The relationship between sleep and concussion recovery
Hoffman, Nicole Leigh
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The effects of sleep on concussion recovery are not well understood, thus are not commonly assessed or considered during concussion management. The purpose of this study was to determine the relationship between sleep and concussion recovery. Participants completed a demographic form and graded symptoms checklist at two time-points: (concussed: within 72 hours post-injury, within 48 hours of symptom recovery; non-concussed: initial visit, follow-up visit). Participants were instrumented with a validated wrist-worn ActiGraph GT9X accelerometer to wear continuously until: 1) symptom recovery (concussed), 2) follow-up (non-concussed). Two versions (original and modified questions) of each subjective sleep questionnaire, the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), were administered to concussed individuals once they experienced symptom recovery to assess sleep since concussion and during the month prior to concussion. This study indicates that greater amounts of time spent awake each night and poorer sleep efficiency at mid-point of recovery, greater sleep duration towards the end of recovery, and poorer self-reported sleep quality post-injury may be associated with the number of days to symptom recovery. Actigraphy and subjective sleep questionnaires may separately provide unique information to guide future research in the next step of exploring benefits of sleep interventions to expedite recovery.