@article{ref1,
title="Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery",
journal="Sleep",
year="2020",
author="Luther, Madison and Poppert Cordts, Katrina M. and Williams, Cydni N.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="STUDY OBJECTIVES: Sleep is vital for brain development and healing after injury, placing children with sleep wake disturbances (SWD) after traumatic brain injury (TBI) at risk for worse outcomes. We conducted a systematic review to quantify SWD after pediatric TBI including prevalence, phenotypes, and risk factors. We also evaluated interventions for SWD and the association between SWD and other post-traumatic outcomes. <br><br>METHODS: Systematic searches were conducted in MEDLINE, PsychINFO, and reference lists for English language articles published from 1999-2019 evaluating sleep or fatigue in children hospitalized for mild complicated, moderate, or severe TBI. Two independent reviewers assessed eligibility, extracted data, and assessed risk of bias using the Newcastle-Ottowa Score for observational studies. <br><br>RESULTS: Among 966 articles identified in the search, 126 full text articles were reviewed, and 24 studies were included (11 prospective, 9 cross-sectional, and 4 case studies). Marked heterogeneity was found in study populations, measures defining SWD, and time from injury to evaluation. Studies showed at least 20% of children with TBI had trouble falling or staying asleep, fatigue, daytime sleepiness, and nightmares. SWD are negatively correlated with post-traumatic cognitive, behavioral, and quality of life outcomes. No comparative intervention studies were identified. Risk of bias was moderate-high for all studies often related to lack of validated or objective SWD measures and small sample size. Heterogeneity precluded meta-analyses. <br><br>CONCLUSIONS: SWD are important morbidities after pediatric TBI, though current data is limited. SWD have implications for TBI recovery, and may represent a modifiable target for improving outcomes after pediatric TBI.<br><br>© Sleep Research Society 2020. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.<p /> <p>Language: en</p>",
language="en",
issn="0161-8105",
doi="10.1093/sleep/zsaa083",
url="http://dx.doi.org/10.1093/sleep/zsaa083"
}