Citation

Hoffman NL, O'Connor PJ, Schmidt MD, Lynall RC, Schmidt JD. J. Neurotrauma 2019; ePub(ePub): ePub.

Affiliation

University of Georgia, Department of Kinesiology, 330 River Rd, Athens, Georgia, United States, 30602; schmidtj@uga.edu.

Copyright

(Copyright © 2019, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2019.6761

PMID

31774024

Abstract

Post-concussion sleep disturbances can be debilitating and may influence days to symptom recovery, but evidence is minimal. The purpose of this study was to explore relationships between days to symptom recovery and aspects of sleep, as measured by actigraphy and subjective sleep questionnaires in a concussed sample. Thirty-one college students were physician-diagnosed with a concussion and asked to complete a daily sleep symptom checklist. Participants (n=14) were excluded based on lack of compliance/early termination (22.6%), recorded <5 nights of data (12.9%), and protracted recoveries (3.2%). Final concussed sample included 17 college-aged students (varsity student-athletes; n=5, university students; n=12). A wrist-worn ActiGraph GT9X Link was provided during initial evaluation (within 72 hours post-injury) and worn continuously until symptom recovery (follow-up evaluation; 14.3±5.9 days post-injury). The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were also completed at follow-up. Pearson's correlations were conducted to determine relationships between days to symptom recovery and actigraphy sleep outcomes (sleep onset latency, wake after sleep onset (WASOnorm), total sleep time, sleep efficiency (SE), and number of awakenings) across recovery stages (2-3 days post-injury, mid-point, and end). Spearman's rho correlations were used to determine relationships between subjective sleep (PSQI global), sleepiness (ESS total), and sleep cluster symptom severity and days to symptom recovery. At recovery mid-point, individuals who were awake longer throughout the night (24.1±9.0%) and/or were less efficient at sleeping (73.7±9.7%) took longer to recover (WASOnorm:r=0.58, p=0.015; SE:r=-0.51, p=0.035). Poorer post-concussion sleep quality (based on PSQI) was correlated with longer recovery (rs=0.70, p=0.001). Post-concussion sleep-wake disturbances at recovery mid-point and overall poorer sleep quality may be associated with longer symptom recovery. Our findings provide preliminary guidance on identifying those who may be at risk for longer recoveries based on poorer sleep post-injury.

Language: en

Keywords

ADULT BRAIN INJURY; ASSESSMENT TOOLS; RECOVERY