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Sleep disturbances and internalizing behavior problems following pediatric traumatic injury

Jesse T Fischer1, H Julia Hannay2, Candice A Alfano1

  • 1Department of Psychology, University of Houston.

Neuropsychology
|March 13, 2018
PubMed

Insights

Children with traumatic injuries, including traumatic brain injury (TBI) and extracranial injury (EI), experience more sleep disturbance (SD) and internalizing problems than typically developing peers. Internalizing problems may increase the risk for post-injury SD.

Area of Science:

  • Pediatric Psychology
  • Neuroscience
  • Trauma Research

Background:

  • Sleep disturbance (SD) and internalizing problems are common in children post-trauma.
  • Understanding the interplay between injury type, SD, and internalizing problems is crucial for effective intervention.

Purpose of the Study:

  • To investigate sleep disturbance and internalizing problems in children with traumatic brain injury (TBI) or extracranial injury (EI) compared to typically developing (TD) children.
  • To examine the longitudinal relationship between SD and internalizing problems following pediatric injury.

Main Methods:

  • Prospective longitudinal study with 87 children (ages 8-15) including TBI, EI, and TD groups.
  • Parent-reported SD and internalizing problems assessed at baseline, 6, and 12 months postinjury.
  • Linear mixed models used to analyze group and time effects on outcomes.

Main Results:

  • Combined injury groups showed significantly higher postinjury SD and internalizing problems than TD children.
  • Internalizing problems predicted subsequent SD, but not vice versa; mediation by internalizing problems was observed for the injury-SD link at 1 year.
  • Injury severity correlated with SD in the EI group; SD was linked to fatigue and externalizing behaviors in both injury groups.

Conclusions:

  • Pediatric traumatic injuries are associated with increased sleep disturbance and internalizing problems.
  • Internalizing problems may be a risk factor for posttraumatic sleep disturbance, suggesting potential intervention targets.
  • Interventions addressing internalizing problems could improve sleep and overall adjustment in injured children.
Abstract

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