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Updated: Oct 2, 2025
A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
Examining the trajectory and predictors of post-concussion sleep quality in children and adolescents
M Fisher1, C Wiseman-Hakes1, J Obeid2
1School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
Insights
Children and adolescents with concussion experience poorer sleep quality, with females more affected. Sleep efficiency improves over time, but full recovery may exceed four weeks.
Area of Science:
- Pediatric Neurology
- Sleep Medicine
- Sports Medicine
Background:
- Concussion significantly impacts sleep quality in children and adolescents.
- Understanding sleep parameter trajectories post-concussion is crucial for recovery.
- Identifying predictors of sleep disturbances aids in targeted interventions.
Purpose of the Study:
- Assess differences in post-concussion sleep quality compared to healthy norms.
- Characterize the evolution of sleep parameters over four weeks.
- Identify factors influencing sleep quality outcomes.
- Compare sleep outcomes between symptomatic and asymptomatic individuals at four weeks.
Main Methods:
- Utilized nightly actigraphy to measure sleep in 79 pediatric participants over four weeks.
- Quantified key sleep parameters: Total Sleep Time (TST), Sleep Efficiency (SE), Wake After Sleep Onset (WASO), Number of Arousals (NOA), and Average Arousal Length (AAL).
Main Results:
- Participants exhibited poorer SE and longer WASO, with adolescents showing longer TST.
- Sleep Efficiency (SE) significantly improved over the four-week recovery period.
- Older age correlated with longer TST, while female sex was linked to longer WASO and AAL.
Conclusions:
- Concussion adversely affects youth sleep quality, especially in females.
- Sleep quality shows improvement over time but may necessitate longer than four weeks for normalization.
- No significant differences in sleep parameters were observed between asymptomatic and symptomatic groups at four weeks.
Objectives:
This study aimed to 1) determine if post-concussion sleep quality of children and adolescents differed from healthy sleep estimates; 2) describe the trajectory of parameters of sleep quality; 3) determine factors that predict sleep quality outcomes; and 4) compare sleep parameter outcomes between asymptomatic and symptomatic participants at 4 weeks post-concussion.
Methods:
Nightly actigraphy estimates of sleep in 79 children and adolescents were measured throughout 4 weeks post-concussion. Total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), number of arousals (NOA), and average arousal length (AAL) were measured.
Results:
Child and adolescent participants experienced significantly poorer SE and longer WASO duration throughout 4 weeks of recovery and adolescents experienced significantly longer TST. SE significantly improved with time post-injury (p = .047). Older age was associated with longer TST (p = .003) and female sex was associated with longer WASO (p = .025) and AAL duration (p = .044). Week 4 sleep parameter outcomes were not significantly different between asymptomatic and symptomatic participants.
Conclusions:
The sleep quality of youth is adversely affected by concussion, particularly in females. Sleep quality appears to improve with time but may require more than 4 weeks to return to normal.
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