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Published on: January 20, 2023
Sleep difficulties and their impact on recovery following mild traumatic brain injury in children
Alice Theadom1, Nicola Starkey2, Kelly Jones1
1a National Institute for Stroke and Applied Neuroscience , Auckland University of Technology , Auckland , New Zealand.
Insights
Sleep difficulties are common in children after mild traumatic brain injury (TBI), peaking at one month and persisting long-term. Poor sleep impacts recovery and behavior, highlighting the need for early intervention.
Area of Science:
- Pediatric neurology
- Sleep medicine
- Neuroscience
Background:
- Mild traumatic brain injury (TBI) can significantly impact a child's recovery and well-being.
- Sleep disturbances are frequently reported in pediatric TBI populations but require further longitudinal investigation.
- Understanding the trajectory of sleep difficulties and their impact on outcomes is crucial for effective management.
Purpose of the Study:
- To quantify the incidence of sleep difficulties in children post-mild TBI over a 12-month period.
- To investigate the association between sleep quality and recovery, symptoms, and behavior.
- To compare sleep patterns in children with TBI to healthy controls.
Main Methods:
- A longitudinal study involving 109 children (8-16 years) with mild TBI.
- Parental assessments of sleep, symptoms, and behavior at baseline, 1, 6, and 12 months post-injury.
- Case-control analysis comparing TBI cases with healthy children at one time point.
Main Results:
- Poor sleep quality was highest at 1 month (39%) and decreased to 28% at 12 months post-TBI.
- Early poor sleep quality (1 month) predicted increased symptom severity and poorer behavioral outcomes at 1 year.
- Children with TBI were significantly more likely to experience sleep difficulties at 1 year compared to controls (OR=3.09).
Conclusions:
- Sleep difficulties are prevalent in children following mild TBI and predict long-term outcomes.
- Early identification and management of sleep disturbances may enhance functional recovery.
- Addressing sleep issues is a critical component of pediatric TBI care.
Objective:
To determine the frequency of sleep difficulties in children following mild traumatic brain injury (TBI) over time and explore the role of sleep on recovery and behaviour.
Methods:
Longitudinal study of 109 children aged between 8-16 years who had experienced a mild TBI, with an embedded case control study. Parents completed assessments of the child's sleep quality, symptoms and behaviour at baseline, 1, 6 and 12 months post-injury. Regression analyses explored the impact of poor sleep on 12-month outcomes. Healthy control children were assessed at one time point for comparison to determine the longer-term impact of brain injury on sleep.
Results:
The number of children experiencing poor sleep quality peaked 1-month post-injury (39%), reducing to 28% 12-months post-injury. Poor sleep quality at 1-month was associated with increased frequency and severity of symptoms and poorer behavioural outcomes 1 year post-TBI. Cases with TBI were significantly more likely to have sleep difficulties 1-year post-injury than controls (Odds ratio = 3.09).
Conclusions:
Sleep difficulties are common following mild TBI in children and are predictive of longer-term outcomes. Identifying children with sleep difficulties post-injury and providing support to facilitate sleep may improve their longer-term functioning.
