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Trouble Falling Asleep After Concussion Is Associated With Higher Symptom Burden Among Children and Adolescents
David R Howell1,2,3, Jessie R Oldham3,4,5, Anna N Brilliant3,5
11 Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA.
Insights
Trouble falling asleep after a sport-related concussion is common in young patients. Confusion, missing school, and noise sensitivity are key factors linked to sleep difficulties post-concussion.
Area of Science:
- Neurology
- Pediatrics
- Sleep Medicine
Background:
- Sleep disturbances are frequently reported after sport-related concussions in adolescents.
- Identifying factors associated with sleep issues is crucial for effective concussion management.
Purpose of the Study:
- To identify factors associated with difficulty falling asleep in pediatric patients following a sport-related concussion.
Main Methods:
- A cohort of 261 patients (aged 6-19) assessed within 10 days of concussion.
- Data collected included symptoms (Post-Concussion Symptom Scale), postural steadiness, school absenteeism, and medical history.
- Statistical analysis, including covariate adjustment, was used to determine independent predictors of sleep disturbance.
Main Results:
- 45% of patients reported trouble falling asleep.
- Trouble falling asleep was associated with increased symptom severity and greater school absenteeism (≥2 days).
- Independent predictors of sleep difficulty included confusion, missing ≥2 days of school, and noise sensitivity.
Conclusions:
- Sleep disturbances are linked to poorer clinical outcomes in pediatric concussion.
- Early assessment of sleep problems may facilitate timely therapeutic interventions for young concussion patients.
Abstract:
Our objective was to identify factors associated with trouble falling asleep postconcussion. Patients seen for care after sport-related concussion were assessed ≤10 days postinjury and were between 6 and 19 years of age. Outcomes included symptoms (Post-Concussion Symptom Scale), postural steadiness, missed school, and medical history. There were 261 patients (49% female; mean age=14.8±2.5 years): 45% reported trouble falling asleep. A greater proportion of patients who reported trouble falling asleep missed ≥2 days of school (64% vs 49%; P = .02). Patients who reported trouble falling asleep endorsed more severe symptom severity than those who did not (median=38 vs 18; P < .001). After covariate adjustment, confusion (aOR = 1.95, 95% CI = 1.131-3.375), missing ≥2 days of school (aOR = 4.52, 95% CI = 1.553-13.16), and noise sensitivity (aOR = 1.48, 95% CI = 1.1.042-2.010) were independently associated with trouble falling asleep. Sleep disturbances are associated with poorer clinical outcomes after concussion. Inclusion of sleep assessments may help to provide early therapeutic pathways for pediatric concussion patients.
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