Sleep Disturbances and Cognition, Behavior, and Brain Structure in Children With mTBI

Area of Science:

• Pediatric neurology
• Sleep medicine
• Neuroscience

Background:

• Sleep disturbances are recognized as a factor in adult mild traumatic brain injury (mTBI) outcomes.
• Their prevalence, mechanisms, and impact on pediatric mTBI are not well understood.
• Identifying sleep problems' contribution to pediatric outcomes could guide interventions.

Purpose of the Study:

• Determine the prevalence of sleep disturbances post-pediatric mTBI.
• Assess associations between sleep disturbances and behavioral symptoms, cognition, and brain structure.

Main Methods:

• Secondary analysis of the Adolescent Brain Cognitive Development Study 5.0 data.
• Propensity score-matched cohort study comparing children with mTBI to typically developing children (TDC) and orthopedic injury (OI) controls.
• Assessed parent-reported sleep, behavior, cognition, and brain structure via MRI.

Main Results:

• Children with mTBI showed higher rates of new-onset and chronic sleep disturbances compared to controls.
• Elevated total sleep disturbance scores and behavioral symptoms were observed in the mTBI group versus TDC.
• Cortical thickness and volume were greater in OI controls than in the mTBI group, and associated with sleep disturbances in mTBI.

Conclusions:

• Sleep disturbances are more prevalent in children following mTBI.
• Newly developing sleep problems after mTBI may be a key pathway to behavioral issues and a target for intervention.
• Cognitive and structural brain outcomes were not significantly associated with sleep disturbances in this cohort.