Research In Action

How important is a good night of sleep? 

In the past few years, there has been a movement to incorporate sleep monitoring devices and similar products into daily life to aid both pediatric and adult patients with health concerns. Research has clearly shown the important role sleep plays in maintaining a healthy circadian rhythm, influencing overall health and well-being. 

Highlighting this point – the next time you watch television, take notice of the number of professional athletes who talk about their smart beds and how they aid their rest and recovery. Watch for commercials promoting affordable and easy-to-use technology that can monitor vital personal health statistics. 

While consistent and restful sleep is important for daily functioning, it is also vital after concussion. 

New research from the Minds Matter Concussion Program at Children’s Hospital of Philadelphia examined approximately 4,500 children who reported to CHOP specialty care concussion settings. Our review found more than 3,000 of those patients reported a change in sleep compared with the time prior to their injury. We defined these changes as a sleep disturbance, meaning: 

• A change in sleep 
• Trouble sleeping 
• Sleeping more or less 
• Frequently waking up 
• Difficulty waking up 

Our research confirmed sleep disturbances were closely tied to persisting symptoms of concussion. We found that patients reporting sleep disturbance had nearly 50% greater odds of having a prolonged recovery compared to those that didn’t report any changes in sleep. Factors such as sex, time between injury, and when a patient first reports for care, diagnosed learning disabilities, and even prior concussion are all known contributors to prolonged recovery. What we found is that sleep disturbances appear to be just as strong a factor. Knowing sleep is a key predictor of recovery would provide another area to address that can help improve health outcomes after injury – parents and caregivers can be more attentive to a child’s sleep patterns, sleep hygiene, and even bedtime routine to help aid recovery.

 Similarly, clinicians should place an increased focus on sleep disturbances after concussion. Screening for sleep disturbances following concussion should be added to clinical screening tools for concussion even when no concerns are present. We acknowledge that clinicians and patients face time limitations when it comes to screening tools and the completion of necessary forms. Ideally, clinicians should include a validated scale like the Pittsburgh Sleep Quality Index (PSQI) or Patient Reported Outcome Measurement Information System – Sleep Disturbance (PROMIS – SD) as a part of their screening. 

We recently received a research grant from the Institute for Translational Medicine and Therapeutics’ Pilot Grant Program for the Translational Biomedical Imaging Center to investigate brain systems responsible for sleep after concussion through Magnetic Resonance Imaging (MRI) and Home Apnea Sleep Testing (HSAT). This will support the next phase of our research, where we will be recruiting concussed adolescents to receive an MRI of their brain and then we will send them home with a HSAT device which uses electroencephalography (EEG) to measure brain waves during sleep. 

Minds Matter is excited to be a pioneer in research in this space. Additional research will guide our efforts to better understand the biological and physiological mechanisms of concussion in youth, leading to opportunities to explore both preventive and post-injury treatments.