The Influence of Sleep Duration and Sleep-Related Symptoms on Baseline Neurocognitive Performance Among Male and Female High School Athletes

Typically, the effects of sleep duration on cognition are examined in isolation. Objective: This study examined the effects of restricted sleep and related symptoms on neurocognitive performance. Method: Baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and postconcussion symptom scale (PCSS) were administered to athletes (N = 7,150) ages 14-17 (M = 15.26, SD = 1.09) prior to sport participation. Three groups of athletes were derived from total sleep duration: sleep restriction (<= 5 hours), typical sleep (5.5-8.5 hours), and optimal sleep (>= 9 hours). A MANCOVA (age and sex as covariates) was conducted to examine differences across ImPACT/PCSS. Follow-up MANOVA compared ImPACT/PCSS performance among symptomatic (e.g., trouble falling asleep, sleeping less than usual) adolescents from the sleep restriction group (n = 78) with asymptomatic optimal sleepers (n = 99). Results: A dose-response effect of sleep duration on ImPACT performance and PCSS was replicated (Wilk's lambda = .98, F-2,F-7145 = 17.25, p < .001, eta(2) = .01). The symptomatic sleep restricted adolescents (n = 78) had poorer neurocognitive performance: verbal memory, F = 11.60, p = .001, visual memory, F = 6.57, p = .01, visual motor speed, F = 6.19, p = .01, and reaction time (RT), F = 5.21, p = .02, compared to demographically matched controls (n = 99). Girls in the sleep problem group performed worse on RT (p = .024). Conclusion: Examining the combination of sleep-related symptoms and reduced sleep duration effectively identified adolescents at risk for poor neurocognitive performance than sleep duration alone.