Preliminary Validation of the Sleep and Concussion Questionnaire as an Outcome Measure for Sleep Following Brain Injury

ABSTRACT

Background

Sleep and wakefulness disturbances are common with traumatic brain injury (TBI); however, there are no condition-specific measures to evaluate sleep following TBI.

Objective

To assess the convergent validity of the Sleep and Concussion Questionnaire (SCQ), a condition-specific (TBI) measure is compared to polysomnography and existing self-report sleep questionnaires.

Participants Included

Thirty-two adults diagnosed with mild TBI, 3–24 months post-injury, average age, 38.9 years, predominantly female (63%) and with symptoms of chronic insomnia.

Methods

Participants underwent polysomnographic evaluation of sleep and completed the SCQ, Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and the Fatigue Severity Scale (FSS). Correlations were assessed using Pearson’s correlations. The sample was sufficiently powered (0.85) to detect a moderate to strong correlation of 0.5 or greater.

Results

SCQ sub-questions were meaningfully correlated with corresponding objective sleep parameters (time awake, number of awakenings, sleep efficiency, sleep onset latency, wake after sleep onset) as measured with polysomnography. Additional significant correlations were seen between total scores on the SCQ and ISI and between SCQ sub questions and total ESS scores.

Conclusions

This work provides initial evidence of the convergent validity of the SCQ with objective sleep parameters and existing self-report measures in patients after mild TBI.

KEYWORDS:

• Mild traumatic brain injury
• sleep disturbance
• insomnia

Acknowledgments

The authors acknowledge the contributions of Marie-Christine Ouellet PhD to the development of the SCQ. We also acknowledge the contributions of Brian Murray MD, FRCPC, D,ABSM, to the conceptualization of the analysis.

Data availability

The data from this study will be available upon reasonable request to the corresponding author.

Disclosure statement

The authors report no conflict of interest.

Author contributions

CWH developed the SCQ (with consultation from Marie-Christine Ouellet, PhD). DMZ and CWH conceptualized the study. DMZ conducted the study and collected all data. DT designed and conducted statistical analyses. DT and CWH interpreted the analysis and drafted the manuscript. DMZ critically reviewed the manuscript, and all authors read and approved the final manuscript.

Additional information

Funding

This work was funded by the Canadian Institutes of Health Research (CIHR) Frederick Banting Charles Best Canada Graduate Scholarship Award (DZ), and Youthdale Sleep Foundation.