Impact of parental injury on adolescent sleep

Abstract

The aim of this study was to determine the impact of serious parental injury on adolescent sleep disorder diagnoses, outpatient care, and medication use. Methods: U.S. military personnel who sustained a serious injury and were parents of adolescents aged 10-18 years were identified. Included adolescents were enrolled in the Military Health System for 2 years before their parent's injury and 2 years after the injury. We used logistic regression clustered by adolescents to compare the odds of having a sleep diagnosis and negative binomial regression analysis clustered by adolescents to compare outpatient sleep disorder visits and sleep medication days before and after parental injury. Results: There were 96,318 parents seriously injured during 2004-2014 who had 117,577 children aged 10-18 years in 2002-2016. Approximately 2% of adolescents had a sleep disorder diagnosis, both before and after their parent's injury or illness. Outpatient sleep disorder visits increased 36% after a parent's injury (incidence rate ratio 1.36 [1.24-1.50]), with a twofold increase in insomnia visits (incidence rate ratio 2.35 [2.08-2.64]). Increases in sleep visits were most pronounced in adolescents of parents with traumatic brain injury, comorbid traumatic brain injury and posttraumatic stress disorder, battle injury, and those who were medically discharged from the military. The number of adolescents using sleep medications increased, but sleep medication days did not increase. Conclusions: Adolescents in our study used more outpatient medical care for sleep disorders; sleep medication use increased after parental injury. Sleep disorders should be considered in the care of adolescents with injured parents.

The mental health and well-being among partners and children of military personnel and veterans with a combat-related physical injury: A scoping review of the quantitative research

“…Four articles examined the health and well-being of children of military personnel or veterans with CRPIs. [41][42][43][44] In the fifth paper, children of physically or psychologically injured military personnel and veterans were found to have a significantly higher number of TRICARE outpatient visits for mental, behavioural health, and injuries, as well as significantly higher visit rates for child maltreatment compared to the children of non-injured military personnel. 42 No significant differences were found according to the nature of the parent's injury (physical vs psychological).…”

“…Of the included articles, three focused on the partners [38][39][40] of US personnel and veterans with CRPIs and four focused on their children (Table 1). [41][42][43][44] Sample sizes ranged from 41 44 to 485,000 (Supplemental Table 1). 43 The majority of partners were women (85-100%) in married or long-term relationships, with mean ages ranging from 29.6-48.5 years 40; 44 Among children, 51% were boys, with mean/median reported ages ranging from 4-14 years.…”

“…43 The majority of partners were women (85-100%) in married or long-term relationships, with mean ages ranging from 29.6-48.5 years 40; 44 Among children, 51% were boys, with mean/median reported ages ranging from 4-14 years. [41][42][43][44] Two articles were cross sectional, using surveys and semi-structured interviews to collect data, four utilised longitudinal TRICARE Management Activity (TMA) healthcare data, and one was a self-selected case series study (Supplemental Table 1). A variety of measures were used to assess mental health and well-being among partners and children of military personnel and veterans with CRPIs, from diagnoses of mental health disorders, medical visits and medication use within medical records to commonly used validated measures of mental health (Supplemental Table 1).…”

“…Well-being measures included caregiver J o u r n a l P r e -p r o o f burden, financial strain, family functioning, and relationships. Child mental health outcomes were assesesed either by medical records [41][42][43] or parental report. 44 CRPIs were determined through verified governmental databases of confirmed injuries for five articles, with one relying on self-reported injury status 38 and one recruiting medically discharged Canadian personnel.…”

“…In the fourth paper, sleep disorders were found to be significantly higher among adolescents with a J o u r n a l P r e -p r o o f parent with a physical or psychological injury compared to the two years preceding the injury. 41 While there was no difference according to physical, psychological, TBI or other injury type, significant increases were seen in the number of days taking sleep medication since the time of injury among adolescents whose parent had experienced an unspecified battle-injury (IRR 19.1 [3.10-119]). 41 Only one study, the seventh paper, explored broader well-being among children of personnel/veterans with CRPIs.…”