title: Poor sleep predicts subacute postconcussion symptoms following mild traumatic brain injury.
abstract: The primary objective was to determine if poor sleep predicts postconcussion symptoms in the subacute period after mild traumatic brain injury (TBI). The impact of poor sleep pre- and post-injury was examined. The research design was cross-sectional. After screening to detect response invalidity, 61 individuals with a self-reported history of mild TBI 1-to-6 months prior answered an online fixed order battery of standardized questionnaires assessing their sleep (current and preinjury) and persistent postconcussion symptoms (Neurobehavioral Symptom Inventory, minus sleep, and fatigue items). The sleep measures were the Insomnia Severity Index, Epworth Sleepiness Scale, a single Likert-scale pre-injury sleep quality rating, and two PROMIS™ measures (sleep-related impairment and sleep disturbance). After controlling for the effects of preinjury sleep quality and demographics, the combination of the sleep measures made a significant contribution to the outcome (F[8,58] = 4.013, p = .001, [Formula: see text]). Only current sleep-related impairment (ß = .60, p < .05) made a significant and unique contribution to neurobehavioral symptoms. Preinjury sleep was not a predictor (ß = -.19, p > .05), although it contributed 3% of the variance in NSI scores after controlling for demographics. Sleep-related impairment is a modifiable factor. As a significant contributor to neurobehavioral symptoms, treatment for post-injury sleep-related impairment warrants further attention.
authors.affiliation: a School of Psychology and Counseling, Queensland University of Technology (QUT) , Brisbane , Queensland , Australia.|b Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT) , Brisbane , Queensland , Australia.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Sullivan
authors.affiliation: a School of Psychology and Counseling, Queensland University of Technology (QUT) , Brisbane , Queensland , Australia.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Berndt
authors.affiliation: a School of Psychology and Counseling, Queensland University of Technology (QUT) , Brisbane , Queensland , Australia.|b Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT) , Brisbane , Queensland , Australia.
authors.forename: Shannon L
authors.initials: SL
authors.lastname: Edmed
authors.affiliation: a School of Psychology and Counseling, Queensland University of Technology (QUT) , Brisbane , Queensland , Australia.|b Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT) , Brisbane , Queensland , Australia.|c Centre for Accident Research and Road Safety, Queensland University of Technology (QUT) , Brisbane , Queensland , Australia.|d Centre for Children's Health Research (CCHR), Queensland University of Technology (QUT) , Brisbane , Queensland , Australia.
authors.forename: Simon S
authors.initials: SS
authors.lastname: Smith
authors.affiliation: a School of Psychology and Counseling, Queensland University of Technology (QUT) , Brisbane , Queensland , Australia.|b Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT) , Brisbane , Queensland , Australia.|c Centre for Accident Research and Road Safety, Queensland University of Technology (QUT) , Brisbane , Queensland , Australia.
authors.forename: Alicia C
authors.initials: AC
authors.lastname: Allan
mesh_terms: D000293:Adolescent; D000328:Adult; D001924:Brain Concussion / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000209:etiology; D038223:Post-Concussion Syndrome / Q000175:diagnosis* / Q000209:etiology*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D057566:Self Report; D012893:Sleep Wake Disorders / Q000209:etiology*; D011795:Surveys and Questionnaires; D015599:Trauma Severity Indices; D055815:Young Adult
keywords: Concussion; insomnia; mild traumatic brain injury; postconcussion symptoms; sleep