Impact of Mild Traumatic Brain Injury on Sleep Patterns in Younger Individuals: A Systematic Review

Concussions or mild traumatic brain injuries (mTBI) are a frequent outcome of contact sports, and adolescents and young adults face a disproportionately higher risk of repeated injury. Prominent sequelae of mTBI observed in younger populations include anxiety, decreased sleep quality, insomnia, and impaired cognitive performance, all of which can extend beyond the acute phase of recovery. Although sleep is an essential aspect of the recovery process, few studies have evaluated the impact of mTBI on objective sleep measures, especially in younger athletes. The purpose of this systematic review was to analyze current literature on objectively measured sleep following mTBI. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, out of 2154 records, 17 studies were included, focusing on individuals aged 10-30 years, as they experience more sports-related concussions. Across 15 actigraphy and 2 polysomnography studies, results concerning total sleep time and sleep efficiency were mixed. However, several studies observed increased wake after sleep onset, a marker of sleep fragmentation, throughout mTBI recovery. Increased sleep fragmentation may explain frequently reported sleep complaints in this population and could ultimately contribute to a cycle of increasingly disrupted sleep. Additional research is needed to understand the relationship between mTBI and sleep, as sleep disruption during this critical period of neurocognitive development can have long-term impacts on brain health.