Examining the trajectory and predictors of post-concussion sleep quality in children and adolescents

ABSTRACT

Objectives

This study aimed to 1) determine if post-concussion sleep quality of children and adolescents differed from healthy sleep estimates; 2) describe the trajectory of parameters of sleep quality; 3) determine factors that predict sleep quality outcomes; and 4) compare sleep parameter outcomes between asymptomatic and symptomatic participants at 4 weeks post-concussion.

Methods

Nightly actigraphy estimates of sleep in 79 children and adolescents were measured throughout 4 weeks post-concussion. Total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), number of arousals (NOA), and average arousal length (AAL) were measured.

Results

Child and adolescent participants experienced significantly poorer SE and longer WASO duration throughout 4 weeks of recovery and adolescents experienced significantly longer TST. SE significantly improved with time post-injury (p = .047). Older age was associated with longer TST (p = .003) and female sex was associated with longer WASO (p = .025) and AAL duration (p = .044). Week 4 sleep parameter outcomes were not significantly different between asymptomatic and symptomatic participants.

Conclusions

The sleep quality of youth is adversely affected by concussion, particularly in females. Sleep quality appears to improve with time but may require more than 4 weeks to return to normal.

KEYWORDS:

• Concussion
• sleep
• sleep quality
• pediatric
• actigraphy

List of abbreviations

• Post-concussion sleep disturbances (PCSD);

• Pittsburgh Sleep Quality Index (PSQI);

• Total sleep time (TST); Sleep efficiency (SE);

• Wake after sleep onset (WASO);

• Number of Awakenings (NOA);

• Average arousal length (AAL);

• Post Concussion Symptom Scale (PCSS);

• 95% confidence interval (95% CI).

Acknowledgments

We would like to thank all the families and children and youth with concussion who participated in the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research.