The Association Between Sleep Quality On Quality Of Life Among Healthy High School Athletes

Abstract

PURPOSE: The objective of our study was to investigate the association between self-reported sleep quality (SQ) and quality of life (QOL) measures in healthy high school athletes. METHODS: We assessed the SQ and QOL of high school athletes (age range = 13-18 years) during their pre-participation physical examination (PPE). Participants completed the Pittsburgh Sleep Quality Index (PSQI), and the PROMIS Pediatric Profile 37 QOL questionnaire. Standard PPE forms which included demographics, sports participation, and injury history were also completed by the participants. Based upon the self-reported sleep habits assessed during the PSQI, we grouped participants into poor (PSQI score ≥ 5) or good (PSQI score < 5) SQ. We compared QOL between groups using independent sample t-tests and Fisher’s exact tests. A series of multivariable linear regression models were then constructed to evaluate the independent association between PSQI and QOL ratings after adjusting for age and sex. RESULTS: A total of 99 participants completed both the PSQI and PROMIS 37 questionnaires; 33 were classified as having poor SQ [mean PSQI: 6.8±2.0; mean age:15.1±1.0; 56% female] and 66 were classified as having good SQ [mean PSQI: 2.2±1.3; mean age: 15.2±1; 59% female]. There were no significant demographic differences (age, sex, level of play, hours per week in sports, injury history) between the groups. While the two groups reported similar bed times, the poor SQ group reported taking significantly longer to fall asleep than the good SQ group (mean=25.7±18.6 vs. 11.2±5.5 minutes; p<0.001), and woke up one hour earlier than the good SQ group (mean=6:10AM vs. 6:28AM; p<0.001). Multivariable regression analysis indicated that worse SQ was significantly associated with higher pain interference (β=0.42; 95% CI=0.14-0.70; p=0.004), anxiety (β=0.48; 95% CI=0.16-0.80; p=0.004), depressive symptoms (β=0.49; 95% CI=0.19-0.80; p=0.002), and fatigue (β=0.60; 95% CI=0.14-0.70; p=0.004) ratings. CONCLUSION: Poor self-reported SQ among healthy adolescent athletes is associated with more anxiety and depressive symptoms, fatigue, and pain interference ratings. When treating youth athletes, clinicians should consider assessing sleep hygiene and patterns in order to provide guidance on issues pertaining to reduced QOL.