Research Reports - Subjective and objective assessment of sleep in adolescents with mild traumatic brain injury

J Neurotrauma. 2015 Jun 1;32(11):847-52

Tham SW(1,)(2), Fales J(2,)(3), Palermo TM(1,)(2)

There is increased recognition that sleep problems may develop in children and
adolescents after mild traumatic brain injury (mTBI). However, few studies have
utilized both subjective and objective measures to comprehensively assess sleep
problems in the pediatric population following the acute post-TBI period. The
aims of this study were to compare sleep in adolescents with mTBI to healthy
adolescents using subjective and objective measures, and to identify the clinical
correlates associated with sleep problems. One hundred adolescents (50
adolescents with mTBI recruited from three to twelve months post-injury and 50
healthy adolescents) completed questionnaires assessing sleep quality,
depression, and pain symptoms, and underwent 10 day actigraphic assessment of
sleep patterns. Adolescents with mTBI reported poorer sleep quality and
demonstrated significantly shorter actigraphic-measured sleep duration, poorer
sleep efficiency, and more wake time after onset of sleep, compared with healthy
adolescents (all, p<0.05). For both groups of adolescents, poorer self-reported
sleep quality was predicted by greater depressive symptoms. Poorer actigraphic
sleep efficiency was predicted by membership in the mTBI group after controlling
for age, sex, depressive symptoms, and presence of pain. Our findings suggest
that adolescents may experience subjective and objective sleep disturbances up to
one year following mTBI. These findings require further replication in larger
samples. Additionally, research is needed to identify possible mechanisms for
poor sleep in youth with mTBI.

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