Citation

Howell DR, Oldham JR, Brilliant AN, Meehan WP. J. Child Neurol. 2019; 34(5): 256-261.

Affiliation

Departments of Orthopaedic Surgery and Pediatrics, Harvard Medical School, Boston, MA, USA.

Copyright

(Copyright © 2019, SAGE Publishing)

DOI

10.1177/0883073818824000

PMID

30669925

Abstract

Our objective was to identify factors associated with trouble falling asleep postconcussion. Patients seen for care after sport-related concussion were assessed ≤10 days postinjury and were between 6 and 19 years of age. Outcomes included symptoms (Post-Concussion Symptom Scale), postural steadiness, missed school, and medical history. There were 261 patients (49% female; mean age=14.8±2.5 years): 45% reported trouble falling asleep. A greater proportion of patients who reported trouble falling asleep missed ≥2 days of school (64% vs 49%; P =.02). Patients who reported trouble falling asleep endorsed more severe symptom severity than those who did not (median=38 vs 18; P <.001). After covariate adjustment, confusion (aOR = 1.95, 95% CI = 1.131-3.375), missing ≥2 days of school (aOR = 4.52, 95% CI = 1.553-13.16), and noise sensitivity (aOR = 1.48, 95% CI = 1.1.042-2.010) were independently associated with trouble falling asleep. Sleep disturbances are associated with poorer clinical outcomes after concussion. Inclusion of sleep assessments may help to provide early therapeutic pathways for pediatric concussion patients.

Language: en

Keywords

head injury; mild traumatic brain injury; pediatric sports medicine; sleep disturbance