title: Sleep difficulties and their impact on recovery following mild traumatic brain injury in children.
abstract: To determine the frequency of sleep difficulties in children following mild traumatic brain injury (TBI) over time and explore the role of sleep on recovery and behaviour.
  
  
  
  Longitudinal study of 109 children aged between 8-16 years who had experienced a mild TBI, with an embedded case control study. Parents completed assessments of the child's sleep quality, symptoms and behaviour at baseline, 1, 6 and 12 months post-injury. Regression analyses explored the impact of poor sleep on 12-month outcomes. Healthy control children were assessed at one time point for comparison to determine the longer-term impact of brain injury on sleep.
  
  
  
  The number of children experiencing poor sleep quality peaked 1-month post-injury (39%), reducing to 28% 12-months post-injury. Poor sleep quality at 1-month was associated with increased frequency and severity of symptoms and poorer behavioural outcomes 1 year post-TBI. Cases with TBI were significantly more likely to have sleep difficulties 1-year post-injury than controls (Odds ratio = 3.09).
  
  
  
  Sleep difficulties are common following mild TBI in children and are predictive of longer-term outcomes. Identifying children with sleep difficulties post-injury and providing support to facilitate sleep may improve their longer-term functioning.
authors.affiliation: a National Institute for Stroke and Applied Neuroscience , Auckland University of Technology , Auckland , New Zealand.
authors.forename: Alice
authors.initials: A
authors.lastname: Theadom
authors.affiliation: b School of Psychology , University of Waikato , Hamilton , New Zealand.
authors.forename: Nicola
authors.initials: N
authors.lastname: Starkey
authors.affiliation: a National Institute for Stroke and Applied Neuroscience , Auckland University of Technology , Auckland , New Zealand.
authors.forename: Kelly
authors.initials: K
authors.lastname: Jones
authors.affiliation: c School of Psychology , University of Surrey , Surrey , UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Cropley
authors.affiliation: a National Institute for Stroke and Applied Neuroscience , Auckland University of Technology , Auckland , New Zealand.
authors.forename: Priya
authors.initials: P
authors.lastname: Parmar
authors.affiliation: d School of Psychology , University of Auckland , Auckland , New Zealand.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Barker-Collo
authors.affiliation: a National Institute for Stroke and Applied Neuroscience , Auckland University of Technology , Auckland , New Zealand.
authors.forename: Valery L
authors.initials: VL
authors.lastname: Feigin
mesh_terms: D000293:Adolescent; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000523:psychology; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010146:Pain / Q000209:etiology; D010290:Parents / Q000523:psychology; D000066553:Problem Behavior; D020127:Recovery of Function / Q000502:physiology*; D012044:Regression Analysis; D012893:Sleep Wake Disorders / Q000209:etiology*; D013997:Time Factors
keywords: Epidemiology; children; longitudinal; sleep; traumatic brain injury