TY - JOUR
T1 - The role of sleep deficiency in the trajectory of postconcussive symptoms in adolescents
AU - Tham, See Wan
AU - Aaron, Rachel V.
AU - Palermo, Tonya M.
N1 - Funding Information:
This work was funded by Seattle Children’s Research Institute Child Health Behavior and Development Mentored Scholars Award.
Funding Information:
This work was supported by the Seattle Children?s Research Institute Center for Child Health Behavior and Development. The authors are grateful to the study participants. This work was funded by Seattle Children?s Research Institute Child Health Behavior and Development Mentored Scholars Award.
Publisher Copyright:
© 2019, © 2019 Taylor & Francis Group, LLC.
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
KW - Postconcussive symptoms
KW - actigraphy
KW - adolescents
KW - insomnia
KW - sleep
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U2 - 10.1080/02699052.2019.1643921
DO - 10.1080/02699052.2019.1643921
M3 - Article
C2 - 31322003
AN - SCOPUS:85070850680
SN - 0269-9052
VL - 33
SP - 1413
EP - 1419
JO - Brain Injury
JF - Brain Injury
IS - 11
ER -