See Wan Tham1,2, Rachel V Aaron3, Tonya M Palermo1,2. 1. a Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine , Seattle , WA , USA. 2. b Center for Child Health, Behavior and Development, Seattle Children's Research Institute , Washington , DC , USA. 3. c Department of Physical Medicine and Rehabilitation, John Hopkins Medicine , Baltimore , MD , USA.
Abstract
Objective: To investigate the trajectory of sleep deficiency after concussion and examine its role as a predictor of postconcussive symptoms (PCS) over 3 weeks and at 3 months post-concussion. Design: This was a prospective pilot study of 29 adolescents recruited from a pediatric Emergency Department (69% female, mean age = 14.0 years, SD = 1.8) following a concussion. Methods: Adolescents completed questionnaire assessments at baseline, Weeks 1, 2, and 3 on PCS and sleep patterns. Concurrently, adolescents also completed a daily diary and wore an actigraph continuously to monitor sleep activity. At 3 months post-concussion, adolescents repeated questionnaire measures. Results: At enrollment, 53.6% reported severe PCS, and 12% maintained severe symptoms at 3 months. Over the first 3 weeks, sleep duration and daytime sleepiness gradually declined; however, insomnia symptoms remained unchanged. After accounting for age, sex and time since concussion, greater insomnia symptoms at enrollment were associated with more severe PCS at 3 weeks and 3 months (β = 1.17, p < .001). In contrast, sleep duration, efficiency, and waketime after sleep onset were not predictors. Conclusions: Study findings suggest that insomnia symptoms after concussion may provide a target for early intervention to reduce prolonged severity and duration of PCS.
Objective: To investigate the trajectory of sleep deficiency after concussion and examine its role as a predictor of postconcussive symptoms (PCS) over 3 weeks and at 3 months post-concussion. Design: This was a prospective pilot study of 29 adolescents recruited from a pediatric Emergency Department (69% female, mean age = 14.0 years, SD = 1.8) following a concussion. Methods: Adolescents completed questionnaire assessments at baseline, Weeks 1, 2, and 3 on PCS and sleep patterns. Concurrently, adolescents also completed a daily diary and wore an actigraph continuously to monitor sleep activity. At 3 months post-concussion, adolescents repeated questionnaire measures. Results: At enrollment, 53.6% reported severe PCS, and 12% maintained severe symptoms at 3 months. Over the first 3 weeks, sleep duration and daytime sleepiness gradually declined; however, insomnia symptoms remained unchanged. After accounting for age, sex and time since concussion, greater insomnia symptoms at enrollment were associated with more severe PCS at 3 weeks and 3 months (β = 1.17, p < .001). In contrast, sleep duration, efficiency, and waketime after sleep onset were not predictors. Conclusions: Study findings suggest that insomnia symptoms after concussion may provide a target for early intervention to reduce prolonged severity and duration of PCS.
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