Sleep Problems After Concussion Are Associated With Poor Balance and Persistent Postconcussion Symptoms

Area of Science:

• Pediatric neurology
• Sleep medicine
• Sports medicine

Background:

• Concussion is a common brain injury in youth.
• Sleep disturbances are frequently reported after concussion but their clinical significance is not fully understood.
• Understanding the impact of sleep problems on concussion recovery is crucial for effective management.

Purpose of the Study:

• To investigate the association between self-reported sleep problems and clinical outcomes in youth following concussion.
• To determine if sleep problems predict persistent postconcussion symptoms.
• To explore the relationship between sleep issues and measures of postural stability, memory, and symptom duration.

Main Methods:

• A cohort of 207 young patients (6-18 years) presenting within 21 days postconcussion were evaluated.
• Clinical assessments included the modified Balance Error Scoring System (mBESS), tandem gait (single- and dual-task), and memory recall (immediate and delayed).
• Patients were grouped based on self-reported sleep problems at their postconcussion evaluation, and outcomes were compared.

Main Results:

• Patients reporting sleep problems exhibited significantly more mBESS errors compared to those without sleep problems (P=.01).
• A higher proportion of patients with sleep problems experienced persistent postconcussion symptoms (53% vs 31%, P=.004).
• Postconcussion sleep problems were independently associated with a twofold increased odds of developing persistent symptoms (aOR=2.02, P=.049).

Conclusions:

• Self-reported sleep problems in youth following concussion are associated with impaired postural stability and a significantly higher risk of persistent symptoms.
• Early identification and management of sleep disturbances postconcussion are recommended to optimize recovery.
• Targeted interventions addressing sleep issues may improve outcomes and reduce the duration of postconcussion symptoms.