title: A Longitudinal Investigation of Sleep Quality in Adolescents and Young Adults After Mild Traumatic Brain Injury.
abstract: OBJECTIVE
  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 to 77 participants with MTBI, 71 with orthopedic injury, and 43 non-injured controls. The age range was 12 to 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, Pittsburgh Sleep Quality Index 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.
authors.affiliation: *Department of Psychology and Philosophy, Sam Houston State University, Huntsville, Texas Departments of †Physical Medicine and Rehabilitation and §Neurology, Baylor College of Medicine, Houston, Texas ‡Department of Psychology, Rice University, Houston, Texas.
authors.forename: Adam T
authors.initials: AT
authors.lastname: Schmidt
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Li
authors.forename: Gerri R
authors.initials: GR
authors.lastname: Hanten
authors.forename: Stephen R
authors.initials: SR
authors.lastname: McCauley
authors.forename: Jessica
authors.initials: J
authors.lastname: Faber
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology; D005221:Fatigue / Q000150:complications; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D038223:Post-Concussion Syndrome / Q000209:etiology; D012720:Severity of Illness Index; D012890:Sleep; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000523:psychology; D055815:Young Adult