A Longitudinal Investigation of Sleep Quality in Adolescents and Young Adults After Mild Traumatic Brain Injury

Abstract

Objective and Background We examined sleep-related problems in adolescents and young adults after a mild traumatic brain injury (MTBI) or orthopedic injury. We extended the analysis of data from a study of early emotional and neuropsychological sequelae in these populations (McCauley et al. 2014. J Neurotrauma. 31:914). Methods We gave the Pittsburgh Sleep Quality Index (PSQI) to 77 participants with MTBI, 71 with orthopedic injury, and 43 non-injured controls. The age range was 12–30 years. We tested sleep quality within 96 hours of injury and at 1- and 3-month follow-up. Participants also completed measures of pain and fatigue, drug and alcohol use, and post-traumatic stress symptoms. Results Older participants (mean age = 25 years) in the MTBI group exhibited a sharp increase in sleep-related symptoms between the baseline assessment and 1 month, and still had difficulties at 3 months. Younger participants with MTBI (mean age = 15 years) and older participants with an orthopedic injury had modest increases in sleep difficulties between baseline and 1 month. The participants with MTBI also had more clinically significant sleep difficulties at all 3 assessments. At 3 months, PSQI scores in younger participants with MTBI and all participants with orthopedic injury did not differ significantly from the non-injured controls’. The controls had no significant change in their sleep symptoms during the 3 months. Conclusions Sleep difficulties in young adults may persist for ≤3 months after MTBI and exceed those after orthopedic injury. Clinicians should seek and treat sleep-related problems after MTBI.

Exploring Accelerometer Versus Self-Report Sleep Assessment in Youth With Concussion

“… 32 It is possible that the PSQI as a self-report instrument may not be sensitive to sleep difficulties in younger people. 45 However, if parents are the ones responsible for reporting sleep symptoms, they tend to overestimate the sleeping hours of their children. 55 A child filling out their own surveys is able to provide more information that would not otherwise be captured on a parent report.…”

“… 44 This cutoff has been used to investigate clinically significant sleep problems in adolescents and young adults after concussion. 45 …”

Static and Dynamic Factors Promoting Resilience following Traumatic Brain Injury: A Brief Review

“…They argue that more research is needed in the future to understand the direct correlation between these findings. Conversely, a recent study by Schmidt et al [ 20 ] suggested that relatively older adults who sustained a mild TBI exhibited a greater number of sleep difficulties over the first three months after injury compared to adolescent and younger adults. Taken together, findings in children clearly suggest that older age at injury is associated with better outcomes following a TBI [ 8 , 18 , 19 ].…”

Zhoubo plus uncaria tincture in the treatment of cerebral concussion sequelae

“…According to the clinical results of this study, the combined treatment of traditional Chinese medicine and Western medicine showed much better efficacy than Western medicine alone in treating CC sequelae and manifested the “optimal combination of traditional Chinese medicine and Western medicine.” The Zhoubo instrument (Japan), traditional Chinese medicine complex, and acupoint massage were organ-combined, thus generating significant positive effects; therefore, the efficacies between the treatment group and the control group were different.The treatment group not only had a higher cure rate but also a shorter treatment course. Furthermore, the ZB-CT treatment was safe, comfortable, and had few side effects, so it was worthy of further study and clinical recommendations 21 , 22 , 23 , 24 , 25 , 26 ) . Our plans were to carry out animal experiments to further demonstrate its scientific theory and clinical feasibility 27 ) .…”