Objective
The prevalence of sport-related concussion (SRC) is high and results in a number of serious health consequences. One area that has received minimal research is the relationship between SRC and sleep. The literature shows that sleep deficiency is a frequent negative consequence of SRC. At the same time, sleep deficiency delays recovery from SRC and contributes added risk of symptom recurrence. A 2014 study of chronic pain patients who learned to apply the complementary and alternative medicine intervention hand self-shiatsu (HSS) had promising, sleep-promoting results that warrant further investigation with other populations. This proof-of-concept study explored the feasibility of HSS as an intervention to promote sleep onset and continuity for young adults with SRC.
Methods
This study employed a prospective case-series design, where participants act as their own controls. Baseline and follow-up data included standardized self-reported assessment tools and sleep actigraphy.
Results
Seven athletes, aged between 18 and 25?years, participated in the study. Although statistically significant improvement in actigraphy sleep scores between baseline and follow-up was not achieved, metrics for sleep quality and daytime fatigue showed significant improvement.
Conclusion
These findings support the hypothesis that HSS has the potential to improve sleep and reduce daytime fatigue in young postconcussion athletes. This pilot study provides guidance to refine research protocols and lays a foundation for further, large-sample, controlled studies.

Key words: Concussion, Insomnia, Youth, Complementary and alternative medicine, Self-management