow age span, and included relatively few follow-up assessments. Here, we used multiple years of data from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study, which spans the adolescent period with an accelerated longitudinal design, to examine whether multiple sleep characteristics in any year predict substance use the following year. Methods The sample included 831 participants (423 females; age 12–21 years at baseline) from NCANDA. Sleep variables included the previous year’s circadian preference, sleep quality, daytime sleepiness, timing of midsleep (weekday and weekend), and sleep duration (weekday and weekend). Each sleep variable’s association with the subsequent year’s substance use (cannabis use or alcohol binge severity) across years 1–5 was tested separately using generalized linear mixed models (zero-inflated Negative Binomial for cannabis; ordinal for binge severity) with age, sex, race, visit, parental education, previous year’s substance use (yes/no) as covariates and subject as a random effect. Results With regard to cannabis use, greater eveningness and shorter weekday sleep duration predicted an increased risk for additional days of cannabis use the following year, while greater eveningness and later weekend midsleep predicted a greater likelihood of any cannabis use the following year. With regard to alcohol binge severity, greater eveningness, greater daytime sleepiness, and shorter sleep duration (weekday and weekend) all predicted an increased risk for more severe alcohol bingeing the following year. Post-hoc stratified analyses indicated that some of these associations may differ between high school-age and college-age participants. Conclusion Our findings extend prior work, indicating that eveningness and later sleep timing, as well as shorter sleep duration, especially on weekdays, are risk factors for future cannabis use and alcohol misuse. These results underscore a need for greater attention to sleep characteristics as potential risk factors for substance use in adolescents and young adults and may inform future areas of intervention. Support (if any) Grants from NIH: R01AA025626 (Hasler) and U01AA021690 (Clark) and UO1 AA021696 (Baker & Colrain)


2021 ◽  
pp. jnnp-2020-325620
Author(s):  
Ivanna M. Pavisic ◽  
Kirsty Lu ◽  
Sarah E. Keuss ◽  
Sarah-Naomi James ◽  
Christopher A. Lane ◽  
...  

ObjectiveTo investigate subjective cognitive decline (SCD) in relation to β-amyloid pathology and to test for associations with anxiety, depression, objective cognition and family history of dementia in the Insight 46 study.MethodsCognitively unimpaired ~70-year-old participants, all born in the same week in 1946 (n=460, 49% female, 18% amyloid-positive), underwent assessments including the SCD-Questionnaire (MyCog). MyCog scores were evaluated with respect to 18F-Florbetapir-PET amyloid status (positive/negative). Associations with anxiety, depression, objective cognition (measured by the Preclinical Alzheimer Cognitive Composite, PACC) and family history of dementia were also investigated. The informant’s perspective on SCD was evaluated in relation to MyCog score.ResultsAnxiety (mean (SD) trait anxiety score: 4.4 (3.9)) was associated with higher MyCog scores, especially in women. MyCog scores were higher in amyloid-positive compared with amyloid-negative individuals (adjusted means (95% CIs): 5.3 (4.4 to 6.1) vs 4.3 (3.9 to 4.7), p=0.044), after accounting for differences in anxiety. PACC (mean (SD) −0.05 (0.68)) and family history of dementia (prevalence: 23.9%) were not independently associated with MyCog scores. The informant’s perception of SCD was generally in accordance with that of the participant.ConclusionsThis cross-sectional study demonstrates that symptoms of SCD are associated with both β-amyloid pathology, and more consistently, trait anxiety in a population-based cohort of older adults, at an age when those who are destined to develop dementia are still likely to be some years away from symptoms. This highlights the necessity of considering anxiety symptoms when assessing Alzheimer’s disease pathology and SCD.


Sign in / Sign up

Export Citation Format

Share Document