The relationship between depressive symptoms, somatic complaints, and concussion history with poor sleep in collegiate athletes

Objective: Ongoing exploration of factors related to poor sleep in collegiate athletes is important as understanding of the risks and consequences of poor sleep in this specific population increases. Design: Retrospective cohort study. Setting: University in the Pacific Northwest. Participants: One-hundred thirty-seven male and female collegiate athletes across 5 collision, contact, and limited contact team sports. Measurements: Depressive symptoms (Patient Health Questionnaire 9; PHQ-9), anxiety symptoms (General Anxiety Disorder 7; GAD-7), and somatic complaints (Patient Health Questionnaire 15; PHQ-15). Sleep quality (Pittsburgh Sleep Quality Index; PSQI) used both a cutoff score ≥6 and a cutoff score of ≥8, indicating "poor sleep quality" to reduce threats to divergent validity. Results: Poor sleep quality as defined by PSQI ≥ 6 was present in 53% of athletes, and as defined by PSQI ≥ 8 was identified in 33.5% of the cohort. There were no differences in the incidence of poor sleepers between sport, race/ethnicity, or sex. Multiple regression analysis revealed that depressive symptoms, somatic complaints, Caucasian race, male sex, and number of concussions were significant predictors of poor sleep (P < .05). The model accounted for 43% of the variance in PSQI and primarily by depressive symptoms explaining 9% of reported sleep quality variability. Anxiety symptoms, sport category, and history of migraines were not significant predictors of poor sleep quality. Conclusions: A high incidence of poor sleep among collegiate athletes was observed regardless of sport, and may be related to depressive symptoms, somatic complaints, Caucasian race, male sex, and historical number of concussions.