Persistent Sleep Problems among Adolescents Post-Concussion: A Longitudinal Investigation of Sleep Quality Across Recovery Phases
Year: 2026
Type: article
Study design: Observational Study
Abstract: ABSTRACT Context: Studies measuring sleep longitudinally among adolescents after concussion suggest poor sleep quality is associated with greater symptoms and longer recovery, including persisting symptoms beyond 28 days from injury. However, patient- and injury-specific factors associated with poor sleep quality throughout and beyond recovery are not fully understood. Objective: To examine what factors are associated with poor sleep quality over three clinically relevant timepoints: <21 days after concussion (Visit 1), <14 days after self-reported concussion symptom resolution (Visit 2), and 8 weeks after concussion symptom resolution (Visit 3). Design: Prospective Cohort Study. Setting: Sports Medicine Clinic. Patients or Other Participants: Seventy-four participants with concussion (15.4±1.6 years; 51% females; 12.7±4.2 days post-concussion to Visit 1) were enrolled. Main Outcome Measure(s): The Pittsburg Sleep Quality Index (PSQI) measured overall sleep quality at each visit, with a score >4 indicating poor sleep quality. Three multivariable regression models estimated adjusted odds rations (aORs) examining associations between poor sleep quality and patient- and injury- specific factors at each visit. Results: Higher initial symptom severity score (95% CI: 1.03,1.14) was associated with increased odds of poor sleep quality classification at Visit 1. Visit 1 poor sleep classification (95% CI: 1.67,21.6) was associated with increased odds of poor sleep quality classification at Visit 2. Visit 1 poor sleep quality classification (95% CI: 1.24,57.1) and Visit 2 poor sleep quality classification (95%CI: 1.19,11.6) were associated with increased odds poor sleep quality classification at Visit 3. Conclusions: Poor sleep quality in the sub-acute phase of concussion was associated with poor sleep quality throughout and beyond the resolution of other concussion symptoms, suggesting the sleep symptoms may have a different recovery timeline than other symptoms associated with concussion. These findings highlight the importance of optimizing sleep soon after injury and monitoring sleep quality throughout concussion recovery.
Source: Journal of Athletic Training
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7167929183
FWCI:
Cites:
Cited by:
Related to: