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Actigraphy-derived sleep patterns in children and adolescents with persistent post-concussion symptoms: An
Maree Cassimatis1,2, Rhonda Orr1, Matthew Ahmadi1,3
1Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
JSAMS Plus
|July 11, 2026
Summary
Sleep disturbance significantly impacts children with persistent post-concussion symptoms (PPCS), worsening mental health and tripling recovery time. Addressing sleep issues is crucial for better concussion outcomes in adolescents.
Area of Science:
- Pediatric neurology
- Sleep medicine
- Clinical psychology
Background:
- Persistent post-concussion symptoms (PPCS) affect a significant portion of children and adolescents.
- Sleep disturbances are common in pediatric concussion patients.
Purpose of the Study:
- To characterize sleep patterns in children and adolescents experiencing PPCS.
- To investigate the impact of sleep disturbance on clinical concussion outcomes, including symptom burden, cognition, and recovery time.
Main Methods:
- A prospective longitudinal study involving 20 participants (aged 11-18) with PPCS.
- Utilized wrist actigraphy for objective sleep assessment and the Insomnia Severity Index (ISI) to identify post-concussion clinical insomnia (PCCI).
- Conducted comprehensive concussion assessments at baseline and 4-week follow-up.
Main Results:
- 45% of participants with PPCS also presented with PCCI.
- Objective sleep parameters included total sleep time (452.1 ± 53.8 min), sleep latency (32.2 ± 16.3 min), wake after sleep onset (76.9 ± 21.4 min), and sleep efficiency (85.9 ± 3.7%).
- Mood disturbance predicted sleep disturbance; PCCI tripled recovery time compared to those without PCCI.
Conclusions:
- Sleep disturbance is strongly linked to poorer mental health in pediatric concussion patients.
- Clinical insomnia and sleep disturbances significantly prolong recovery duration in children and adolescents with PPCS.
- Targeting sleep issues may be a critical component in managing pediatric concussion recovery.
