Children who sustained traumatic brain injury take longer to fall asleep compared to children who sustained orthopedic injuries: actigraphy findings

ABSTRACT

Objective: Primary: to examine objective sleep outcomes in children who sustained moderate to severe traumatic brain injury (TBI). Secondary: to examine the relation of objective sleep with subjective sleep, fatigue, and injury variables.

Setting: A single tertiary brain injury unit.

Participants: Children (5–15 years) with moderate to severe TBI (n = 23) or orthopedic injury (OI; n = 13).

Design: Cohort study.

Measures: Primary: objective sleep measure (actigraphy watch). Secondary: subjective sleep measure (questionnaire), fatigue questionnaire, and injury variables.

Results: On actigraphy, children with TBI had longer sleep onset latency compared to children with OI. On the sleep questionnaire, children with TBI obtained higher scores for total sleep disturbance, initiating and maintaining sleep, and excessive somnolence. On the fatigue questionnaire, greater difficulties were found for total, sleep/rest, and cognitive fatigue for the TBI group. In the TBI group, actigraphy data did not correlate with sleep questionnaire, fatigue, or injury variables.

Conclusion: Our study showed evidence of objective and subjective sleep disturbance in children with moderate to severe TBI, but these two types of sleep measures were not related. It is possible that distinct mechanisms underpin objective and subjective sleep disturbance, which may require different interventions.

KEYWORDS:

• Sleep disturbance
• insomnia
• traumatic brain injuries
• head injury
• children
• actigraphy

Acknowledgments

We would like to thank Dr Angus Gray for his assistance with the recruitment of children with orthopedic injuries.

Declaration of interest

The authors declare no conflicts of interest.

Data sharing

Authors agree to make their data available upon reasonable request.

Additional information

Funding

The study was in-part funded by the Research Infrastructure Block Grant: Top Slice awarded to SL & SLN by the School of Psychology, University of Sydney.